Endocrinologie pédiatrique dans des contextes a faibles ressources: prestation de soins de santé, épidémiologie et phénotypes des maladies dans des populations non-Caucasiennes

 

Julia von Oettingen

Institut de recherche du Centre universitaire de santé McGill

 

Domaine : santé de la mère, des enfants et des adolescents

Programme Chercheurs-boursiers cliniciens - Junior 1

Concours 2018-2019

Non-communicable chronic diseases and maternal-child health are two of the most important global health care challenges. In children, type 1 diabetes is one of the most common chronic diseases with significant short- and long-term complications. Congenital hypothyroidism (inborn under-function of the thyroid) can result from maternal-fetal iodine deficiency, and is the most important cause of preventable intellectual disability that can be avoided by biochemical screening of newborns. In pregnant women, diabetes and high blood pressure are common causes of morbidity and mortality in mothers and their offspring. In low-income countries, however, quality care for non-communicable diseases in mothers and children is often unavailable. For example, prenatal care does not include screening for diabetes and hypertension, pediatric diabetes centers are often unavailable, and 70% of newborns globally do not have access to any screening. Research infrastructure in these settings is often poorly developed, and diabetes and endocrine conditions in children are insufficiently studied.

The goal of my research program is to improve health care delivery and health outcomes for diabetes and endocrine disorders in children globally. The program will focus on the Republic of Haiti as a low-income country, the poorest country in the Western hemisphere, and an example of a low-resource, remote setting. In three projects, we will measure the prevalence of common endocrine conditions in mother-child health and 1) develop an approach to the prenatal care of non-communicable diseases adapted to low-resource settings, 2) characterize types of diabetes and social determinants of diabetes control in Haitian youth in Haiti and Quebec, and 3) determine the iodine status in the population of Haiti and develop a remote setting-adapted newborn screening program. The outcomes of my research program will improve pediatric diabetes and endocrine care delivery in low-resource and remote settings, with translational benefit to populations in Canada and globally.