The Mediterranean Network for the management of food induced diseases WORKSHOP MEDI-CEL The Mediterranean Network for Celiac Disease V Progress Meeting - Istanbul, June 30 th July 1 st 2012
Montenegro (Crna Gora)
Contry: Montenegro Location: Southeast Europe Area total 13,812 km2 Population (2011) 625,266 Density 50/km2 Government: parlamentary republic Capital: Podgorica Montenegro
In Montenegro lives children under 18 of age The total number of boys is of girls coeliacs
Referal center - Podgorica Clinical Center of Montenegro Institute for childen s diseases Ministry of Health Republic health insurance Coeliac society of Montenegro
Pimary care: Pediatricians and General doctors ( lack of awareness of CD in children) Referal center - Podgorica Clinical Center of Montenegro Institute for children s diseases Pediatrition – gastroenterologist endoscopist Pathology department Laboratory
Undergraduate and postgraduate education of physicians at University of Montenegro Training for some young doctors Training for physicians specializing pediatrics, 3 months Society of Pediatrics ( lectures, meetings...) Publication on the field of CD in national health journals and congress proceedings
Institute for children s diseases ESPGHAN guidelines are applied Diagnosis is in majority of cases confirmed with small bowel biopsy We colected data and prospective study about CD Support for national association
Diagnostic Anti tTG Anti-gliadin antibody (AGA) Endoscopic and biopsy small bowel mucosal Patochystological examination (Marsh classification modified by Oberhuber) HLA (not widely available the nearest place is Belgrade, Serbia) We sometimes screen family members serologically and never genetically
Coeliac society of Montenegro Establiched 2003g Web page Education - lectures, seminars, Training for specific population groups –preschool and school children, teachers in vocational school etc Give brochures, recepies, news, medical advaice etc Adults and children
After the diagnosis: Written instructions on gluten free diet Some recepies Recommendation to join the patients’ society
Gluten free diet The situation of the gluten free diet in Montenegro, in relation to cultural and traditional attitudes Some companies from Europe are present on our market, as well as some minor local producers Traditional naturally gluten free foods are: potatoes and corn. Children who suffer from coeliac disease have 4 to 10 kg of gluten- free flour
Problems Awareness and recognition of celiac disease begins at the primary health care level We havenot support groups nutritionits, nurses, psychologists... Gastroenterologists-1 Society of Pediatricians, Society of Gastroenterologists - lectures, meetings, Coeliac society of Montenegro - articles in newspapers, interviews for radio and TV, educational workshops for family members and interested