Abstract
Background: Celiac disease (CD) is an immune-mediated enteropathy triggered by dietary gluten in genetically predisposed individuals. While historically considered a pediatric condition, CD is increasingly recognized across all age groups and frequently presents with non-classical manifestations such as unexplained iron deficiency anemia (IDA). This study aimed to evaluate the diagnostic practices, perceptions, and clinical experience regarding celiac disease among Sudanese physicians.
Methods: A descriptive cross-sectional study was conducted conducted between January and February 2025 among general practitioners, internists, gastroenterologists, and pediatricians in Sudan. Data were collected using a validated structured questionnaire adapted from an international study. Statistical analyses were performed using R software (version 4.4.3).
Results: A total of 372 physicians completed the survey. The majority were general practitioners (54.0%) and practiced in urban settings (62.9%). Clinical familiarity with CD was overall limited, with nearly one-fifth of respondents (19.4%) reporting having never diagnosed or managed a CD case. Notably, physicians were significantly more likely to consider serologic testing for CD in younger presentations compared to an elderly presentation (77-year-old male with unexplained iron deficiency anemia; p < 0.001).
Conclusion: Significant gaps exist in the recognition and diagnostic workup of celiac disease among physicians in Sudan, particularly in adult and elderly presentations appearing with non-classical features like IDA. Targeted medical education and continuous professional development are critical to improving diagnostic suspicion, preventing underdiagnosis, and optimizing patient outcomes.
Keywords: Celiac disease, Iron deficiency anemia, Diagnostic practice, Physicians, Sudan