Alyssa Golden, Averil Griffith, Walter Demczuk, Brigitte Lefebvre, Allison McGeer, Gregory Tyrrell, George Zhanel, Julianne Kus, Linda Hoang, Jessica Minion, Paul Van Caeseele, Hanan Smadi, David Haldane, George Zahariadis, Kristen Mead, Laura Steven, Lori Strudwick, Anita Li, Michael Mulvey, Irene Martin
Background: Invasive pneumococcal disease (IPD), which is caused by Streptococcus pneumoniae, has been a nationally notifiable disease in Canada since 2000. The use of conjugate vaccines has markedly decreased the incidence of IPD in Canada; however, the distribution of serotypes has shifted in favour of non-vaccine types. This report summarizes the demographics, serotypes and antimicrobial resistance of IPD infections in Canada in 2020.
Methods: The Public Health Agency of Canada's National Microbiology Laboratory (Winnipeg, Manitoba) collaborates with provincial and territorial public health laboratories to conduct national surveillance of IPD. A total of 2,108 IPD isolates were reported in 2020. Serotyping was performed by Quellung reaction and antimicrobial susceptibilities were determined in collaboration with the University of Manitoba/Canadian Antimicrobial Resistance Alliance. Population-based IPD incidence rates were obtained through the Canadian Notifiable Disease Surveillance System.
Results: Overall incidence of IPD in Canada decreased significantly from 11.5 (95% confidence interval [CI]: 10.1-13.1) to 6.0 (95% CI: 5.0-7.2), and from 10.0 (95% CI: 9.7-10.3) to 5.9 (95% CI: 5.7-6.2) cases per 100,000 from 2019 to 2020; in those younger than five years and those five years and older, respectively. The most common serotypes overall were 4 (11.2%, n=237), 3 (10.9%, n=229) and 8 (7.2%, n=151). From 2016 to 2020, serotypes with increasing trends (p<0.05) included 4 (6.4%-11.2%), 3 (9.5%-10.9%), 8 (5.2%-7.2%) and 12F (3.6%-5.7%). The overall prevalence of PCV13 serotypes increased over the same period (30.3%-34.9%, p<0.05). Antimicrobial resistance rates in 2020 included 23.0% clarithromycin and 9.9% penicillin (IV meningitis breakpoints). Multidrug-resistant IPD has significantly increased since 2016 (4.2%-9.5%, p<0.05).
Conclusion: Though the incidence of IPD decreased in 2020 in comparison to previous years across all age groups, disease due to PCV13 serotypes 3 and 4, as well as non-PCV13 serotypes such as 8 and 12F, increased in prevalence. Continued surveillance of IPD is imperative to monitor shifts in serotype distribution and antimicrobial resistance.
{"title":"Invasive pneumococcal disease surveillance in Canada, 2020.","authors":"Alyssa Golden, Averil Griffith, Walter Demczuk, Brigitte Lefebvre, Allison McGeer, Gregory Tyrrell, George Zhanel, Julianne Kus, Linda Hoang, Jessica Minion, Paul Van Caeseele, Hanan Smadi, David Haldane, George Zahariadis, Kristen Mead, Laura Steven, Lori Strudwick, Anita Li, Michael Mulvey, Irene Martin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Invasive pneumococcal disease (IPD), which is caused by <i>Streptococcus pneumoniae</i>, has been a nationally notifiable disease in Canada since 2000. The use of conjugate vaccines has markedly decreased the incidence of IPD in Canada; however, the distribution of serotypes has shifted in favour of non-vaccine types. This report summarizes the demographics, serotypes and antimicrobial resistance of IPD infections in Canada in 2020.</p><p><strong>Methods: </strong>The Public Health Agency of Canada's National Microbiology Laboratory (Winnipeg, Manitoba) collaborates with provincial and territorial public health laboratories to conduct national surveillance of IPD. A total of 2,108 IPD isolates were reported in 2020. Serotyping was performed by Quellung reaction and antimicrobial susceptibilities were determined in collaboration with the University of Manitoba/Canadian Antimicrobial Resistance Alliance. Population-based IPD incidence rates were obtained through the Canadian Notifiable Disease Surveillance System.</p><p><strong>Results: </strong>Overall incidence of IPD in Canada decreased significantly from 11.5 (95% confidence interval [CI]: 10.1-13.1) to 6.0 (95% CI: 5.0-7.2), and from 10.0 (95% CI: 9.7-10.3) to 5.9 (95% CI: 5.7-6.2) cases per 100,000 from 2019 to 2020; in those younger than five years and those five years and older, respectively. The most common serotypes overall were 4 (11.2%, n=237), 3 (10.9%, n=229) and 8 (7.2%, n=151). From 2016 to 2020, serotypes with increasing trends (<i>p</i><0.05) included 4 (6.4%-11.2%), 3 (9.5%-10.9%), 8 (5.2%-7.2%) and 12F (3.6%-5.7%). The overall prevalence of PCV13 serotypes increased over the same period (30.3%-34.9%, <i>p</i><0.05). Antimicrobial resistance rates in 2020 included 23.0% clarithromycin and 9.9% penicillin (IV meningitis breakpoints). Multidrug-resistant IPD has significantly increased since 2016 (4.2%-9.5%, <i>p</i><0.05).</p><p><strong>Conclusion: </strong>Though the incidence of IPD decreased in 2020 in comparison to previous years across all age groups, disease due to PCV13 serotypes 3 and 4, as well as non-PCV13 serotypes such as 8 and 12F, increased in prevalence. Continued surveillance of IPD is imperative to monitor shifts in serotype distribution and antimicrobial resistance.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"48 9","pages":"396-406"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10732480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Todoric, L. Vrbova, Maria Elizabeth Mitri, S. Gasmi, Angelica Stewart, Sandra Connors, Hui Zheng, A. Bourgeois, M. Drebot, J. Paré, Marnie Zimmer, P. Buck
National West Nile virus (WNV) surveillance was established in partnership with the federal, provincial and territorial governments starting in 2000, with the aim to monitor the emergence and subsequent spread of WNV disease in Canada. As the disease emerged, national WNV surveillance continued to focus on early detection of WNV disease outbreaks in different parts of the country. In Canada, the WNV transmission season occurs from May to November. During the season, the system adopts a One Health approach to collect, integrate, analyze and disseminate national surveillance data on human, mosquito, bird and other animal cases. Weekly and annual reports are available to the public, provincial/territorial health authorities, and other federal partners to provide an ongoing national overview of WNV infections in Canada. While national surveillance allows a jurisdiction-by-jurisdiction comparison of data, it also helps to guide appropriate disease prevention strategies such as education and awareness campaigns at the national level. This paper aims to describe both the establishment and the current structure of national WNV surveillance in Canada.
{"title":"An overview of the National West Nile Virus Surveillance System in Canada: A One Health approach.","authors":"D. Todoric, L. Vrbova, Maria Elizabeth Mitri, S. Gasmi, Angelica Stewart, Sandra Connors, Hui Zheng, A. Bourgeois, M. Drebot, J. Paré, Marnie Zimmer, P. Buck","doi":"10.14745/ccdr.v48i05a01","DOIUrl":"https://doi.org/10.14745/ccdr.v48i05a01","url":null,"abstract":"National West Nile virus (WNV) surveillance was established in partnership with the federal, provincial and territorial governments starting in 2000, with the aim to monitor the emergence and subsequent spread of WNV disease in Canada. As the disease emerged, national WNV surveillance continued to focus on early detection of WNV disease outbreaks in different parts of the country. In Canada, the WNV transmission season occurs from May to November. During the season, the system adopts a One Health approach to collect, integrate, analyze and disseminate national surveillance data on human, mosquito, bird and other animal cases. Weekly and annual reports are available to the public, provincial/territorial health authorities, and other federal partners to provide an ongoing national overview of WNV infections in Canada. While national surveillance allows a jurisdiction-by-jurisdiction comparison of data, it also helps to guide appropriate disease prevention strategies such as education and awareness campaigns at the national level. This paper aims to describe both the establishment and the current structure of national WNV surveillance in Canada.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"2673 1","pages":"181-187"},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81009284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. O’Brien, S. Drews, A. Lewin, C. Osiowy, M. Drebot, C. Renaud
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic galvanized blood donor seroprevalence studies, which continue to inform public health policy. We propose that the two Canadian blood suppliers, Héma-Québec and Canadian Blood Services, expand their role in public health surveillance in the post-pandemic period. Together blood suppliers have near-national reach, collecting blood donations nearly every day in all larger cities and many smaller municipalities. Blood donors are a healthy subset of the general population. Demographic data, routine infectious disease testing and screening questionnaire data are collected for all donations. Close to one million blood samples per year could be made available for surveillance. With 90% repeat donors, longitudinal sampling is possible. Current blood donor surveillance includes monitoring infectious marker rates in low risk (e.g. HIV, hepatitis C virus) or asymptomatic (e.g. West Nile virus) populations, and ad hoc studies to monitor transfusion-transmissible infections. These include tick-borne infections such as Babesia microti and foodborne infections such as hepatitis E. Canadian Blood Services and Héma-Québec are actively seeking to engage with public health professionals to further develop a role in public health surveillance.
{"title":"Canadian blood suppliers: An expanding role in public health surveillance?","authors":"S. O’Brien, S. Drews, A. Lewin, C. Osiowy, M. Drebot, C. Renaud","doi":"10.14745/ccdr.v48i04a02","DOIUrl":"https://doi.org/10.14745/ccdr.v48i04a02","url":null,"abstract":"The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic galvanized blood donor seroprevalence studies, which continue to inform public health policy. We propose that the two Canadian blood suppliers, Héma-Québec and Canadian Blood Services, expand their role in public health surveillance in the post-pandemic period. Together blood suppliers have near-national reach, collecting blood donations nearly every day in all larger cities and many smaller municipalities. Blood donors are a healthy subset of the general population. Demographic data, routine infectious disease testing and screening questionnaire data are collected for all donations. Close to one million blood samples per year could be made available for surveillance. With 90% repeat donors, longitudinal sampling is possible. Current blood donor surveillance includes monitoring infectious marker rates in low risk (e.g. HIV, hepatitis C virus) or asymptomatic (e.g. West Nile virus) populations, and ad hoc studies to monitor transfusion-transmissible infections. These include tick-borne infections such as Babesia microti and foodborne infections such as hepatitis E. Canadian Blood Services and Héma-Québec are actively seeking to engage with public health professionals to further develop a role in public health surveillance.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"16 1","pages":"124-130"},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75061342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Ndubuka, Sabyasachi Gupta, Rim Zayed, Brian Quinn, M. Khaketla, Elaine Chan, Kristyn Franklin, Erin McGill
Background Sixty-eight laboratory-confirmed cases of the coronavirus disease 2019 (COVID-19) (12 in Alberta [AB], 56 in Saskatchewan [SK]) were linked to a gathering at a hospital in Alberta on June 1-4, 2020, and a wake/funeral in a First Nations community in northern Saskatchewan on June 9-11, 2020. Objective The objectives were to provide a comprehensive description of the epidemiology of the outbreak and describe the chains of transmission to inform the hypothesis that there were multiple introductions of COVID-19 at the wake/funeral. Methods Case investigation and contact tracing was conducted by local public health in AB and SK. The Public Health Agency of Canada conducted a centralized case analysis. An epidemic curve and a Gantt chart for period of communicability were created to support or refute whether there had been multiple introductions of COVID-19 at the wake/funeral. Results Illness onset dates ranged from May 31 to July 1, 2020. Ages ranged from 2 to 80 years (median age=43 years). Five cases were hospitalized; there were no deaths. The available case exposure information supports the hypothesis that there had been multiple introductions of COVID-19 at the wake/funeral. Public health authorities in AB and SK declared the outbreak over on July 20, 2020; based on two incubation periods (i.e. 28 days) following the illness onset of the last primary case. Conclusion During multijurisdictional outbreaks, data sharing, coordination across health authorities and centralized analysis is essential to understanding the events that lead to the outbreak and possible hypotheses around chains of transmission.
{"title":"Multijurisdictional outbreak of COVID-19 associated with a wake/funeral event in a northern Saskatchewan First Nations community.","authors":"N. Ndubuka, Sabyasachi Gupta, Rim Zayed, Brian Quinn, M. Khaketla, Elaine Chan, Kristyn Franklin, Erin McGill","doi":"10.14745/ccdr.v48i04a04","DOIUrl":"https://doi.org/10.14745/ccdr.v48i04a04","url":null,"abstract":"Background\u0000Sixty-eight laboratory-confirmed cases of the coronavirus disease 2019 (COVID-19) (12 in Alberta [AB], 56 in Saskatchewan [SK]) were linked to a gathering at a hospital in Alberta on June 1-4, 2020, and a wake/funeral in a First Nations community in northern Saskatchewan on June 9-11, 2020.\u0000\u0000\u0000Objective\u0000The objectives were to provide a comprehensive description of the epidemiology of the outbreak and describe the chains of transmission to inform the hypothesis that there were multiple introductions of COVID-19 at the wake/funeral.\u0000\u0000\u0000Methods\u0000Case investigation and contact tracing was conducted by local public health in AB and SK. The Public Health Agency of Canada conducted a centralized case analysis. An epidemic curve and a Gantt chart for period of communicability were created to support or refute whether there had been multiple introductions of COVID-19 at the wake/funeral.\u0000\u0000\u0000Results\u0000Illness onset dates ranged from May 31 to July 1, 2020. Ages ranged from 2 to 80 years (median age=43 years). Five cases were hospitalized; there were no deaths. The available case exposure information supports the hypothesis that there had been multiple introductions of COVID-19 at the wake/funeral. Public health authorities in AB and SK declared the outbreak over on July 20, 2020; based on two incubation periods (i.e. 28 days) following the illness onset of the last primary case.\u0000\u0000\u0000Conclusion\u0000During multijurisdictional outbreaks, data sharing, coordination across health authorities and centralized analysis is essential to understanding the events that lead to the outbreak and possible hypotheses around chains of transmission.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"7 1","pages":"140-145"},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89124505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
É. Fortin, P. De Wals, D. Talbot, M. Ouakki, G. Deceuninck, C. Sauvageau, R. Gilca, Marilou Kiely, G. De Serres
Background Residents of long-term care facilities (LTCFs) and private residences for seniors (PRSs) were given priority for vaccination against coronavirus disease 2019 (COVID-19). Given the shortage of vaccine in the winter of 2021, the Comité sur l'immunisation du Québec recommended postponing the administration of second doses to ensure more rapid and widespread administration of first doses. The objective of this study was to measure the impact of first-dose vaccination on 1) the incidence of cases and complications in LTCFs and PRSs and 2) the frequency of outbreaks in LTCFs. Methods In this ecological study, COVID-19 incidence and complications in residents of LTCFs and PRSs in Québec were compared with the general (community) population at a point in time when there was still only limited eligibility for vaccination. Results After vaccination in LTCFs, the incidence rate of COVID-19 decreased by 92% compared with 49% in the community, and deaths decreased by 95%. By six weeks post-vaccination, almost no facility reported five or more cases per 100 beds per week. The incidence rate decreased by 91% in PRSs compared with 2% in the community. Hospitalizations and deaths in PRSs decreased by 94% and 90%, respectively. Conclusion As a result of 1) vaccination of residents with one dose, 2) natural immunity already acquired in LTCFs and PRSs, 3) vaccination of healthcare workers and 4) other non-pharmaceutical prevention measures implemented, the circulation of the coronavirus in these settings was largely interrupted.
{"title":"Impact of the first vaccine dose on COVID-19 and its complications in long-term care facilities and private residences for seniors in Québec, Canada.","authors":"É. Fortin, P. De Wals, D. Talbot, M. Ouakki, G. Deceuninck, C. Sauvageau, R. Gilca, Marilou Kiely, G. De Serres","doi":"10.14745/ccdr.v48i04a07","DOIUrl":"https://doi.org/10.14745/ccdr.v48i04a07","url":null,"abstract":"Background\u0000Residents of long-term care facilities (LTCFs) and private residences for seniors (PRSs) were given priority for vaccination against coronavirus disease 2019 (COVID-19). Given the shortage of vaccine in the winter of 2021, the Comité sur l'immunisation du Québec recommended postponing the administration of second doses to ensure more rapid and widespread administration of first doses. The objective of this study was to measure the impact of first-dose vaccination on 1) the incidence of cases and complications in LTCFs and PRSs and 2) the frequency of outbreaks in LTCFs.\u0000\u0000\u0000Methods\u0000In this ecological study, COVID-19 incidence and complications in residents of LTCFs and PRSs in Québec were compared with the general (community) population at a point in time when there was still only limited eligibility for vaccination.\u0000\u0000\u0000Results\u0000After vaccination in LTCFs, the incidence rate of COVID-19 decreased by 92% compared with 49% in the community, and deaths decreased by 95%. By six weeks post-vaccination, almost no facility reported five or more cases per 100 beds per week. The incidence rate decreased by 91% in PRSs compared with 2% in the community. Hospitalizations and deaths in PRSs decreased by 94% and 90%, respectively.\u0000\u0000\u0000Conclusion\u0000As a result of 1) vaccination of residents with one dose, 2) natural immunity already acquired in LTCFs and PRSs, 3) vaccination of healthcare workers and 4) other non-pharmaceutical prevention measures implemented, the circulation of the coronavirus in these settings was largely interrupted.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"21 1","pages":"164-169"},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89490852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The National Collaborating Centre for Indigenous Health (NCCIH) is unique among the National Collaborating Centres as the only centre focused on the health of a population. In this fifth article of the Canada Communicable Disease Report's series on the National Collaborating Centres and their contribution to Canada's public health response to the coronavirus disease 2019 (COVID-19) pandemic, we describe the work of the NCCIH. We begin with a brief overview of the NCCIH's mandate and priority areas, describing how it works, who it serves and how it has remained flexible and responsive to evolving Indigenous public health needs. Key knowledge translation and exchange activities undertaken by the NCCIH to address COVID-19 misinformation and to support the timely use of Indigenous-informed evidence and knowledge in public health decision-making during the pandemic are also discussed, with a focus on acting on lessons learned moving forward.
{"title":"Supporting health equity for First Nations, Inuit and Métis peoples.","authors":"M. Greenwood, D. Atkinson, J. Sutherland","doi":"10.14745/ccdr.v48i04a01","DOIUrl":"https://doi.org/10.14745/ccdr.v48i04a01","url":null,"abstract":"The National Collaborating Centre for Indigenous Health (NCCIH) is unique among the National Collaborating Centres as the only centre focused on the health of a population. In this fifth article of the Canada Communicable Disease Report's series on the National Collaborating Centres and their contribution to Canada's public health response to the coronavirus disease 2019 (COVID-19) pandemic, we describe the work of the NCCIH. We begin with a brief overview of the NCCIH's mandate and priority areas, describing how it works, who it serves and how it has remained flexible and responsive to evolving Indigenous public health needs. Key knowledge translation and exchange activities undertaken by the NCCIH to address COVID-19 misinformation and to support the timely use of Indigenous-informed evidence and knowledge in public health decision-making during the pandemic are also discussed, with a focus on acting on lessons learned moving forward.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"95 1","pages":"119-123"},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88618258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kathleen Lydon-Hassen, L. Jonah, Lisa Mayotte, Ashley Hrabowy, B. Graham, Beverley Missens, A. Nelson, M. Andkhoie, Deana Nahachewsky, D. Yalamanchili, Sabyasachi Gupta, N. Ndubuka, I. Khan, W. Yacoub, M. Bryson, D. Paquette
Background The Public Health Agency of Canada's integrated bio-behavioural surveillance system-Tracks surveys-assesses the burden of HIV, hepatitis C and associated risks in key populations in Canada. From 2018-2020, Tracks surveys were successfully implemented by First Nations Health Services Organizations in Alberta and Saskatchewan. Methods First Nations-led survey teams invited community members who identified as First Nations, Inuit or Métis to participate in Tracks surveys and testing for HIV, hepatitis C and syphilis. Information was collected on social determinants of health, use of prevention services, substance use, sexual behaviours and care for HIV and hepatitis C. Descriptive statistics are presented. Results Of the 1,828 survey participants, 97.4% self-identified as First Nations and 91.4% lived in an on-reserve community. Over half (52.2%) were cisgender female, average age was 36.3 years, 82.5% lived in stable housing, 82% had access to primary healthcare and 73.8% reported having good to excellent mental health. Most participants (97%) had a family member who had experienced residential school. High proportions experienced stigma and discrimination (65.6%), financial strain (64.3%) and abuse in childhood (65.1%). Testing for HIV (62.8%) and hepatitis C (55.3%) was relatively high. Prevalence of HIV was 1.6% (of whom 64% knew their infection status). Hepatitis C ribonucleic acid prevalence was 5% (44.9% of whom knew their current infection status). Conclusion Historical and ongoing experiences of trauma, and higher prevalence of hepatitis C were identified, reaffirming evidence of the ongoing legacies of colonialism, Indian Residential Schools and systemic racism. High participation in sexually transmitted blood-borne infection testing and prevention reflect the importance of First Nations-led culturally sensitive, safe and responsive healthcare services and programs to effect improved outcomes for First Nations peoples.
{"title":"Summary findings from Tracks surveys implemented by First Nations in Saskatchewan and Alberta, Canada, 2018-2020.","authors":"Kathleen Lydon-Hassen, L. Jonah, Lisa Mayotte, Ashley Hrabowy, B. Graham, Beverley Missens, A. Nelson, M. Andkhoie, Deana Nahachewsky, D. Yalamanchili, Sabyasachi Gupta, N. Ndubuka, I. Khan, W. Yacoub, M. Bryson, D. Paquette","doi":"10.14745/ccdr.v48i04a05","DOIUrl":"https://doi.org/10.14745/ccdr.v48i04a05","url":null,"abstract":"Background\u0000The Public Health Agency of Canada's integrated bio-behavioural surveillance system-Tracks surveys-assesses the burden of HIV, hepatitis C and associated risks in key populations in Canada. From 2018-2020, Tracks surveys were successfully implemented by First Nations Health Services Organizations in Alberta and Saskatchewan.\u0000\u0000\u0000Methods\u0000First Nations-led survey teams invited community members who identified as First Nations, Inuit or Métis to participate in Tracks surveys and testing for HIV, hepatitis C and syphilis. Information was collected on social determinants of health, use of prevention services, substance use, sexual behaviours and care for HIV and hepatitis C. Descriptive statistics are presented.\u0000\u0000\u0000Results\u0000Of the 1,828 survey participants, 97.4% self-identified as First Nations and 91.4% lived in an on-reserve community. Over half (52.2%) were cisgender female, average age was 36.3 years, 82.5% lived in stable housing, 82% had access to primary healthcare and 73.8% reported having good to excellent mental health. Most participants (97%) had a family member who had experienced residential school. High proportions experienced stigma and discrimination (65.6%), financial strain (64.3%) and abuse in childhood (65.1%). Testing for HIV (62.8%) and hepatitis C (55.3%) was relatively high. Prevalence of HIV was 1.6% (of whom 64% knew their infection status). Hepatitis C ribonucleic acid prevalence was 5% (44.9% of whom knew their current infection status).\u0000\u0000\u0000Conclusion\u0000Historical and ongoing experiences of trauma, and higher prevalence of hepatitis C were identified, reaffirming evidence of the ongoing legacies of colonialism, Indian Residential Schools and systemic racism. High participation in sexually transmitted blood-borne infection testing and prevention reflect the importance of First Nations-led culturally sensitive, safe and responsive healthcare services and programs to effect improved outcomes for First Nations peoples.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"24 1","pages":"146-156"},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78600472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sabrina Wong, Shanika Rajapakshe, D. Barber, A. Patey, W. Levinson, R. Morkem, Gillian Hurwitz, Kimberly Wintermute, J. Leis
Background Respiratory tract infection (RTI) is the leading reason for avoidable antimicrobial use in primary care, yet provider-level feedback on its use is only available in some provinces. The aim of this study was to validate case definitions for RTI across the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) and determine baseline provider-level variability in antimicrobial prescribing in 2019. Methods The RTI case definitions were developed using demographic, diagnostic coding and keywords in electronic medical record. Manual chart abstraction was performed to identify cases of acute otitis media. Remaining RTI definitions were validated using a random sample of 5,164 patients with encounters in 2019. The proportion of patients with an RTI treated with antibiotics was determined by provider, per patient, per episode and per patient encounter. Results Negative predictive value, positive predictive value and prevalence were as follows: 1.00 (0.99-1.00), 0.99 (0.96-0.99) and 4.14% (4.10-4.19) for common cold; 1.00 (0.99-1.00), 0.94 (0.88-0.98) and 1.09% (1.07-1.12) for acute otitis media; 0.98 (0.96-1.00), 0.93 (0.87-0.97) and 1.2% (1.18-1.22) for acute pharyngitis; 0.99 (0.99-1.00), 0.88 (0.81-0.93) and 1.99% (1.96-2.02) for sinusitis; 0.99 (0.97-0.99), 0.95 (0.89-0.98) and 4.01% (3.97-4.05) for acute bronchitis/asthma. By provider, median (interquartile range [IQR]) proportion treated with antibiotics (per patient) was 6.72 (14.92) for common cold, 64.29 (40.00) for acute otitis media, 20.00 (38.89) for pharyngitis, 54.17 (38.09) for sinusitis, 8.33 (20.00) for acute bronchitis/asthma and 21.10 (20.56) for overall RTI. Conclusion The CPCSSN can provide national surveillance of antimicrobial prescribing practices for RTI across primary care. Baseline variability underscores the need for provider feedback and quality improvement.
{"title":"Antibiotic prescribing for respiratory tract infection across a national primary care network in 2019.","authors":"Sabrina Wong, Shanika Rajapakshe, D. Barber, A. Patey, W. Levinson, R. Morkem, Gillian Hurwitz, Kimberly Wintermute, J. Leis","doi":"10.14745/ccdr.v48i04a06","DOIUrl":"https://doi.org/10.14745/ccdr.v48i04a06","url":null,"abstract":"Background\u0000Respiratory tract infection (RTI) is the leading reason for avoidable antimicrobial use in primary care, yet provider-level feedback on its use is only available in some provinces. The aim of this study was to validate case definitions for RTI across the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) and determine baseline provider-level variability in antimicrobial prescribing in 2019.\u0000\u0000\u0000Methods\u0000The RTI case definitions were developed using demographic, diagnostic coding and keywords in electronic medical record. Manual chart abstraction was performed to identify cases of acute otitis media. Remaining RTI definitions were validated using a random sample of 5,164 patients with encounters in 2019. The proportion of patients with an RTI treated with antibiotics was determined by provider, per patient, per episode and per patient encounter.\u0000\u0000\u0000Results\u0000Negative predictive value, positive predictive value and prevalence were as follows: 1.00 (0.99-1.00), 0.99 (0.96-0.99) and 4.14% (4.10-4.19) for common cold; 1.00 (0.99-1.00), 0.94 (0.88-0.98) and 1.09% (1.07-1.12) for acute otitis media; 0.98 (0.96-1.00), 0.93 (0.87-0.97) and 1.2% (1.18-1.22) for acute pharyngitis; 0.99 (0.99-1.00), 0.88 (0.81-0.93) and 1.99% (1.96-2.02) for sinusitis; 0.99 (0.97-0.99), 0.95 (0.89-0.98) and 4.01% (3.97-4.05) for acute bronchitis/asthma. By provider, median (interquartile range [IQR]) proportion treated with antibiotics (per patient) was 6.72 (14.92) for common cold, 64.29 (40.00) for acute otitis media, 20.00 (38.89) for pharyngitis, 54.17 (38.09) for sinusitis, 8.33 (20.00) for acute bronchitis/asthma and 21.10 (20.56) for overall RTI.\u0000\u0000\u0000Conclusion\u0000The CPCSSN can provide national surveillance of antimicrobial prescribing practices for RTI across primary care. Baseline variability underscores the need for provider feedback and quality improvement.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"45 1","pages":"157-163"},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80691649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The incidence of syphilis among Canadian women of childbearing age has risen dramatically in the past decade, with a resurgence of infants born with congenital syphilis. While guidelines exist to guide maternal infection during pregnancy, there is little evidence available to guide management in situations where the developing fetus is found to be severely affected. Case review Our patient presented in the second trimester of her pregnancy as syphilis contact. Positive serologic tests (venereal disease research laboratory titre of 1:64) and a chancre suggested primary infection. Ultrasound demonstrated a fetus at 19+3 weeks gestation with hydrops fetalis and a markedly abnormal brain. Amniocentesis confirmed congenital syphilis infection on polymerase chain reaction testing. After nine days of intravenous penicillin G, the fetal status had worsened, and the family ultimately chose a medical termination of the pregnancy. Discussion Evolving ultrasound technology has allowed us to identify severely affected fetuses, who may historically have been delivered stillborn. Following routine syphiliotherapy with benzathine penicillin, these abnormal ultrasound features may take weeks or months to reverse, which poses a challenge in prognostication and counselling. Case reports data suggests intensive treatment with intravenous penicillin may be effective in severe cases where fetal hydrops is present. Conclusion This case highlights the potential morbidity of fetal syphilis infection and underscores the paucity of current literature. Information sharing will be essential to build a modern knowledge base on treating this ancient disease.
{"title":"Exploring management of antenatally diagnosed fetal syphilis infection.","authors":"M. Rosenthal, V. Poliquin","doi":"10.14745/ccdr.v48i23a09","DOIUrl":"https://doi.org/10.14745/ccdr.v48i23a09","url":null,"abstract":"Background\u0000The incidence of syphilis among Canadian women of childbearing age has risen dramatically in the past decade, with a resurgence of infants born with congenital syphilis. While guidelines exist to guide maternal infection during pregnancy, there is little evidence available to guide management in situations where the developing fetus is found to be severely affected.\u0000\u0000\u0000Case review\u0000Our patient presented in the second trimester of her pregnancy as syphilis contact. Positive serologic tests (venereal disease research laboratory titre of 1:64) and a chancre suggested primary infection. Ultrasound demonstrated a fetus at 19+3 weeks gestation with hydrops fetalis and a markedly abnormal brain. Amniocentesis confirmed congenital syphilis infection on polymerase chain reaction testing. After nine days of intravenous penicillin G, the fetal status had worsened, and the family ultimately chose a medical termination of the pregnancy.\u0000\u0000\u0000Discussion\u0000Evolving ultrasound technology has allowed us to identify severely affected fetuses, who may historically have been delivered stillborn. Following routine syphiliotherapy with benzathine penicillin, these abnormal ultrasound features may take weeks or months to reverse, which poses a challenge in prognostication and counselling. Case reports data suggests intensive treatment with intravenous penicillin may be effective in severe cases where fetal hydrops is present.\u0000\u0000\u0000Conclusion\u0000This case highlights the potential morbidity of fetal syphilis infection and underscores the paucity of current literature. Information sharing will be essential to build a modern knowledge base on treating this ancient disease.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"13 1","pages":"111-114"},"PeriodicalIF":0.0,"publicationDate":"2022-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81603821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Syphilis is an infection caused by Treponema pallidum spirochetes. The diagnosis of this sexually transmitted disease may be missed, partly due to the painless nature of genital ulcers in its primary stage. Women in Canada are screened for syphilis in their first trimester of pregnancy, but late pregnancy testing is not done in all provinces to date; therefore, undetected vertical transmission of syphilis may occur. This case emphasizes the importance of recognizing congenital syphilis in infants and young children with unexplained growth problems and biochemical and hematological abnormalities. Congenital syphilis remains a rare diagnosis, but in the context of increased syphilis rates in Canada during recent years, clinicians should consider this diagnosis in infants presenting with compatible clinical manifestations.
{"title":"Delayed diagnosis of maternal and congenital syphilis: An unrecognized epidemic?","authors":"Zachary Dionisopoulos, F. Kakkar, A. Blanchard","doi":"10.14745/ccdr.v48i23a10","DOIUrl":"https://doi.org/10.14745/ccdr.v48i23a10","url":null,"abstract":"Syphilis is an infection caused by Treponema pallidum spirochetes. The diagnosis of this sexually transmitted disease may be missed, partly due to the painless nature of genital ulcers in its primary stage. Women in Canada are screened for syphilis in their first trimester of pregnancy, but late pregnancy testing is not done in all provinces to date; therefore, undetected vertical transmission of syphilis may occur. This case emphasizes the importance of recognizing congenital syphilis in infants and young children with unexplained growth problems and biochemical and hematological abnormalities. Congenital syphilis remains a rare diagnosis, but in the context of increased syphilis rates in Canada during recent years, clinicians should consider this diagnosis in infants presenting with compatible clinical manifestations.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"221 1","pages":"115-118"},"PeriodicalIF":0.0,"publicationDate":"2022-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79889900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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