International Union for Circumpolar Health Ministry of Public Health and Social Development of RF Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Sciences Medical Polar Fund “Science” The Northern Forum

Abstracts

Seminar Infection Diseases in Arctic

Objectives: To describe the epidemiology and control of an extensive outbreak of tuberculosis (TB) in a remote Canadian First Nations (aboriginal) community, within the context of agent, host and environmental risk factors.

Study Design: Retrospective and prospective data collection during a community epidemic.

Methods: Meetings were held with the community to identify health concerns. Data on cases were collected retrospectively and prospectively from 1994-2005. Mycobacterium tuberculosis fingerprint patterns were identified. Blood was collected from community members for cytokine polymorphism (CP) analysis in terms of the genetic response to TB.

Results: In this community of 615 persons, the average annual incidence of TB from 1994-2004 was 636/100,000. Males comprised 86% of cases and 59% of cases occurred in those age 20-39 years. TB of the central nervous system occurred in 11% of cases compared to 1% of cases in other Canadian populations. A unique fingerprint was identified in the outbreak. All isolates were drug sensitive. Blood from a cross-section of the community is currently being analyzed for CP genetics. Environmental factors for spread of infection included severely crowded housing (average person per room 1.1 compared to Canadian average of 0.4). An aggressive control program of early diagnosis and mass preventive therapy was instituted in 2004. Community workers have been key to current successes. Plans are ongoing to analyze the virulence and possible neurotropism of this fingerprint. Improvement in housing conditions remains a priority for the community.

Conclusions: In this extensive outbreak, agent, host and environmental factors warranted an enhanced and aggressive program for early case detection, therapy and prevention. The entire community was offered skin testing and those with infection considered for Isoniazid through directly observed therapy.

Note. Abstracts are published in author's edition

© 1996-2005, Siberian Branch of Russian Academy of Sciences, Novosibirsk
Last update: 06-Jul-2012 (11:52:05)