UNIVERSITY CLINICAL CENTER TUZLA DEPARTMENT OF PEDIATRICS BOSNIA

UNIVERSITY CLINICAL CENTER TUZLA DEPARTMENT OF PEDIATRICS BOSNIA AND HERZEGOVINA Dr. SELMA TERZIĆ, pediatrician

Bosnia and Herzegovina • Bosnia and Herzegovina has a 4. 5 millions inhabitants and it is divided in 10 Cantons • Each Canton has the Association of patients with Celiac disease

Bosnia and Herzegovina CD can be diagnosed in four towns: Tuzla, Sarajevo, Mostar and Banja Luka Ø Serological tests: • Anti-gliadin antibodies: Ig. A, Ig. G • Anti-endomysial antibodies Ig. A • Anti-tissue transglutaminase antibodies Ig. A Ø Endoscopy for a small bowel mucosal biopsy Ø Human leukocyte antibodies (HLA)

Bosnia and Herzegovina • Children who suffer from Celiac disease have a social support of 20€ per month • Depending on age, they also get from 5 to 10 kilos of gluten- free flour

Bosnia and Herzegovina Children without health insurance have to pay for following finding: § Anti-tissue transglutaminase antibodies assay: 112 € § Small Intestinal Biopsy: 25 € § Pathology exam of the biopsy: 30 € § Gluten-free flour, 1 kilo 5. 5 €

Bosnia and Herzegovina • The University Clinical Center Tuzla was conducted study about epidemiology of celiac disease in Tuzla Canton for the period of 1995 -2007. and obtained the following results:

Bosnia and Herzegovina From the total of 68 celiac disease affected children: • 44 children have typical forme, • 16 children have atypical forme, • 8 children have asymptomatic forms and they were diagnosed in the screening of children with DMT 1 and Hashimoto thyroiditis L. Osmančević, S. Terzić, 2009

Bosnia and Herzegovina • The overall average incidence rate of celiac disease in 1995 was 0. 05/1000 children • Serological screening for Celiac disease at the Clinical Center Tuzla started to work from year 2000 • The prevalence of celiac disease in 2007 was 0. 73/1000 children L. Osmančević, S. Terzić, 2009.

Bosnia and Herzegovina § Unfortunately, there is no statistical data about the prevalence of Celiac disease in Bosnia and Herzegovina or from each Canton § Today in Bosnia and Herzegovina has registered about 300 ill children

Bosnia and Herzegovina • Social conditions and prices for gluten-free food are unfavourable for patients with celiac disease, but I hope that this is going to be changed for better in futur

Thank you!

Tuzla, Bosnia and Herzegovina terzic_selma@hotmail. com