ObjectivesGreenland reports the highest rates of chlamydial infection and gonorrhea in the Arctic. Our objective was to determine the presence, and describe the basic epidemiology, of Mycoplasma genitalium for Greenland.Study designCross-sectional study.Methods314 residents from Nuuk and Sisimiut, between the ages of 15 and 65 years, participated in “Inuulluataarneq” (the Greenland Sexual Health Project) between July 2008 and November 2009. Participants provided self-collected samples for sexually transmitted infection (STI) testing and completed a sexual health survey. Descriptive statistics and logistic regression were used to summarize the basic characteristics of STI cases overall and M. genitalium and Chlamydia trachomatis specifically. Clinically relevant characteristics in each full model were gender (male or female), age (in years), age at sexual debut (in years), number of sexual partners in the past 3 months (continuous) and history of forced sex and community.ResultsThe overall prevalence of STIs was 19.0%, specifically: 9.8% for M. genitalium and 9.4% for C. trachomatis; 100% of M. genitalium-positive cases carried macrolide resistance determinants. Being female [OR =3.2; 95% confidence interval (CI): 1.1–9.8] and younger age (OR=0.9; 95% CI: 0.9–1.0) were associated with M. genitalium positivity. Age was also associated with C. trachomatis (OR=0.9; 95% CI: 0.8–0.9) and STI positivity overall (OR=0.9; 95% CI: 0.9–0.9).ConclusionsWe observed a high prevalence of M. genitalium and macrolide resistance in this study. A better understanding of M. genitalium sequelae is needed to inform policy around testing, treatment, control and antibiotic use.
BackgroundThe British Columbia Perinatal Data Registry (BCPDR) contains individual-level obstetrical and neonatal medical chart data for virtually all births occurring in British Columbia, Canada. The objective of this study was to assess the validity of information in the BCPDR by performing a provincial chart re-abstraction study.MethodsA two-stage stratified clustered sampling design was employed. Obstetrical facilities were stratified based on geographic location and obstetrical volume. Charts of mothers and newborns with a length of stay of five or more days or transfer to another facility following the delivery were oversampled. A total of 85 maternal and 32 newborn variables were assessed for completeness (percent completion) and validity (sensitivity and specificity for categorical variables, intra-class correlation coefficient [ICC] for continuous variables).Results1,084 maternal and 1,142 newborn charts were abstracted. Mandatory variables such as primary indication for induction and primary indication for cesarean delivery were 100 % complete. Some variables such as pre-pregnancy weight were relatively more complete in the re-abstraction as compared with the BCPDR (83.0 % vs 76.8 %; p < 0.001). The validity of key surveillance variables was high (e.g., HIV screening completed [sensitivity 98.0 %, 95 % confidence interval (CI) 97.0–98.8 %; specificity 72.3 %, 95 % CI 60.8–81.9 %], induction of labour [sensitivity 93.9 %, 95 % CI 90.2–96.5 %; specificity 98.7 %, 95 % CI 97.7–99.3 %], primary elective cesarean delivery [sensitivity 96.0 %, 95 % CI 83.8–99.7 %; specificity 99.8 %, 95 % CI 99.4–100.0 %], gestational age from newborn examination [ICC 0.99, 95 % CI 0.99–0.99]). Examples of variables with lower validity included total admissions prior to delivery episode, maternal smoking status, and timing of breastfeeding initiation.ConclusionMany important clinical and population health variables in the BCPDR had excellent validity. Some key variables warrant strengthening through improved definitions, system changes, and abstractor training.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-015-0563-7) contains supplementary material, which is available to authorized users.
BackgroundIn 2016, a public health emergency was declared in British Columbia due to an unprecedented number of illicit drug overdose deaths. Injection drug use was implicated in approximately one third of overdose deaths. An innovative delivery model using mobile supervised consumption services (SCS) was piloted in a rural health authority in BC with the goals of preventing overdose deaths, reducing public drug use, and connecting clients to health services.MethodsTwo mobile SCS created from retrofitted recreational vehicles were used to serve the populations of two mid-sized cities: Kelowna and Kamloops. Service utilization was tracked, and surveys and interviews were completed to capture clients’, service providers’, and community stakeholders’ attitudes towards the mobile SCS.ResultsOver 90% of surveyed clients reported positive experiences in terms of access to services and physical safety of the mobile SCS. However, hours of operation met the needs of less than half of clients. Service providers were generally dissatisfied with the size of the space on the mobile SCS, noting constraints in the ability to respond to overdose events and meaningfully engage with clients in private conversations. Additional challenges included frequent operational interruptions as well as poor temperature control inside the mobile units. Winter weather conditions resulted in cancelled shifts and disrupted services. Among community members, there was variable support of the mobile SCS.ConclusionsOverall, the mobile SCS were a viable alternative to a permanent site but presented many challenges that undermined the continuity and quality of the service. A mobile site may be best suited to temporarily provide services while bridging towards a permanent location. A needs assessment should guide the stop locations, hours of operation, and scope of services provided. Finally, the importance of community engagement for successful implementation should not be overlooked.
Background: During the coronavirus disease 2019 (COVID-19) pandemic, temporary foreign workers (TFWs) provided a critical role to maintaining the food supply in Canada, yet workers faced a number of challenges that made them particularly vulnerable to COVID-19. The objective of this study was to describe the epidemiological investigation and public health response to a COVID-19 outbreak among TFWs in an agricultural setting in British Columbia from March to May 2020. Methods: An outbreak was declared on March 28, 2020 following detection of two cases of COVID-19 among a group of 63 TFWs employed by a nursery and garden centre. Outbreak control measures included immediate isolation of cases, case finding via outreach screening and testing, cohorting of asymptomatic workers and enhanced cleaning and disinfection. The outbreak was declared over on May 10, 2020. Results: A total of 26 COVID-19 cases were identified among the group of TFWs; no cases were identified among local workers. Cases were primarily male (77%) with a median age of 41 years. Symptom onsets ranged from March 8 to April 9, 2020. One case required overnight hospitalization for pneumonia. Conclusion: This was the first COVID-19 community outbreak identified in British Columbia and the first COVID-19 outbreak identified among TFWs in Canada. This outbreak began prior to implementation of provincial and federal quarantine orders for international travellers. A provincial policy was later developed that requires TFWs to quarantine in government-funded accommodation prior to deployment to agricultural settings.
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