Discussions on screening children in Malta for coeliac disease, part of a larger Mediterranean project, are nearing their conclusion, The Sunday Times of Malta has learnt.

The disease will be detected by a blood drop from the fingertip, causing only minor discomfort to the children compared to the current intravenous blood test used in most countries to test for the condition.

The procedure will not require an equipped laboratory and is extremely cost effective.

The screening will form part of a larger project entitled ICT tools for the Diagnosis of Autoimmune Disease in the Mediterranean Area. It is being led by the Department of Physics and Chemistry at the University of Palermo and directed by Prof. Giuseppe Raso. Malta is a partner in the project.

Giuseppe Magazzu, researcher and director of the Paediatric Gastroenterology and Cystic Fibrosis Unit at the University Hospital Policlinico G. Martino in Messina.

In coeliac disease, the immune system is mistakenly triggered by a substance in food called gluten, which produces antibodies and attacks the small intestine. If the disease remains undiagnosed, the villi in the small intestine, which absorb the vital nutrients from food, are damaged, leading to a multitude of symptoms ranging from minor discomfort to life-threatening conditions. 

An estimated one in 100 people suffers from coeliac disease in Europe, but only a quarter of them receive an accurate diagnosis. In fact, coeliac disease is the most common food-related chronic disease among children in Europe, with the prevalence rising in recent decades

The idea to screen children for coeliac disease in Malta emerged from a study entitled ‘A Point-of-Care test for facing the burden of undiagnosed coeliac disease in the Mediterranean area: a pragmatic design study’, which was presented at the 2013 International Meeting on Coeliac Disease in Chicago.

The participating countries in that study were Slovenia, Turkey and Italy, and one of its researchers was Giuseppe Magazzu, director of the Paediatric Gastroenterology and Cystic Fibrosis Unit at the University Hospital Policlinico G. Martino in Messina, also a partner in the new project involving Malta.

Point-of-care testing is done at the time of consultation with instant availability of results

Prof. Magazzu, who is the clinical director of the coeliac disease section of the project and a visiting professor at Mater Dei Hospital, will be in Malta next weekend for the 4th National Coeliac Conference.

Speaking to The Sunday Times of Malta during coeliac awareness week and ahead of the national conference, Prof. Magazzu said many factors were assessed in the study.

“When a fingertip blood drop was used, those who tested positive and those suspected of having coeliac disease were then referred to a coeliac centre to undergo further investigations to confirm a coeliac diagnosis,” he explained. 

The study concluded that point-of-care testing is an urgent priority to be implemented among people in countries with limited resources, such as in rural populations and for schoolchildren. Point-of-care testing is an investigation that is taken at the time of consultation with instant availability of results. It happens as close to the patient as possible, allowing for faster treatment and diagnosis. The aim of the study was to gather information and then disseminate a well-validated, inexpensive and rapid test for coeliac disease that does not require an equipped laboratory. 

The screening is planned for development in Malta and Sicily, in a collaboration between the Paediatric Gastroenterology Unit of the University of Messina and the Department of Paediatrics at Mater Dei Hospital, which have already been working together since 2015. It also involves other partners, including Maltese key paediatricians, health specialists and authorities and Acrosslimits Ltd, along with the collaboration of the laboratory of Palermo’s Buccheri La Ferla Hospital.

The project will aim to improve the diagnostic accuracy of non-invasive tests. Prof Magazzu explained that according to the new diagnostic criteria of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, diagnosis of coeliac disease may be made in children without the need to perform an intestinal biopsy, utilising blood tests if highly positive. 

Prof Magazzu is also known for coordinating a study bet-ween 2013 and 2014 about the applicability of new European diagnostic criteria for children. The study took place across 13 different Mediterranean countries including Malta.  

Studies such as these are important, said Prof. Magazzu, since the prevalence of coeliac disease is estimated to be around one per cent in Western populations, but most patients remain undiagnosed. “This is the largest prospective study providing a wide picture of coeliac disease diagnosis feasibility in Mediterranean countries with different health resources and facilities.” 

The results showed of the study coeliac disease diagnosis in the Mediterranean still relied on intestinal biopsies.

Commitment to coeliac awareness 

The conference next weekend is being organised by Narrative Structures under the patronage of President Marie-Louise Coleiro Preca. The keynote speaker will be Knut Lundin, a professor of medicine at the Faculty of Medicine, University of Oslo, Norway, and a leading consultant gastroenterologist.

The conference will take place thanks also to Barilla and Golden Harvest, as well as Dr Schar and Peak’s Free From, together with support from NGOs – the Malta Coeliac Association, the Maltese Paediatric Association and the Malta College of Family Doctors. The Times of Malta is the media partner.

For more information send an email message to: information@narrativestructures.com or visit Narrative Structures on Facebook. In 2015, Narrative Structures launched its first National Coeliac Conference to raise awareness on the disease.