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Prevalence of irritable bowel syndrome, celiac disease and their manifestations among Muhimbili university of health and allied sciences staff and students: a cross sectional study


Abstract

Background: Global prevalence of irritable bowel syndrome is high among medical students and health care professionals with significant morbidity. Similarly, the prevalence of celiac disease in irritable bowel syndrome is higher than the general population. These conditions impair quality of life and contribute to social-economic burden. In Tanzania, little is known about irritable bowel syndrome and celiac disease among medical students and health care professionals.
Methods: A cross sectional study was conducted to MUHAS and Mloganzila Academic Medical Center (MAMC) staff and students who fulfilled the online shared Rome IV criteria of irritable bowel syndrome from August to November 2018. A structured questionnaire was used to collect socio-demographic data, anthropometric measurements and clinical manifestations. Blood samples for full blood picture, liver enzymes and Erythrocyte Sedimentation Rate were taken. Celiac disease was tested using anti-tissue transglutaminase antibody test. Qualitative and quantitative data were summarized using frequency distribution tables. Chi-square and fishers exact test were used to study comparison between groups. Logistic regression was used to study associations. Data was analyzed using SPSS version 20.0 and a P value of ≤0.05 was considered significant.
Results: Out of 1,321 participants, 192 (14.5%) had irritable bowel syndrome in which 77 (40.1%) were males and 115 (59.9%) were females. Among the 192 participants with irritable bowel syndrome, 3 (1.6%) were positive for celiac disease, 2 (66.7%) were females and 1 (33.3%) was a male. Of the 3 patients with CD, 2 had elevated ALAT and 1 had anaemia. Age (AOR 2.53, 95% C.I 1.57-4.09), sex (AOR 1.67, 95% C.I 1.16-2.41), marital status (AOR 4.95 C.I 2.07-11.82), alcohol intake (AOR 2.47, 95% C.I 1.16-5.23), year of study (AOR 8.49, 95% 5.71-12.64) and sleep duration (AOR 2.24, 95% C.I 1.23-4.06) were found to be independently associated with IBS.
Conclusion: Prevalence of IBS and its associated factors in our study population was similar to findings from studies done elsewhere. Also, our study revealed a low prevalence of celiac disease among IBS participants.
 

Keywords

Irritable bowel syndrome, Celiac disease, prevalence and manifestations, ALAT, alanine aminotransferase AOR, adjusted odds ratio, ASAT, aspartate aminotransferase BMI, body mass index, CD, Celiac disease, EMA, endomysial antibody, ESR, erythrocyte sedimentation rate GFD, gluten free diet, HB, haemoglobin, HLA, Human leukocyte antigen, IBS, Irritable bowel syndrome, IDA, iron deficiency anemia, IFN?, Interferon gamma, IgA, immunoglobulin A, IgG, Immunoglobulin G, IgM, immunoglobulin M, Kg/m2, kilogram/meter2, MAMC, muhimbili academic medical centre MCV, Mean cell Volume, MCHC, Mean Cell Hemoglobin Concentration, MUHAS, muhimbili university of Health and allied sciences OR, Odds ratio, PLT, platelets, QoL, quality of life, T1DM, Type 1 diabetes mellitus tTGA, tissue transglutaminase, WBC, white blood cells

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