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Screening Tests for Children (Ages 2 to 12)

Screening tests are laboratory tests that help to identify people with increased risk for a condition or disease before they have symptoms or even realize they may be at risk so that preventive measures can be taken. They are an important part of preventive health care.

Without symptoms of illness, children generally do not need many laboratory tests. However, helping children develop healthy habits, such as eating well and staying active, could prevent serious and costly health problems as they get older. For example, helping an overweight or obese child reduce their weight can prevent diabetes and heart disease in recent years.

Not all children may need screening tests for all the conditions listed here. Read the sections below for more information on each condition and to determine if the evaluation may be appropriate for your child. You should discuss screening options with your child’s health professional.

Obesity

There are many serious health consequences of being obese, including an increased risk of developing type 2 diabetes, high blood pressure and high cholesterol, joint problems, sleep apnea and social and psychological problems. Children who continue to be overweight to adulthood have an increased risk of serious health problems, such as heart disease, stroke, and some types of cancer.

Recommendations

Routine exams of obesity in children from 2 years. At least once a year, a health professional should assess the weight status of a child.
The child’s weight and height, as well as age and gender are considered to determine the percentile of the child’s body mass index (BMI). BMI is a useful tool for estimating body fat.

  • Overweight: An overweight child (one whose BMI is between the 85th percentile and the 94th percentile in the standardized growth charts) faces additional health risks.
  • Obese: an obese child (in the 95th percentile or higher in standardized growth charts) faces even more serious health risks.

Diabetes

While most cases of type 1 diabetes are diagnosed in children under 18, the signs and symptoms often develop rapidly and the diagnosis is often made in an emergency room. Thirty percent of new cases of type 1 diabetes in children have diabetic ketoacidosis. Therefore, blood glucose measurements such as detection of type 1 diabetes in asymptomatic children are currently not necessary.

Risk factor’s

Overweight, obesity and physical inactivity are factors that contribute to the development of type 2 diabetes, and have also become national health problems. As public health experts work to educate Americans about how to avoid diabetes and its serious complications, parents and children should be aware that healthy eating habits and activity options can reduce an individual’s risk. of developing type 2 diabetes and related complications later in life.

These risk factors include:

  • Having a close relative with type 2 diabetes
  • Be Native American, African American, Latino, Asian American or Pacific Islander
  • Having signs or conditions associated with insulin resistance, such as acanthosis nigricans, high blood pressure (hypertension), unhealthy lipid levels (dyslipidemia), polycystic ovary syndrome or having a reduced birth weight (small for gestational age)
  • Having a biological mother with diabetes or gestational diabetes.

Recommendations

  • Consider assessing overweight children who have 2 or more additional diabetes risk factors every 3 years, starting at 10 years of age or at the onset of puberty if that occurs earlier.
  • Screen using one of the following tests:
    • Fasting glucose (fasting blood glucose, FBG): This test measures the level of blood glucose after fasting for 8 to 12 hours.
    • Hemoglobin A1c (also called A1c or glycosylated hemoglobin): This test evaluates the average amount of glucose in the blood during the last 2 to 3 months and has been recommended as another test to detect diabetes.
    • 2-hour oral glucose tolerance test (OGTT): This test involves taking a fasting blood sample to measure glucose, followed by the person taking a solution containing 1.75 g of glucose per kilogram of body weight up to a maximum of 75 grams and then take another sample two hours after the person begins to consume the glucose solution.

If any of these results is abnormal, the test is repeated another day. If the repeated result is also abnormal, a diagnosis of diabetes is made.

High Cholesterol

Starting in childhood, the waxy substance called cholesterol and other fatty substances known as lipids begin to accumulate in the arteries, hardening into plaques that narrow the arterial ducts. During adulthood, plaque buildup and the resulting health problems occur not only in the arteries that supply blood to the heart muscle but in the arteries throughout the body (a problem known as atherosclerosis). For both men and women in the United States, the main cause of death is heart disease, and the amount of cholesterol in the blood greatly affects a person’s chances of getting it.
Monitoring and maintaining healthy cholesterol levels are important for staying healthy. The detection of high cholesterol, usually with a lipid profile, is important because there are generally no symptoms. A lipid profile generally includes total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Non-HDL cholesterol can also be calculated by subtracting the HDL-C value from the total cholesterol result.

Recommendations

  • Routine lipid tests on all young people once between the ages of 9 and 11 and again between the ages of 17 and 21. The test is recommended at a younger age and a more frequent detection with a lipid profile for young people who have a higher risk of developing heart disease in adulthood. . Children under 2 years are too young to get tested.
  • Routine screening for children and adolescents with normal risk of heart disease.
  • Detection of high cholesterol in young people 20 years and under only if they are at a higher risk. Currently, there is insufficient evidence to recommend for or against routine screening in all young people, according to the Working Group.

Risk factor’s

  • Family history: Young people are at greater risk if they have a father, grandfather, aunt / brother or brother with high cholesterol or if they have a family history of cardiovascular disease (before age 55 in a male relative and 65 in a female relative)
  • Personal health: young people are also at greater risk if:
    • You are overweight or obese
    • Have a high fat diet, especially saturated or trans fats
    • Get little or no exercise
    • Have diabetes or hypertension (high blood pressure)
    • Smoking cigarettes or using other tobacco products.

Lead Poisoning

Lead is a metal that was once a common additive for household paint and leaded gasoline and was used in water pipes and as welding in canned foods.
The soil surrounding these houses may also be contaminated with lead. Children who live, play or spend time in these environments are at risk of being exposed to this metal and can carry lead to their bodies by inhaling or ingesting contaminated dust, water, paint chips or items contaminated with lead.
Exposure of a young child to lead can damage the brain and other organs and cause behavioral problems and developmental delays. Even at low levels, lead can cause irreversible damage without causing physical symptoms, and cognitive impairment may not be noticed until the child enters school.

Recommendations

An assessment of the risk of exposure to lead should be performed on visits by a healthy child at 6 months, 9 months, 12 months, 18 months, 24 months and at 3, 4, 5 and 6 years of age. A blood lead level test should be performed only if the risk assessment is positive.
Universal screening or blood lead level tests are no longer recommended, except for children in high prevalence areas with increased risk factors.

Pediatricians can also offer screening tests for:

  • Children eligible for Medicaid at the age of 1 year and again at 2 years of age
  • Children of all ages who are recent immigrants, refugees or adopted as soon as possible
  • A child whose parent, guardian or provider requests a blood lead test due to suspected exposure


Individuals should consult with their health professional and / or the local health department about specific lead detection guidelines for risks in their area.

Tuberculosis

Tuberculosis (TB) is an infectious disease caused by the Mycobacterium tuberculosis bacteriaTuberculosis is primarily directed to the lungs, but it can affect any area of the body. It can be transmitted through the air from person to person through droplets of respiratory secretions such as sputum or aerosols released by coughing, sneezing, laughing or breathing.

TB in children is a public health concern because it is a marker for recent transmission of the bacteria, and infants and young children are more likely than older children and adults to develop life-threatening forms of the disease.

Recommendations

Due to their weak immune system, babies under 2 years old are especially susceptible to this infection. Tests with a tuberculin skin test are recommended for children who are at risk for TB, which include:

  • If a baby has been exposed to someone with active or suspected TB, such as a family member or other contact
  • He is an immigrant from a country where TB is endemic or has traveled to those countries for more than a week.

Iron Deficiency Anemia

Children grow and develop quickly and need iron in their diet to develop normally. If a child does not consume enough iron, there is a risk of developing iron deficiency. Iron deficiency can cause anemia, a condition that can delay a child’s mental, motor, and behavioral development and create problems that last long after the iron level rises to a healthy level. Bad motor skills, behavioral problems at home and at school, and poor performance at school can be the long-term consequences of not getting enough iron as a young child (0 to 3 years old).

Recommendations

Children will be evaluated with a hemoglobin and hematocrit test if they have risk factors for iron deficiency or iron deficiency anemia.

Risk factors for iron deficiency anemia in young children may include:

  • Exclusive breastfeeding after 4 months of age without supplemental iron
  • Households with low income or living in poverty
  • Drink more than 24 ounces of cow’s milk per day after 12 months of age.
  • History of:
    • Medications that interfere with iron absorption.
    • Extensive blood loss
    • Restricted diet that does not provide enough iron
    • Prematurity or low birth weight
    • Lead exposure

High Blood Pressure

Blood pressure is the force that your blood exerts on arterial walls. High blood pressure, also known as hypertension, occurs when that force is constantly too high.

High blood pressure in children is rare, but it can be a serious problem. About 3.5 percent of children and adolescents have high blood pressure. Approximately the same percentage of children have a blood pressure that is above what is considered optimal, but not high enough to diagnose as hypertension. Among obese and overweight children, the high blood pressure rate can reach almost 25%.

The detection of high blood pressure in children is important because over time, hypertension can damage a child’s circulatory system and contribute to heart attack, stroke and other health problems later in life. In general, the longer a child has high blood pressure, the greater the potential for damage to the child’s heart and other organs, including the kidneys, brain or eyes.

The detection of hypertension in children is also important because it can be an indicator of underlying conditions such as diabetes or kidney disease.

how is the arterial pressure measured?

There are two numbers measured for blood pressure. Systolic blood pressure is the pressure when the heart beats. Diastolic Blood pressure is when the heart relaxes between beats and the pressure drops. Together, they are written as systolic about diastolic pressure. For example, a blood pressure of 120/80 mm Hg (millimeters of mercury) corresponds to a systolic pressure of 120 and a diastolic pressure of 80.

What is normal blood pressure?

Begin the blood pressure measurement for healthy children at 3 years and then measure it annually. Children under 3 years old should have their blood pressure measured at each medical visit if they increase the risk of developing hypertension. Some of these risks include:

  • Congenital heart disease
  • Recurrent urinary tract infections
  • Kidney disease
  • Born prematurely

The conditions include:

  • Obesity
  • Taking medication known to raise blood pressure
  • Diabetes
  • Kidney disease
  • A severe narrowing in the aorta, the major blood vessel carrying oxygenated blood to the body


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