Impact of Celiac Disease on the Quality of Life of Children: Analysis From a Moroccan Cohort

Abstract

OBJECTIVE: Celiac disease (CD) requires a lifelong gluten-free diet, which impacts the health-related quality of life (HRQoL) of children. To better understand this impact, our study evaluated the HRQoL of children diagnosed with CD and followed at the University Hospital Center (CHU) of Oujda using the Arabic-validated version of the Coeliac Disease Dutch Questionnaire (CDDUX). METHODS: A cross-sectional study included 49 children with CD, aged 8 to 18 years, and their parents. The CDDUX assessed three subdomains of HRQoL: "gluten-free diet," "communication," and "living with CD." Sociodemographic and medical data were collected and analyzed using Statistical Package for Social Sciences (SPSS) version 25 (IBM Corp., Armonk, NY). RESULTS: The participants were primarily from urban areas (63%) and mostly female (59%), with an average age of 12.5 years. Most children had been on a gluten-free diet for 1-4 years and were diagnosed at an average age of 7.5 years. Unstable family situations were reported in 23% of children, and 18% of children had associated chronic conditions such as type 1 diabetes or hypothyroidism. The results showed that children and parents had differing perceptions, particularly regarding the social and emotional impact of CD. Parents rated HRQoL lower (39.3±14.9) than the children (42.46±17.2; p=0.01). Children living in rural areas or from unstable family backgrounds reported lower scores. CONCLUSION: The HRQoL of children with CD is influenced by sociodemographic and family factors. Social and educational support, particularly for rural and economically disadvantaged families, is essential to improving the perception of HRQoL in children with CD.