A descriptive analysis of notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991–2008

Abstract

ObjectivesTo describe the major characteristics of reported notifiable gastrointestinal illness (NGI) data in the Northwest Territories (NWT) from January 1991 through December 2008.DesignDescriptive analysis of 708 reported cases of NGI extracted from the Northwest Territories Communicable Disease Registry (NWT CDR).SettingPrimary, secondary and tertiary health care centres across all 33 communities of the NWT.PopulationNWT residents of all ages with confirmed NGI reported to the NWT CDR from January 1991 through December 2008.Main outcome measureLaboratory-confirmed NGI, with a particular emphasis on campylobacteriosis, giardiasis and salmonellosis.ResultsCampylobacteriosis, giardiasis and salmonellosis were the most commonly identified types of NGI in the territory. Seasonal peaks for all three diseases were observed in late summer to autumn (p<0.01). Higher rates of NGI (all 15 diseases/infections) were found in the 0–9-year age group and in men (p<0.01). Similarly, rates of giardiasis were higher in the 0–9-year age group and in men (p<0.02). A disproportionate burden of salmonellosis was found in people aged 60 years and older and in women (p<0.02). Although not significant, the incidence of campylobacteriosis was greater in the 20–29-years age group and in men (p<0.07). The health authority with the highest incidence of NGI was Yellowknife (p<0.01), while for salmonellosis and campylobacteriosis, it was Tlicho (p<0.01) and for giardiasis, the Sahtu region (p<0.01). Overall, disease rates were higher in urban areas (p<0.01). Contaminated eggs, poultry and untreated water were believed by health practitioners to be important sources of infection in cases of salmonellosis, campylobacteriosis and giardiasis, respectively.ConclusionsThe general patterns of these findings suggest that environmental and behavioural risk factors played key roles in infection. Further research into potential individual and community-level risk factors is warranted.

The need for community-led, integrated and innovative monitoring programmes when responding to the health impacts of climate change

“…Although climate change is recognised as having numerous effects on health and wellbeing [1][2][3][4][5][6][7][8][9][10], this research discovered that few monitoring programmes integrated both environment and health indicators in their programmes in a holistic way. The lack of integration between environmental and health indicators may point to a lack of integration between environmental and health monitoring more broadly, which is particularly problematic for Indigenous communities that conceptualise wellbeing as closely tied to the environment and land [10][11][12]21,27,30,65]. Additionally, the analysis of indicators revealed a paucity of community-based monitoring programmes focused on mental wellbeing, which should be addressed for many reasons, including the intimate connections between climate change and Indigenous mental wellbeing that have been identified by community members and researchers alike [2][3][4][5][6].…”

“…This is particularly important for Indigenous communities, who are often inadequately engaged in monitoring programmes [63][64][65]. Although public health monitoring is strong in many Circumpolar nations, 2 there is a continued need to adequately use Indigenous Knowledge in these programmes in a meaningful way; failure to do so has led to various gaps and challenges in coverage, data quality and relevance [4,[10][11][12]21,26,27,[29][30][31]65].…”

Wastewater treatment and public health in Nunavut: a microbial risk assessment framework for the Canadian Arctic

“…The total volume and duration of effluent being discharged were suggested as the most important factors influencing the level of environmental impact. (Goldfarb et al 2013;McKeown et al 1999;Messier et al 2012;Pardhan-Ali et al 2012a, 2012b. Although AGI is associated with many food-and water-borne pathogens as well as being transmissible person-to-person, it may be the most relevant health outcome to use for a risk assessment of wastewater systems in the region at this time given the absence of pathogen-specific data.…”

How does the media portray drinking water security in Indigenous communities in Canada? An analysis of Canadian newspaper coverage from 2000-2015

“…For instance, untreated water was a suspected source of Giardia infection accounting for 29% of notifiable gastrointestinal illness in the Northwest Territories [25]. Furthermore, about a third of residents of the Nunavik Inuit region consume untreated water, placing some Inuit at increased risk for waterborne gastroenteritis [26, 27].…”