Indoor air quality risk factors for severe lower respiratory tract infections in Inuit infants in Baffin Region, Nunavut: a pilot study

Kovesi, Tom; Creery, David; Gilbert, Nicolas L.; Dales, Robert; Fugler, Don; Thompson, BR; Randhawa, N.; Miller, J. David

doi:10.1111/j.1600-0668.2006.00423.x

Cited by 62 publications

(47 citation statements)

References 53 publications

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“…Studies in Alaskan aboriginal populations suggest that continued low-level nasopharangeal colonization facilitates transmission to susceptible children (4). Environmental and housing conditions, including overcrowding, are also potential contributing factors to these health disparities (27)(28)(29). The data also indicate an apparent emergence of type a disease, with all Hia cases occurring among aboriginal persons.…”

Section: Discussionmentioning

confidence: 81%

Invasive Bacterial Diseases in Northern Canada

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Deeks

et al. 2008

Emerg. Infect. Dis.

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International Circumpolar Surveillance (ICS) is a population-based invasive bacterial disease surveillance network. Participating Canadian regions include Yukon, Northwest Territories, Nunavut, and northern regions of Québec and Labrador (total population 132,956, 59% aboriginal). Clinical and demographic information were collected by using standardized surveillance forms. Bacterial isolates were forwarded to reference laboratories for confi rmation and serotyping. After pneumococcal conjugate vaccine introduction, crude annual incidence rates of invasive Streptococcus pneumoniae decreased from 34.0/100,000 population (1999)(2000)(2001)(2002)) to 23.6/100,000 population (2003)(2004)(2005); substantial reductions were shown among aboriginals. However, incidence rates of S. pneumoniae, Haemophilus infl uenzae, and group A streptococci were higher in aboriginal populations than in non-aboriginal populations. H. infl uenzae type b was rare; 52% of all H. infl uenzae cases were caused by type a. Data collected by ICS contribute to the understanding of the epidemiology of invasive bacterial diseases among northern populations, which assists in formulation of prevention and control strategies, including immunization recommendations.

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Section: Discussionmentioning

confidence: 81%

Invasive Bacterial Diseases in Northern Canada

Degani

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Deeks

et al. 2008

Emerg. Infect. Dis.

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“…Prematurity, tobacco smoke exposure (prenatal and postnatal), overcrowding and poor ventilation are all risk factors for respiratory infections and hospital admissions for Inuit children living in Nunavut [37,38]. Although tobacco smoke exposure data were limited in this review, environmental tobacco smoke is reported to be present in ~90% of Nunavut homes, which are small, overcrowded and have low air change rates [39]. …”

Section: Discussionmentioning

confidence: 99%

Causes and risk factors for infant mortality in Nunavut, Canada 1999–2011

et al. 2012

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BackgroundThe northern territory Nunavut has Canada’s largest jurisdictional land mass with 33,322 inhabitants, of which 85% self-identify as Inuit. Nunavut has rates of infant mortality, postneonatal mortality and hospitalisation of infants for respiratory infections that greatly exceed those for the rest of Canada. The infant mortality rate in Nunavut is 3 times the national average, and twice that of the neighbouring territory, the Northwest Territories. Nunavut has the largest Inuit population in Canada, a population which has been identified as having high rates of Sudden Infant Death Syndrome (SIDS) and infant deaths due to infections.MethodsTo determine the causes and potential risk factors of infant mortality in Nunavut, we reviewed all infant deaths (<1yr) documented by the Nunavut Chief Coroner’s Office and the Nunavut Bureau of Statistics (n=117; 1999–2011). Rates were compared to published data for Canada.ResultsSudden death in infancy (SIDS/SUDI; 48%) and infection (21%) were the leading causes of infant death, with rates significantly higher than for Canada (2003–2007). Of SIDS/SUDI cases with information on sleep position (n=42) and bed-sharing (n=47), 29 (69%) were sleeping non-supine and 33 (70%) were bed-sharing. Of those bed-sharing, 23 (70%) had two or more additional risk factors present, usually non-supine sleep position. CPT1A P479L homozygosity, which has been previously associated with infant mortality in Alaska Native and British Columbia First Nations populations, was associated with unexpected infant death (SIDS/SUDI, infection) throughout Nunavut (OR:3.43, 95% CI:1.30-11.47).ConclusionUnexpected infant deaths comprise the majority of infant deaths in Nunavut. Although the CPT1A P479L variant was associated with unexpected infant death in Nunavut as a whole, the association was less apparent when population stratification was considered. Strategies to promote safe sleep practices and further understand other potential risk factors for infant mortality (P479L variant, respiratory illness) are underway with local partners.

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“…Although earlier studies suggested that indoor nitrogen dioxide concentration was associated with lower respiratory tract infection in infants, 38 this has not been supported by recent investigations. 39,40 In our Cape Dorset pilot study, 14 we did not find elevated indoor nitrogen dioxide concentrations. Lower respiratory tract infection in children has been associated with reported mould and indoor fungal exposure.…”

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confidence: 82%

“…It was translated into Inuktitut when necessary and administered by a community liaison officer from the Qikiqtani Inuit Association. 15,20 Data were collected about the child's age and sex, prior episodes of bronchiolitis or pneumonia, prior visits to the local nursing station, admissions to hospital, any prior history of prematurity or asthma, home occupancy and exposure to environmental tobacco smoke. These liaison officers had no background in health care or research, but they were trained by the senior investigator (T.K.)…”

Section: Study Populationmentioning

confidence: 99%