New screening program helps identify chronic diseases in Indigenous children living in remote Canadian communities


Study published in the Journal of the Canadian Medical Association (CMAJ) examines the importance of additional screening

A formal study on a medical screening program for Indigenous children in remote Canadian communities found that additional screening increased access to appropriate medical care for children at increased risk for diabetes and kidney disease. chronic (CRI).

The research report, published Sept. 13 in the Journal of the Canadian Medical Association (CMAJ), describes how screening was done to identify ways to help young people aged 10 to 17

The study was carried out by 11 physicians and researchers from several Manitoba hospitals, universities and health care organizations. The study included more than 300 children who were part of the screening intervention and additional lab testing procedures.

It was stated in a previous study, known as The Finished Program, that “Indigenous populations are disproportionately affected by kidney failure at a younger age than other ethnic groups in Canada. Since symptoms do not appear until the disease is advanced, the risk of early kidney failure is often unrecognized. ”

The study indicated that the First Nations Community Screening Project to Improve Kidney Health and Prevent Dialysis was a point-of-care screening program in rural and remote Manitoba First Nations communities that aimed to identify and treat hypertension, diabetes and chronic kidney disease.

The study also indicated that the program identified chronic illness in 20 percent of the children screened.

“Interventions such as active surveillance programs have the potential to improve chronic disease care for First Nations children,” the study said.

“Substantial health disparities exist between Aboriginal and non-Aboriginal people in Canada. The prevalence of diabetes and chronic kidney disease (CKD) among Aboriginal people in Canada is 20% and 25.5% (higher), respectively, which is two to five times higher than the general population .

A previous study published in CMAJ (2019) involving First Nations residents of northwestern Ontario reported that more than 5,200 were tested and 14 percent of them suffered from chronic kidney disease and most of this group, 80 percent, suffered from cardiovascular disease. comorbidities.

The study also addressed what it said was the “controversial issue” of screening for CRF in children given the uncertainty of its effectiveness.

Around the world, screening for CRF in children is a controversial issue, given the uncertainty of its effectiveness, according to the CMAJ study. In Canada, screening for CRF in the general pediatric population is not currently recommended.

The controversy was raised in a study published in the Clinical Journal of the American Society of Nephrology.

The Canadian study said the CRF screening approach did not consider screening high-risk (indigenous) populations with reduced access to primary care resources.

“Manitoba has the highest rates of CRF in Canada, with a prevalence of 1,704 per million population, compared to the overall rate of 1,372 per million population in Canada.

The study also reported that Canada’s Indigenous population is overrepresented with progression of kidney disease eight years earlier than non-Indigenous Canada.

The CMAJ report concluded that “the study provides evidence to support the introduction of active screening initiatives in First Nations pediatric communities, including biennial screening programs in primary care clinics, to help fill current gaps in the health system ”.

The full text of the CMAJ report can be found here.

Len Gillis is a reporter for the Local Journalism Initiative at It covers health care in Northern Ontario.

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