First Nations Communities In Manitoba Research Articles

Bacterial diversity and resistome analysis of drinking water stored in cisterns from two First Nations communities in Manitoba, Canada.

The microbiological content of water is an ongoing concern in First Nations communities in Canada. Many communities lack water treatment plants and continue to be under drinking water advisories. However, lack of access to treatment plants is only a part of the problem as poor water distribution systems also contribute to the failure to provide safe drinking water. Here, we studied the microbial diversity and antibiotic resistome from water stored in cisterns from two First Nations communities in Manitoba, Canada. We found that the cistern water contained a high number of bacteria and showed the presence of diverse antimicrobial resistance genes. Interestingly, the bacterial diversity and antimicrobial resistance genes varied considerably from that of the untreated source water, indicating that the origin of contamination in the cistern water came from within the treatment plant or along the delivery route to the homes. Our study highlights the importance of proper maintenance of the water distribution system in addition to access to water treatment facilities to ensure a supply of safe water to First Nations communities in Canada.IMPORTANCEThe work described addresses a critical issue in First Nations communities in Canada-the microbiological content of water. Many of these communities lack access to water treatment plants and frequently experience drinking water advisories. This study focused on the microbial diversity and antibiotic resistome in water stored in cisterns within two First Nations communities in Manitoba, Canada. These findings reveal that cistern water, a common source of drinking water in these communities, contains a high number of bacteria and a wide range of antimicrobial resistance genes. This highlights a serious health risk as exposure to such water can lead to the spread of drug-resistant infections, posing a threat to the well-being of the residents.

Quantitative Assessment of First Nations Drinking Water Distribution Systems for Detection and Prevalence of Thermophilic Campylobacter Species.

Water is considered a major route for transmitting human-associated pathogens. Although microbial water quality indicators are used to test for the presence of waterborne pathogens in drinking water, the two are poorly correlated. The current study investigates the prevalence of thermophilic DNA markers specific for Campylobacter spp. (C. jejuni and C. coli) in source water and throughout the water distribution systems of two First Nations communities in Manitoba, Canada. A total of 220 water samples were collected from various points of the drinking water distribution system (DWDS) between 2016 and 2018. Target Campylobacter spp. were always (100%) detected in a home with a fiberglass (CF) cistern, as well as the community standpipe (SP). The target bacteria were also frequently detected in treated water at the Water Treatment Plant (WTP) (78%), homes with polyethylene (CP) (60%) and concrete (CC) (58%) cisterns, homes with piped (P) water (43%) and water truck (T) samples (20%), with a maximum concentration of 1.9 × 103 cells 100 mL−1 (C. jejuni) and 5.6 × 105 cells 100 mL−1 (C. coli). Similarly, target bacteria were detected in 68% of the source water samples with a maximum concentration of 4.9 × 103 cells 100 mL−1 (C. jejuni) and 8.4 × 105 cells 100 mL−1 (C. coli). Neither target Campylobacter spp. was significantly associated with free and total chlorine concentrations in water. The study results indicate that there is an immediate need to monitor Campylobacter spp. in small communities of Canada and, particularly, to improve the DWDS in First Nations communities to minimize the risk of Campylobacter infection from drinking water sources. Further research is warranted in improving/developing processes and technologies to eliminate microbial contaminants from water.

Evaluating the strengths and challenges of PAX dream makers approach to mental health promotion: perspectives of youth and community members in indigenous communities in Manitoba, Canada

ABSTRACT PAX Good Behaviour Game (PAX-GBG) is an evidence-based approach to co-create a nurturing environment where all children can thrive. This school-based approach was identified as a promising intervention for suicide prevention by First Nations communities in Manitoba, Canada. To enhance this mental health promotion approach, PAX Dream Makers was developed. It is a youth-led addition to PAX-GBG for middle and high school students. This study’s aim was to examine, from the communities’ perspectives, the influence of PAX Dream Makers on youth as well as its strengths, challenges and suggestions for future improvements. A case study method was conducted using interviews and focus groups with 30 youth and 17 adult mentors and elders. Participants reported that PAX Dream Makers provided support and encouragement to the youth, increased their resilience and provided an opportunity to be positive role models. It strengthened PAX-GBG implementation in schools. Challenges included: adult mentors availability, frequent teacher turn-over and community mental distress. Suggestions expressed were: being mindful of cultural and community contexts, increasing community leadership’s understanding of PAX-GBG and better recruitment of mentors and youth. PAX Dream Makers approach was well-received by communities and holds great promise for promoting the well-being of First Nations youth.

Impact of a screen, triage and treat program for identifying chronic disease risk in Indigenous children.

Background:The First Nations Community Based Screening to Improve Kidney Health and Prevent Dialysis project was a point-of-care screening program in rural and remote First Nations communities in Manitoba that aimed to identify and treat hypertension, diabetes and chronic kidney disease. The program identified chronic disease in 20% of children screened. We aimed to characterize clinical screening practices before and after intervention in children aged 10–17 years old and compare outcomes with those who did not receive the intervention.Methods:This observational, prospective cohort study started with community engagement and followed the principles of ownership, control, access and possession (OCAP). We linked participant data to administrative data at the Manitoba Centre for Health Policy to assess rates of primary care and nephrology visits, disease-modifying medication prescriptions and laboratory testing (i.e., glycosylated hemoglobin [HbA1c], estimated glomerural filtration rate [eGFR] and urine albumin- or protein-to-creatinine ratio). We analyzed the differences in proportions in the 18 months before and after the intervention. We also conducted a 1:2 propensity score matching analysis to compare outcomes of children who were screened with those who were not.Results:We included 324 of 353 children from the screening program (43.8% male; median age 12.3 yr) in this study. After the intervention, laboratory testing increased by 5.8% (95% confidence interval [CI] 1.1% to 10.1%) for HbA1c, by 9.9% (95% CI 4.2% to 15.5%) for eGFR and by 6.2% (95% CI 2.3% to 10.0%) for the urine albumin- or protein-to-creatinine ratio. We observed significant improvements in laboratory testing in screened patients in the group who were part of the program, compared with matched controls.Interpretation:Chronic disease surveillance and care increased significantly in children after the implementation of a point-of-care screening program in rural and remote First Nation communities. Interventions such as active surveillance programs have the potential to improve the chronic disease care being provided to First Nations children.

Impact of remote prenatal education on program participation and breastfeeding of women in rural and remote Indigenous communities.

BackgroundFirst Nations (FN) women have a higher risk of diabetes than non-FN women in Canada. Prenatal education and breastfeeding may reduce the risk of diabetes in mothers and offspring. The rates of breastfeeding initiation and participation in the prenatal program are low in FN communities.MethodsA prenatal educational website, social media-assisted prenatal chat groups and community support teams were developed in three rural or remote FN communities in Manitoba. The rates of participation of pregnant women in prenatal programs and breastfeeding initiation were compared before and after the start of the remote prenatal education program within 2014-2017.FindingsThe participation rate of FN pregnant women in rural or remote communities in the prenatal program and breastfeeding initiation during 1-year after the start of the community-based remote prenatal education program were significantly increased compared to that during 1-year before the start of the program (54% versus 36% for the participation rate, 50% versus 34% for breastfeeding initiation, p < 0·001). Availability of high-speed Wi-Fi and/or postpartum supporting team were associated with favorite study outcomes. Positive feedback on the remote prenatal education was received from participants.InterpretationThe findings suggest that remote prenatal education is feasible and effective for improving the breastfeeding rate and engaging pregnant women to participate in the prenatal program in rural or remote FN communities. The remote prenatal education remained active during COVID-19 in the participating communities, which suggests an advantage to expand remote prenatal education in other Indigenous communities.FundingCanadian Institutes of Health Research, the Lawson Foundation and University of Manitoba.

What Changes Would Manitoba First Nations Like to See in the Primary Healthcare They Receive? A Qualitative Investigation.

Background:First Nations (FN) have unique perspectives and experiences of health and healthcare services, which are critical to the provision of effective community-based primary healthcare (CBPHC).Objective:This paper shares FN perspectives on primary healthcare (PHC), taking geographical, cultural and historical realities into account, to elucidate opportunities to improve current healthcare services.Methods:Semi-structured in-depth qualitative interviews were completed with 183 residents of 8 Manitoba FN communities. Grounded theory-guided data analysis was conducted.Results:Improving PHC performance requires delivering timely and holistic healthcare that integrates traditional health knowledge, comprehensive CBPHC increasing services such as healthcare and medical transportation, healthy food as an important preventative measure and a culturally informed workforce backed by local leadership and promoting cultural respect.Conclusion:The relationship between self-determination and health is a critical factor in the implementation of CBPHC. FN must be respected to decide healthcare priorities that reflect the needs and visions of each community.

Detection of fecal bacteria and antibiotic resistance genes in drinking water collected from three First Nations communities in Manitoba, Canada.

This study analyzed the microbiological quality of drinking and source water from three First Nations communities in Manitoba, Canada that vary with respect to the source, storage and distribution of drinking water. Community A relies on an aquifer and Community B on a lake as source water to their water treatment plants. Community C does not have a water treatment plant and uses well water. Quantification of free residual chlorine and fecal bacterial (E. coli and coliforms), as well as detection of antibiotic resistance genes (sul, ampC, tet(A), mecA, vanA, blaSHV, blaTEM, blaCTX-M, blaOXA-1, blaCYM-2, blaKPC, blaOXA-48, blaNDM, blaVIM, blaGES and blaIMP) was carried out. While water treatment plants were found to be working properly, as post-treatment water did not contain E. coli or coliforms, once water entered the distribution system, a decline in the chlorine concentration with a concomitant increase in bacterial counts was observed. In particular, water samples from cisterns not only contained high number of E. coli and coliforms, but were also found to contain antibiotic resistance genes. This work shows that proper maintenance of the distribution and storage systems in First Nations communities is essential in order to provide access to clean and safe drinking water.

Screening for kidney disease in Indigenous Canadian children: The FINISHED screen, triage and treat program.

Indigenous populations are disproportionately affected by kidney failure at younger ages than other ethnic groups in Canada. As symptoms do not occur until disease is advanced, early kidney disease risk is often unrecognized. We sought to evaluate the yield of community-based screening for early risk factors for kidney disease in youth from rural Indigenous communities in Canada. The FINISHED project screened 11 rural First Nations communities in Manitoba, Canada after community and school engagement. The results for the 10- to 17-year olds are reported here. Body mass index (BMI), blood pressure, estimated glomerular filtration rate (eGFR), hemoglobin A1c's (HbA1c) and urine albumin-to-creatinine ratios (ACR) were assessed. All children were triaged and referred to either primary or tertiary care, depending on risk. A total of 353 were screened (estimated 22.4% of population). The median age was 12 years (IQR 10 to 13), 55% were female and 55% were overweight or obese. Overall, 21.8% of children had at least one abnormality. Hypertension was identified in 5.4% and 11.9% had prehypertension. None of the children had an eGFR < 60 ml/min/1.73 m2 however 10.5% had an ACR > 3 mg/mmol and 6.2% had an eGFR < 90 ml/min/1.73 m2 suggestive of early kidney disease. Diabetes was identified in 1.4%, and 1.4% had HbA1c's between 6.1% and 6.49%. Risk factors for chronic kidney disease are highly prevalent in rural Indigenous children. More research is required to confirm the persistence of these findings, and to evaluate the efficacy of screening children to prevent or delay progression to kidney failure.

Adapting and enhancing PAX Good Behavior Game for First Nations communities: a mixed-methods study protocol developed with Swampy Cree Tribal Council communities in Manitoba

IntroductionHigh rates of mental health problems, such as suicidal behaviours, among First Nations youth in Canada are a major public health concern. The Good Behavior Game (GBG) is a school-based...

Correlates of Suicidality: Investigation of a Representative Sample of Manitoba First Nations Adolescents

We examined individual, friend or family, and community or tribe correlates of suicidality in a representative on-reserve sample of First Nations adolescents. Data came from the 2002-2003 Manitoba First Nations Regional Longitudinal Health Survey of Youth. Interviews were conducted with adolescents aged 12 to 17 years (n=1125) from 23 First Nations communities in Manitoba. We used bivariate logistic regression analyses to examine the relationships between a range of factors and lifetime suicidality. We conducted sex-by-correlate interactions for each significant correlate at the bivariate level. A multivariate logistic regression analysis identified those correlates most strongly related to suicidality. We found several variables to be associated with an increased likelihood of suicidality in the multivariate model, including being female, depressed mood, abuse or fear of abuse, a hospital stay, and substance use (adjusted odds ratio range=2.43-11.73). Perceived community caring was protective against suicidality (adjusted odds ratio=0.93; 95% confidence interval=0.88, 0.97) in the same model. Results of this study may be important in informing First Nations and government policy related to the implementation of suicide prevention strategies in First Nations communities.

Ininiwi-Kiskānītamowin: A Framework for Long-Term Science Education

Abstract This article first describes an integration of the theoretical models currently found in the literature that discusses the implementation of science programs in Indigenous contexts. The article then reports on the findings from a two-day conference discussing best practice for incorporating Indigenous knowledge in science education, which involved 50 science teachers, consultants, and administrators from urban, rural, and First Nations communities in Manitoba. Participants read “Ininiwi-Kiskānītamowin,” a proposed framework for a lifelong strategy on science and math education; presented information about their individual science programs; and participated in an action research project that identified the components that were common across all programs. The four common components were Elders, language, culture, and experiential learning, which we then incorporated more explicitly into the Ininiwi-kiskānītamowin framework. The investigation also implicated a modification of the Ininiwi-kiskānītamo...

From Past to Present: Understanding First Nations Health Patterns in a Historical Context

By many measures of health, Canada's First Nations compare very poorly to the non-Native population as a whole. The need to explain, and to correct, this disparity has led public health researchers to consider a wide variety of community characteristics. One area that is as yet under-utilized, but may yield important insights into the complex question of First Nations health, is history. This paper presents an overview of the potential uses of historical methods in the study of the health of First Nations communities in Manitoba. It also introduces the major historical data sources available to public health researchers involved in such research. There are three main benefits to the inclusion of history in public health research. First, we may learn about the impact of health changes on Aboriginal groups in the past. Second, we may better understand the origins of present-day health concerns, many of which emerged out of the events of the recent or not so recent past. Finally, we may gain important insights into the nature of the disease process, and the diseases themselves, by employing the past as a laboratory. The addition of an historical approach can enhance health research directed towards First Nations communities in Manitoba.

Social Capital as a Health Determinant in First Nations: An Exploratory Study in Three Communities

The study examined the concept of social capital in First Nations communities. Its two main goals were to clearly define social capital and to create culturally-appropriate methods for measuring it in First Nations communities. The research was conducted with the participation of three First Nations communities in Manitoba. After offering a brief summary of the findings of the study, the paper discusses social capital as a determinant of health in First Nations communities and possible research and policy implications.

Social Capital and Youth Suicide Risk Factors in First Nations Communities

The paper presents a model of plausible mechanisms linking social capital to suicide risk factors among First Nations youth, informed by a study that explored the concept of social capital in First Nations communities, and by a study on mental health services in First Nations communities in Manitoba. The model incorporates several components of social capital. The plausible impact of social capital on protective and risk factors of suicide among youth is explored.

Narrating troubling experiences.

This article presents a process-oriented perspective that relates to the broad question of how self-related experience comes to be endowed with meaning. The approach highlights the implications of 'living by' particular culturally based understandings in specific contexts and centers on how jointly cultural, social, and cognitive processes offer potentialities for orienting the experiential self without determining self-related experiences. This process-oriented perspective revolves around the interplay between the range of historically contingent cultural resources available for endowing experience with meaning and the socially and structurally grounded processes through which individuals learn about, orient towards and traffic in interpretive plausibilities--a socially situated experientially based process. This perspective is informed by, and provides an entree for exploring, variability within a cultural setting. The narrative accounts examined are from individuals who grew up speaking either Ojibwa or Cree (both Algonkian languages) in First Nations communities in Manitoba, Canada.

NIDDM-Y in First Nation children in Canada.

Prevalence of NIDDM-Y in children in many First Nations communities in Manitoba and northwestern Ontario is now severalfold greater than the prevalence of IDDM in the general pediatric population. Rates vary among First Nations communities in Canada owing to inconsistent screening programs and different genetic risk. The number of undiagnosed, asymptomatic cases is predicted to be at least 2x greater than the known cases. Serious complications of diabetes are known to occur in the early third decade of life and within 10 years of diagnosis. Long-term follow-up data are scarce. Nonpharmacologic management in youths has been successful in short-term studies but generally unsuccessful in achieving long-term acceptable glycemic control. The safety and efficacy of pharmacologic interventions have not been proven in this age group, particularly the prepubertal group. NIDDM-Y fits the WHO criteria for a disease appropriate for screening. There is an urgent need for consistent community-based screening programs and randomized controlled trials of pharmacologic interventions to test the safety and efficacy of these agents in primary prevention and secondary prevention of complications in youths.