To determine the incidence of meningitis caused by Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae in the North American Arctic during 2000-2010.
Surveillance data were obtained from the International Circumpolar Surveillance network. We defined a case of bacterial meningitis caused by H. influenzae, N. meningitidis, or S. pneumoniae as a culture-positive isolate obtained from a normally sterile site in a resident with a meningitis diagnosis.
The annual incidence/100,000 persons for meningitis caused by H. influenzae, N. meningitidis, and S. pneumoniae among all North American Arctic residents was: 0.6, 0.5, and 1.5, respectively; the meningitis incidence among indigenous persons in Alaska and Canada (indigenous status not recorded in Greenland) for those three bacteria was: 2.1, 0.8, and 2.4, respectively. The percentage of pneumococcal isolates belonging to a 7-valent pneumococcal conjugate vaccine serotype declined from 2000-2004 to 2005-2010 (31%-2%, p-value
Greenland 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.
Cross-sectional study.
314 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.
The 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).
We 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.
Notes
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Cites: MMWR Recomm Rep. 2006 Aug 4;55(RR-11):1-9416888612
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Cites: Sex Transm Infect. 2007 Jul;83(4):319-2317475688
The incidence of tuberculosis (TB) disease in Greenland doubled in the 1990s. To combat the increase, national TB interventions were initiated in 2000 and strengthened in 2007.
To determine whether the effect of interventions could be detected, we estimated the TB disease risk among children=15 years before and after interventions were implemented.
For a study cohort, we recruited all children =15 years of age included in the Greenlandic Civil Registration System (CRS) from 1990 to 2010. The CRS identifier was used to link cohort participants with TB cases identified based on the Greenlandic National TB registry. Bacille Calmette Guerin (BCG) vaccination status was identified through year of birth, as BCG was offered to newborns born either before 1991 or after 1996. Years with interventions were defined as 2000-2006 (primary interventions) and 2007-2010 (intensified interventions). Risk of TB was estimated using Poisson regression.
The study included 35,858 children, of whom 209 had TB disease. The TB disease incidence decreased after interventions were implemented (2007-2010: IRR [incidence rate ratios] 0.62, 95% CI: 0.39-0.95, p=0.03, compared with the 1995-1999 period). The TB disease risk was inversely associated with BCG vaccination (IRR: 0.54, 95% CI: 0.41-0.72, p
Notes
Cites: Int J Tuberc Lung Dis. 2001 Mar;5(3):257-6511326825
Cites: Int J Circumpolar Health. 2004;63 Suppl 2:221-415736656
In Denmark the tuberculosis (TB) incidence rates per 100.000 individuals per year have decreased from 162 in the 1920s to 6. Greenland is a highly endemic country for TB with an incidence rate that parallels that of India. Nine per cent of the Greenlandic children are infected with Mycobacterium tuberculosis. The global TB burden of disease is levelling off - even showing a small reduction in the estimated annual incidence rates. Drug resistance and HIV co-infection as well as diabetes pose great challenges in achieving the WHO/Stop TB partnership goals set out for 2015 and 2050.
