Abstract
AIM: The adherence to a gluten-free diet (GFD) in celiac disease (CD) is influenced by socioeconomic factors and language barriers, which are especially relevant to minority populations. The study aimed to compare CD outcomes in children of Eritrean asylum seekers living in Israel to those of native Israeli children. METHODS: This retrospective case-control study included demographic, clinical, laboratory, endoscopic, and histologic data of all Eritrean children diagnosed with CD during 2015-2023. For each Eritrean child, 5 consecutive Israeli children served as controls. RESULTS: The study included 22 Eritrean children and 110 controls. Over a 12-month follow-up under a GFD, more Eritrean children maintained anti-tissue transglutaminase (TTG) antibodies > 10 times above the ULN compared to controls (43% vs. 1.4%, p < 0.001). A multivariate analysis indicated a greater likelihood of achieving normalisation of anti-TTG antibodies in the controls (hazard ratio = 4.97, 95% confidence interval 1.17-21.13, p = 0.030). Complete compliance to a GFD was reported by 7 (50%) Eritrean children versus 69 (99%) controls (p < 0.001). CONCLUSION: Eritrean asylum seekers' children with CD have a significantly slower decline in anti-TTG antibody levels compared to native Israeli children. Intervention to improve adherence to a GFD may positively impact CD outcomes in this population.