Sex disparity and perception of obesity/overweight by parents and grandparents

OBJECTIVE:

To explore the factors associated with the sex disparity showing a greater prevalence of obesity/overweight in boys compared with girls in Chinese school children.

METHODS:

Sampled students and their parents were asked to complete a questionnaire. Perceptions of weight status by the parents, grandparents and children themselves were collected. A logistic regression analysis was used.

RESULTS:

The sampled students included 327 obese/overweight students and 1078 students with normal body mass index (BMI). The crude OR of obesity/overweight for boys compared with girls was 1.57 (95% CI 1.22 to 2.01). The increased risk of childhood obesity/overweight for boys remained after adjustment for prenatal and infant factors, daily habits and family situation, but disappeared after adjustment for perception of weight status (OR 1.27 [95% CI 0.93 to 1.67]). There were differences in underestimation of children’s weight status between boys and girls by their parents and grandparents (OR 1.33 [95% CI 1.08 to 1.64] and OR 1.42 [95% CI 1.15 to 1.75], respectively).

CONCLUSIONS:

Misconceptions about a child’s weight status were prevalent among parents and grandparents, and boys’ weight status was more frequently underestimated than girls. The disparity of underestimating weight according to sex may partially contribute to the difference in the prevalence of obesity/overweight between boys and girls among Chinese school children.     

Nutritional differences in neurologically impaired children

OBJECTIVES:

To determine whether the recommended nutritional intake of moderately to severely neurologically impaired children is congruent with current growth parameter expectations.

METHODS:

Observational cross-sectional study at a children’s hospice and a tertiary care children’s hospital. Medically stable enterally fed children followed by the palliative care team underwent anthropometric assessment and chart review for diagnosis, intake and medications. Intakes, guidelines and recommendations were compared.

RESULTS:

Intakes were less than recommended. All children were <50th percentile weight-for-age, with many <3rd percentile. Fourteen of 15 were in higher percentiles for absolute and relative body fat.

CONCLUSIONS:

Recommended dietary intakes were not achieved by these children. Despite this, measures of body fat indicate adequate intake. Low weight values may reflect diagnosis-related growth stunting or decreased muscle mass and bone density from immobility. The Centers for Disease Control and Prevention (Georgia, USA) weight-for-age and body mass index are not suitable measures of adequate intake in this group of children.     

Daily physical activity in young children and their parents: A descriptive study

BACKGROUND:

Little is known about physical activity (PA) in young children and about the relationship between their PA and that of their parents.

OBJECTIVE:

The main purpose of the present study (Y-Be-Active) was to examine the daily PA levels of young children and their parents, and to explore the relationship between children’s and parents’ PA.

METHOD:

Fifty-four children (mean age 4.3 years) and their parents (54 mothers, mean age 35.8 years; 50 fathers, mean age 38.2 years) wore accelerometers for three weekdays and two weekend days. Parents also completed questionnaires on family sociodemographics and PA habits.

RESULTS:

Children spent most of their time in light PA. Almost all children attained 30 min of daily moderate-to-vigorous PA (MVPA), and most boys and girls attained 60 min of daily MVPA on weekdays. Only 60% of fathers and approximately one-half of mothers attained 30 min of daily MVPA on weekdays and weekend days. Children’s and fathers’ PA were correlated on weekends. Few parents (20% to 30%) participated regularly in organised PA with their child. Fathers’ involvement in PA with their children was associated with higher MVPA in children.

CONCLUSIONS:

Many young children and parents did not meet current Canadian recommendations for daily PA. Parental involvement in PA with their young children, particularly the involvement of fathers, appeared to promote higher levels of MVPA in young children.     

Television viewing, computer use and total screen time in Canadian youth

BACKGROUND

Research has linked excessive television viewing and computer use in children and adolescents to a variety of health and social problems. Current recommendations are that screen time in children and adolescents should be limited to no more than 2 h per day.

OBJECTIVE

To determine the percentage of Canadian youth meeting the screen time guideline recommendations.

METHODS

The representative study sample consisted of 6942 Canadian youth in grades 6 to 10 who participated in the 2001/2002 World Health Organization Health Behaviour in School-Aged Children survey.

RESULTS

Only 41% of girls and 34% of boys in grades 6 to 10 watched 2 h or less of television per day. Once the time of leisure computer use was included and total daily screen time was examined, only 18% of girls and 14% of boys met the guidelines. The prevalence of those meeting the screen time guidelines was higher in girls than boys.

CONCLUSION

Fewer than 20% of Canadian youth in grades 6 to 10 met the total screen time guidelines, suggesting that increased public health interventions are needed to reduce the number of leisure time hours that Canadian youth spend watching television and using the computer.     

Paediatricians’ awareness of children’s oral health: Knowledge,training, attitudes and practices among Turkish paediatricians

BACKGROUND:

In Turkey, 74.1% of children between three and six years of age develop dental caries.

OBJECTIVE:

To assess the depth of oral health and dental knowledge among paediatricians in Turkey, to determine their level of oral health education and to determine factors that were associated with higher knowledge scores.

METHODS:

A cross-sectional survey of demographics that assessed the participants’ knowledge of oral and dental health, attitudes regarding oral health during well-child visits and opinions regarding infant oral health care visits was conducted. The outcome variables were the proportions of paediatricians who adhered to good clinical practice guidelines, recommended dental visits for children younger than one year of age, and having a knowledge score >50%.

RESULTS:

The participant characteristics that were significantly associated with a greater mean number of correct answers were female sex, good clinical practice, confidence in detecting dental caries and the presence of a dentistry department in their hospital (P=0.001, P<0.001, P<0.001 and P=0.02, respectively). Only 13.9% of paediatricians referred children younger than one year of age to a dentist. After adjusting for the level of oral health education received during residency training, sex and having children, only the knowledge score was significantly associated with referring patients younger than one year of age to a dentist (P=0.01).

CONCLUSIONS:

Some paediatricians’ knowledge was found to be associated with practices that were in accordance with professional society recommendations. The lack of dental knowledge and training in residency limits the paediatricians’ role in promoting children’s oral health in daily practice.     

Polymerase chain reaction detection of Kingella kingae in children with culture-negative septic arthritis in eastern Ontario

BACKGROUND:

The bacterium Kingella kingae may be an under-recognized cause of septic arthritis in Canadian children because it is difficult to grow in culture and best detected using molecular methods.

OBJECTIVES:

To determine whether K kingae is present in culture-negative joint fluid specimens from children in eastern Ontario using polymerase chain reaction (PCR) detection methods.

METHODS:

K kingae PCR testing was performed using residual bacterial culture-negative joint fluid collected from 2010 to 2013 at a children’s hospital in Ottawa, Ontario. The clinical features of children with infections caused by K kingae were compared with those of children with infections caused by the ‘typical’ septic arthritis bacteria, Staphylococcus aureus and Streptococcus pyogenes.

RESULTS:

A total of 50 joint fluid specimens were submitted over the study period. Ten were culture-positive, eight for S aureus and two for S pyogenes. Residual joint fluid was available for 27 of the 40 culture-negative specimens and K kingae was detected using PCR in seven (25.93%) of these samples. Children with K kingae were significantly younger (median age 1.7 versus 11.3 years; P=0.01) and had lower C-reactive protein levels (median 23.8 mg/L versus 117.6. mg/L; P=0.01) than those infected with other bacteria.

CONCLUSIONS:

K kingae was frequently detected using PCR in culture-negative joint fluid specimens from children in eastern Ontario. K kingae PCR testing of culture-negative joint samples in children appears to be warranted.     

Association of dual-task walking performance and leg muscle quality in healthy children

Background

Previous literature mainly introduced cognitive functions to explain performance decrements in dual-task walking, i.e., changes in dual-task locomotion are attributed to limited cognitive information processing capacities. In this study, we enlarge existing literature and investigate whether leg muscular capacity plays an additional role in children’s dual-task walking performance.

Methods

To this end, we had prepubescent children (mean age: 8.7 ± 0.5 years, age range: 7–9 years) walk in single task (ST) and while concurrently conducting an arithmetic subtraction task (DT). Additionally, leg lean tissue mass was assessed.

Results

Findings show that both, boys and girls, significantly decrease their gait velocity (f = 0.73), stride length (f = 0.62) and cadence (f = 0.68) and increase the variability thereof (f = 0.20-0.63) during DT compared to ST. Furthermore, stepwise regressions indicate that leg lean tissue mass is closely associated with step time and the variability thereof during DT (R² = 0.44, p = 0.009). These associations between gait measures and leg lean tissue mass could not be observed for ST (R² = 0.17, p = 0.19).

Conclusion

We were able to show a potential link between leg muscular capacities and DT walking performance in children. We interpret these findings as evidence that higher leg muscle mass in children may mitigate the impact of a cognitive interference task on DT walking performance by inducing enhanced gait stability.     

Evaluation of Neurodevelopment and Factors Affecting it in Children With Acyanotic Congenital Cardiac Disease

Background:

The rate of congenital heart disease is 0.8% in all live births. The majority of this, however, is acyanotic congenital heart disease. The survival rate of children with cardiac disease has increased with the developments provided in recent years and their lifetime is extended.

Objectives:

This study aims to evaluate neurodevelopment of children with uncomplicated acyanotic congenital heart disease in preschool period and determine the factors affecting their neurodevelopmental process.

Patients and Methods:

132 children with acyanotic congenital heart disease aged 6 - 72 months were involved in the study. Mental development and intelligence levels of patients under 2 years old were assessed by using Bayley Development Scale-III, and Stanford Binet Intelligence test was employed for patients over 2 years old. Denver Developmental Screening Test II was applied to all patients for their personal-social, fine motor, gross motor and language development.

Results:

The average age of patients (67 girls, 65 boys) included in the study was 35.2 ± 19.6 months. It was determined that there were subnormal mental level in 13 (10%) patients and at least one specific developmental disorder in 33 (25%) patients. Bayley Mental Development Scale score of patients who had received incubator care in perinatal period was found significantly low (88 ± 4.2) compared to those with no incubator care (93.17 ± 8.5) (P = 0.028). Low educational level of father was established to be linked with low mental development scores at the age of 2 and following that age (P < 0.05). Iron deficiency anemia was discovered to be related to low psychometric test scores at every age (P < 0.05).

Conclusions:

Neurodevelopmental problems in children with acyanotic congenital heart disease were found higher compared to those in society. Mental development and intelligence levels of patients were determined to be closely associated with receiving incubator care, father’s educational level and iron deficiency anemia.     

Fundamental Movement Skills Development under the Influence of a Gymnastics Program and Everyday Physical Activity in Seven-Year-Old Children

Objective

The objectives of this study were: a) to examine the influence of an 18-week basic artistic gymnastics program on fundamental movement skills (FMS) development in seven-year-old children; b) to determine correlations between children’s daily activities and successful performance of FMS and basic artistic gymnastics skills.

Methods

Seventy five first grade primary school children took part in this study. A physical education teacher specialized in artistic gymnastics conducted a gymnastics program for 18 weeks, three times a week. The level of gymnastics skills and FMS were identified at the beginning and at the end of the program. The level of gymnastics skills was evaluated by performance of eight artistic gymnastics skills, while FMS were evaluated by the use of FMS-polygon. Physical activity and inactivity was evaluated by using a proxy-questionnaire “Netherlands Physical Activity Questionnaire˝ (NPAQ).

Findings

According to the dependent samples t test, significant differences were found in the FMS-polygon and all gymnastics skills before and after the 18-week gymnastics program. Increasing correlations were established over time between gymnastics skills and the FMS-polygon. Unorganized daily activity of children significantly correlated with their mastering of gymnastics skills and FMS. The presented findings confirm: (1) the thesis that basic artistic gymnastics skills and FMS could be developed simultaneously, (2) the theory of positive transfer of similar skills between FMS and artistic gymnastic skills.

Conclusion

Mastering basic artistic gymnastics skills will provoke improvement of FMS and finally become a prerequisite for successful introduction of learning more complex gymnastics skills. The obtained results imply that an increase of children’s unorganized daily activities can improve the mastering of basic gymnastics skills and simultaneously the development of FMS.     

Treating and Reducing Anxiety and Pain in the Paediatric Emergency Department: The TRAPPED survey

BACKGROUND:

Management of children’s pain and anxiety in the emergency department is likely suboptimal.

OBJECTIVE:

To determine the availability of currently used strategies in Canadian paediatric emergency departments.

METHODS:

A cross-sectional survey involving all centres of the Pediatric Emergency Research Canada group was performed. The primary outcome was the availability of specific procedures for pain and anxiety management for children in the emergency department. One person per centre was identified to complete the survey. Data were collected from October 2013 to January 2014 using an electronic survey tool.

RESULTS:

All 15 Pediatric Emergency Research Canada centres agreed to participate. The verbal numerical scale was widely used (80%) to assess pain. One-half of respondents (53%) had access to a child life specialist. The following techniques were available for minor procedures: television as a distraction tool (87% of respondents), topical anesthetic before intravenous needle insertion (73%) and positioning of the child on parent’s lap (60%); most remaining centres reported that these could be easily implemented. Intravenous morphine was available at every centre. Intranasal fentanyl was available (60%) or considered to be easy to implement (33%). Few centres reported availability of clinical guidelines regarding pain for doctors (27%) and nurses (40%); all respondents considered them to be easy to implement.

CONCLUSIONS:

There was wide variation in paediatric pain and anxiety management strategies among tertiary care Canadian emergency departments. Several pain-reduction procedures (distraction, positioning on parent’s lap, topical anesthetic, intranasal administration) were identified that could be easily implemented to address the gap.     

Childhood drowning in Manitoba: A 10-year review of provincial Paediatric Death Review Committee data

BACKGROUND:

Drowning is the second leading cause of unintentional injury death for Canadian children up to 19 years of age. Specific regional drowning prevention strategies require a detailed understanding of patterns of injury, including risk factors. Paediatric death review committees have the opportunity to identify these risk factors, and to identify and advocate prevention strategies.

OBJECTIVES:

The purpose of the present study was to analyze Manitoba Paediatric Death Review Committee (PDRC) drowning data to identify drowning risk factors and potential prevention strategies.

METHODS:

A 10-year (1988–1997) review of the College of Physicians and Surgeons of Manitoba PDRC database was performed. Drowning deaths were summarized in terms of demographic variables and lack of supervision at the time of the drowning events.

RESULTS:

Seventy-three drowning deaths were reviewed by the PDRC during the study period. These children ranged from 29 days to 14 years of age. They included 50 boys and 30 First Nations children. The highest mortality rates were found in First Nations children (12.4/100,000 First Nations children compared with 1.9/100,000 non-First Nations children), boys (3.9/100,000 boys compared with 1.9/100,000 girls) and toddlers aged one to four years (5.9/100,000 children).

CONCLUSIONS:

Priority populations for drowning prevention in Manitoba include First Nations children, boys and toddlers. Death review committees can contribute to childhood injury prevention by reviewing injury deaths, analyzing and reporting injury mortality data, and identifying and advocating prevention strategies.     

Prevalence of vitamin D insufficiency among healthy school-age Cree children

BACKGROUND:

First Nations children are at higher risk for vitamin D deficiency and rickets.

OBJECTIVE:

To assess the prevalence of vitamin D deficiency and the correlations between fat mass, parathyroid hormone and dietary habits with serum vitamin D level in a random sample of Cree children eight to 14 years of age.

METHODS:

Serum 25-hydroxyvitamin D (25[OH]D) levels and additional information regarding anthropometrics and dietary habits were obtained from participants in two Cree communities. Vitamin D deficiency and insufficiency was defined as serum 25(OH)D levels <30 nmol/L and <50 nmol/L, respectively. Proportions to estimate the vitamin D status were weighted to account for the complex sampling design, and Pearson’s correlation coefficients were used to estimate the associations of milk and fish intake, parathyroid hormone and fat mass with serum 25(OH)D levels.

RESULTS:

Data from 52 healthy Cree children (mean [± SD] age 11.1±2.0 years; 27 boys) were included in the analyses. The median serum 25(OH)D level was 52.4 nmol/L (range 22.1 nmol/L to 102.7 nmol/L). Forty-three percent (95% CI 29% to 58%) and 81% (95% CI 70% to 92%) of Cree children had vitamin D levels <50 nmol/L and <75 nmol/L, respectively. Vitamin D intake was positively associated with serum 25(OH)D levels. Obese children had lower vitamin D levels; however, the difference was nonsignificant.

CONCLUSION:

There may be a substantial proportion of Cree children who are vitamin D deficient. Increasing age, lower dietary vitamin D intake and, possibly, higher body mass index were associated with decreased vitamin D levels; however, causality cannot be inferred.     

Aortic Intima-Media Thickness and Mean Platelet Volume in Children With Type 1 Diabetes Mellitus

Background:

Diabetes mellitus type 1 is the most common endocrine metabolic disorder occurring in childhood and adolescence due to the autoimmune destruction of pancreatic beta cells as a result of various environmental factors interacting with an underlying genetic predisposition. Diabetes is a risk factor for early onset atherosclerosis, and the high mortality rate seen in these patients is partially related to cardiovascular diseases.

Objectives:

This study was conducted to compare mean platelet volume as a marker of early atherosclerosis with aortic intima-media thickness in children with type 1 diabetes and to identify its correlation with known cardiovascular risk factors.

Patients and Methods:

The study included 27 patients between age range of 6 and 17 years that were diagnosed with type 1 diabetes and 30 healthy children of the same age range who did not have any chronic disease. In both groups, we used the color Doppler ultrasound to measure children’s aortic intima-media thickness and identify their mean platelet volumes.

Results:

There was no significant difference between the groups regarding gender distribution, age, High-Density Lipoprotein (HDL) and Low-Density Lipoprotein (LDL) cholesterol levels (P > 0.05). Also no significant difference could be documented between the patient and control groups regarding the aortic intima-media thickness and mean platelet volume (P > 0.05). However, there was a significant correlation between aortic intima-media thickness and mean platelet volume (r = 0.351; P < 0.05).

Conclusions:

In the present study, there was no evidence of early atherosclerosis in children with type 1 diabetes. However, mean platelet volume having a significant correlation with aortic intima-media thickness may be useful as an early marker of atherosclerosis.     

Prevalence of overweight and obesity in the Netherlands in 2003 compared to 1980 and 1997

Objective

To assess the prevalence of overweight and obesity in children living in the Netherlands and compare the findings with the Third and Fourth National Growth Studies carried out in 1980 and 1997, respectively.

Design and methods

Data were obtained from the child health care system. International cut‐off points for body mass index (BMI) were used to determine overweight and obesity. Cases were weighted for ethnicity and municipality size in such a way that the sample matched the distribution in the general population. The LMS method was used to calculate the age‐related distribution of BMI, and the prevalence was calculated from the fitted distribution.

Patients

Data on 90 071 children aged 4–16 years were routinely collected by 11 community health services during 2002–2004.

Results

On average, 14.5% of the boys and 17.5% of the girls were overweight (including obesity), which is a substantial increase since 1980 (boys 3.9%, girls 6.9%) and 1997 (boys 9.7%, girls 13.0%). Similarly, 2.6% of the boys and 3.3% of the girls aged 4–16 years were obese, which is much higher than in 1980 (boys 0.2%, girls 0.5%) and 1997 (boys 1.2%, girls 2.0%). At the age of 4, 12.3% of the boys and 16.2% of the girls were already overweight.

Conclusions

The prevalence of overweight and obesity in the Netherlands is still rising, and at an even faster rate than before. Evidence‐based interventions are needed to counter the obesity epidemic, and there is an urgent need for pre‐school intervention programmes.     

Children who ‘grow up’ in hospital: Inpatient stays of six months or longer

OBJECTIVE:

To describe the clinical course of all infants and children hospitalized for six consecutive months (180 days) or longer at a tertiary/quaternary children’s hospital in Western Canada.

METHODS:

A retrospective review of medical records for all eligible patients from January 1, 2007 to December 31, 2012 at Stollery Children’s Hospital (Edmonton, Alberta) was performed.

RESULTS:

A total of 61 patients experienced 64 eligible hospitalizations. The mean length of stay was 326 days, corresponding to a cumulative 20,892 hospital days (57.2 patient-years). Prevalent procedures resulting in long hospitalization were long-term tracheostomy ± ventilation in 32 (52%) patients, need for organ transplantation in 24 (39%) with completed transplantation in 15 (25%), and ventricular-assist devices (VADs) in seven (11%). Sixteen (26%) patients in the study group died, and 16 (26%) were placed in long-term care or out-of-home care at the end of their long hospitalization. Of children displaced from their family home, 14 (88%) were Aboriginal.

CONCLUSION:

Infants and children who experience very long hospitalizations have complex illnesses, with substantial risk for mortality and a high rate of displacement from their families after discharge. Aboriginal children appear to be particularly vulnerable to displacement and problem solving for this population must be undertaken, involving a variety of stakeholders.     

Prevalence of Mental Health Problems in Children and Its Associated Socio-Familial Factors in Urban Population of Semnan,Iran (2012)

Background:

The World Health Organization (WHO) defines mental health as “a state of well-being in which every individual realizes own potential, can cope with the normal pressures of life, is able to work effectively, and can make a contribution to community”.

Objectives:

Mental Health Problems (MHP) is a great concern for all societies in terms of its burden and impact. This survey screened MHP and its impact in an Iranian urban population aged 6 - 12 years old, and explored its associated socio-familial factors.

Patients and Methods:

The survey was conducted in the elementary schools of Semnan, using random cluster sampling. Collection and analysis of data was performed using the parent version of the “Strengths and Difficulties Questionnaire (SDQ)” and survey commands of Stata-nine, taking into account cluster effect and population weights. Associations were assessed by fitting simple and multiple logistic regression models. P < 0.05 was considered significant.

Results:

With regard to the SDQ total score, 19.3% (95% CI: 8.6, 30.1) scored above the normal threshold (9.6% abnormal, 9.7% borderline). The frequency of problems ranged between 16.1% (peer problems) and 8.4% (emotional symptoms), and in all subscales boys were affected more than girls. The impact score was abnormal in 68.4% of all children, and was greater in girls than in boys. “A previously diagnosed mental health disorder” (OR = 11.11, 95% CI: 5.55, 25.00), “male gender” (OR = 1.43, 95% CI: 1.10, 1.87 and “less time spent with the child by father” (OR = 1.61, 95% CI: 1.20, 2.17) were significantly associated with an abnormal SDQ.

Conclusions:

The high rate of MHP in 6 - 12 year-old children and the lack of any significant correlation with their age, underpins the importance of early screening for MHP in schools, with particular focus on high risk groups.     

Risk of urinary tract infection in infants and children with acute bronchiolitis

OBJECTIVES:

To estimate the prevalence of urinary tract infection in infants and children with bronchiolitis.

METHODS:

A retrospective cross-sectional study involving patients zero to 24 months of age who were hospitalized with acute bronchiolitis was conducted.

RESULTS:

A total of 835 paediatric patients with acute bronchiolitis were admitted to the paediatric ward between January 2010 and December 2012. The mean (± SD) age at diagnosis was 3.47±2.99 months. There were 325 (39%) girls and 510 (61%) boys. For the purpose of data analysis, the patient population was divided into three groups: group 1 included children hospitalized with respiratory syncytial virus (RSV) bronchiolitis; group 2 included children hospitalized with clinical bronchiolitis with no virus detected; and group 3 included children hospitalized with clinical bronchiolitis due to a respiratory virus other than RSV. Results revealed that urinary tract infection was present in 10% of patients, and was most common in group 3 (13.4%) followed by group 2 (9.7%), and was least common in group 1 (6%) (P=0.030).

CONCLUSIONS:

The possibility of a urinary tract infection should be considered in a febrile child with a diagnosis of bronchiolitis, particularly if the trigger is a respiratory virus other than RSV.     

Health and growth status of immigrant and refugee children in Toronto,Ontario: A retrospective chart review

OBJECTIVE:

To describe selected anthropometric and health status variables among immigrant and refugee children ≤6 years of age within an inner city clinic in Toronto, Ontario.

METHODS:

A retrospective chart review of patients born between January 1, 1998 and December 31, 2008, was conducted at a Toronto community health centre serving a primarily immigrant and refugee population. Outcome measures included calculated age-specific percentiles for height and weight, and the prevalence of anemia, iron deficiency, enteric parasites, elevated lead levels, HIV and hepatitis B. Postal codes were collected and used to determine the patient’s neighbourhood income quintile.

RESULTS:

A total of 331 patients, born between January 1, 1998 and December 31, 2008, were identified. Of these, a total of 210 charts were manually reviewed. The prevalence of height-for-age and weight-for-age under the third percentile on the Centers for Disease Control and Prevention Growth Charts were 7.2% and 11.6%, respectively, and 8.4% and 5.0%, respectively, on the WHO Growth Standards Chart. Prevalence rates were also calculated for anemia (22.8%), iron deficiency (53.3%), hepatitis B (2.5%), parasitic infections (33.6%), elevated blood lead levels (4.9%) and HIV (0%). Neighbourhood income quintiles revealed that 46.7% of patients were residing in the lowest (ie, poorest) income quintile neighbourhoods.

CONCLUSION:

These findings reveal a high burden of illness within the population presenting to an immigrant/refugee health clinic, and illustrate the need for further research in this area, as well as increased efforts to ensure appropriate screening within clinics serving a high volume of newcomer patients.