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Developmental Disability Across Cultures
What is culture? Culture is a pattern of ideas, customs and behaviours shared by a particular people or society. It is dynamic, yet stable. Health is a cultural concept in that culture frames and shapes how we perceive, experience and manage health and illness.1-3 In 2010, the World Health Organization…
Post-traumatic Stress Disorder
Definition Post-traumatic stress disorder (PTSD) is an anxiety disorder some people develop after seeing or living through an event that has caused or threatened serious harm or death.1 Prevalence According to a review of the literature, the prevalence of PTSD among child refugees is approximately 11%.2 Prevalence estimates have ranged,…
Breastfeeding
Optimal nutrition Globally, the two leading causes of death for children under 5 years of age are pneumonia and diarrhea, conditions that are also associated with undernourishment. Both conditions can improve with breastfeeding.1 Breast milk’s unique and complex composition includes specific maternal antibodies and other bioactive factors, such as anti-infective…
G6PD Deficiency
G6PD deficiency Globally, glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme defect. It is predominantly found in African, Middle Eastern and South Asian populations. Only males are affected because the gene that encodes G6PD resides on the X chromosome. Very infrequently, female carriers may have symptoms. The map below…
Hereditary Anemias
An approach to anemia All children and youth new to Canada should be screened for anemia upon arrival.1 Those who have experienced substantial poverty, such as refugees, are at particularly high risk of iron deficiency anemia. Iron deficiency anemia is often due to the complex interaction of malnutrition and chronic…
Zinc Deficiency
Prevalence Mild-to-moderate zinc deficiency is relatively common, affecting up to one-third of the global population. Severe zinc deficiency is rare.1 Etiology Zinc deficiency can result from inadequate dietary intake, reduced absorption due to diarrhea or malabsorption syndromes, a diet high in phytate, and chronic liver or kidney disease. In resource-poor…
Folic Acid Deficiency
Prevalence Although the prevalence of folic acid deficiency among pregnant newcomers to Canada is not known, World Health Organization data have shown low serum folic acid levels among pregnant women in countries such as Sri Lanka (57%), India (41.6%), Myanmar (13%) and Thailand (15%).1 Etiology Folic acid is required for…
Thalassemia
Epidemiology The maps below show the prevalence of alpha and beta thalassemias. Figure 1. Global distribution of α- and β- thalassemia Source: Weatherall, DJ. Phenotype-genotype relationships in monogenic disease: Lessons from the thalassaemias. Nature Reviews Genetics 2001;2(4):245-55. Alpha thalassemias Silent carriers of alpha thalassemia — people who have the alpha-thalassemia…
Sickle Cell Disease
Epidemiology The map below shows the global distribution of the frequency of the HbS allele for sickle cell anemia. Figure 1: Global distribution of frequency of HbS allele for sickle cell disease Source: Piel FB, Patil AP, Howes RE, et al. Global epidemiology of sickle haemoglobin in neonates: A contemporary…
Vitamin D Deficiency
Prevalence Vitamin D deficiency has been found to be common in refugee children.1,2 One study found the prevalence among refugees treated at Australian health centres to be between 40% and 80%.3 Definition The best indicator of vitamin D status is serum concentration of 25-hydroxy-vitamin-D (25OHD).4 Current Canadian Paediatric Society (CPS)…