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PubMed2001

Injury mortality risk assessment and targeting the subpopulations for prevention in the Northwest Territories, Canada.

BACKGROUND AND OBJECTIVE: Prevention of injury mortality is a top priority for public health in the Northwest Territories, Canada. However, the frequency of injury mortality may not be evenly distributed in subgroups. Assessment of population relative risk of injury mortality can assist in better targeting of prevention programs. METHODS: A population-based case-control study consisting of 197 cases was used to quantify the relative risks of injury mortality for variables age, sex, ethnicity, geographic location and remoteness. RESULTS: A multivariate logistic model showed that the odds ratios were 2.90 (95% CI 2.09-4.03) for males, 3.39 (95% CI 2.55-4.52) for age group 15-64 years, 11.50 (95% CI 6.47-20.42) for age group over 64 years, 1.51 (95% CI 1.13-2.02) for people in remote communities, and 2.04 (95% CI 1.50-2.79) for people above 66 degrees latitude. Aboriginal people of Dene and Inuit presented increased risks in the stratified analysis by community remoteness and latitude. CONCLUSIONS: Males, over age 14, living in remote communities, living in the far north, and being aboriginal were at higher risk of injury mortality. Based on the relative risks of injury mortality and the population size in each subpopulation, injury prevention investments should be extended to remote communities.

Adolescent↗
PubMed1975

Neonatal hypertyrosinemia and evidence for deficiency of ascorbic acid in Arctic and subarctic peoples.

Hypertyrosinemia tyrosine concentration in whole blood greater than 0.42 mmol/l or 7.5 mg/dl is prevalent among lnuit newborn of the Canadian Eastern Arctic. The rate was 14.8 per 100 newborn between January 1970 and December 1972 (first survey period) and 6.2/100 between January 1973 and September 1974 (second survey period); the corresponding rates among Indian newborn of Nouveau Quebec were 2.6 and 2.2%. Among Anglo-Saxons the rate was less than 0.5% and in French Canada it commonly exceeded 0.94%. Serum concentrations of ascorbic acid were low (less than or equal to 0.25 mg/dl) in the pregnant and age-matched adult lnuit when measured by Nutrition Canada during the first survey period. The percentages of inuit children (up to 4 years old) and pregnant women at "high risk" for scurvy (serum concentration of ascorbic acid less than 0.2 mg/dl) were 14.8 and 47.1, respectively; the corresponding national percentages were 3.0 and 2.2, respectively. Deficiency of ascorbic acid in pregnant women is probably the cause of the unusual prevalence of neonatal hypertyrosinemia among the native Arctic and subarctic peoples because ascorbic acid is required to maintain optimal activity of p-hydroxyphenylpyruvic acid hydroxylase and to permit normal oxidation of tyrosine.

Adolescent↗
PubMedDate not supplied

Hepatitis A among residents of First Nations Reserves in British Columbia, 1991-1996.

BACKGROUND: Hepatitis A spreads by the fecal-oral route. We hypothesize that it is more common in Aboriginal communities because of poverty, crowded housing and inadequate or substandard water and sewage systems. METHODS: We tabulated on-reserve cases reported to First Nations and Inuit Health Branch, Health Canada. We obtained information on community water supply, sewage disposal and mean population per housing unit, from site inspections in a 1994 survey. RESULTS: Crude incidence on-reserve was 31 per 100,000 persons per year (95% CI: 25 to 37), twice as high as in the general population of BC (15.1 per 100,000). Higher incidence of hepatitis A was associated with more persons per housing unit and with presence of community water supply problems. CONCLUSIONS: An ecologic, multi-factorial approach to disease prevention is needed, including upgrading housing and sanitary infrastructure, specific measures (i.e., hepatitis A vaccination) and general measures (e.g., education, poverty reduction, population planning).

Adolescent↗
PubMed1992

Digital dermatoglyphic patterns of Eskimo and Amerindian populations: relationships between geographic, dermatoglyphic, genetic, and linguistic distances.

Dermatoglyphic traits have been used to assess population affinities and structure. Here, we describe the digital patterns of four Eskimo populations from Alaska: two Yupik-speaking villages from St. Lawrence Island and two Inupik groups presently residing on mainland Alaska. For a broader evolutionary perspective, these four Eskimo populations are compared to other Inuit groups, to North American Indian populations, and to Siberian aggregates. The genetic structures of 18 New and Old World populations were explored using R-matrix plots and Wright's FST values. The relationships between dermatoglyphic, blood genetic, geographic, and linguistic distances were assessed by comparing matrices through Mantel correlations and through partial and multiple correlations. Statistically significant relationships between dermatoglyphics and genetics, genetics and geography, and geography and language were revealed. In addition, significant correlations between dermatoglyphics and geography, with linguistic variation constant, were noted for females but not for males. These results attest to the usefulness of dermatoglyphics in resolving various evolutionary questions concerning normal human variation.

Alaska↗
PubMed1992

Infant mortality in Greenland: secular trend and regional variation.

Infant mortality and stillbirths were studied in the Inuit population of Greenland. Infant mortality rate decreased from 110 per 1000 live births in 1951 to 50 in 1970 and 20 in 1989. Statistically significant decrease was in particular seen for acute respiratory infections and certain perinatal conditions. Both perinatal and postperinatal mortality rates increased significantly with remoteness from the capital and were higher in settlements than in towns. The overall trend in Greenland is similar to the Danish pattern 30 years earlier, but there was pronounced regional variation. In towns, the infant mortality rate decreased continuously while in settlements an initial decrease was followed by a substantial increase during 1980-87 when the mortality rate doubled. The greater part of this increase could be attributed to an increased number of deaths in the postperinatal period countrywide during 1981-84 and an increased number of perinatal deaths in the settlements of one particular municipality during 1983-86.

Cause of Death↗
PubMed2004

Finding temporary relief: strategy for nursing recruitment in northern aboriginal communities.

To address a recurring shortage of nurses in the aboriginal communities of Northwestern Ontario, the First Nations and Inuit Health Branch, Health Canada, commissioned a study to explore the viability of establishing a relief pool among nurses from nearby small industrial towns. An open/close-ended survey completed by a random sample of 237 nurses from the target population documented levels of awareness, willingness, and preparedness for northern practice, as well as recruitment incentives and disincentives. Findings demonstrate an awareness of the overlap between the professional and personal dimensions characteristic of such practices, and suggest support for innovative rotations that would cut across federal/provincial/community jurisdictions. Although complex, given time and willingness, a regional relief system seems viable.

Humans↗
PubMed1992

Postvenereal Reiter's syndrome in Greenland.

Reiter's syndrome is very frequent in the Inuit of Greenland, because of high frequencies of venereal disease and HLA-B27. The authors report the results of the epidemiologic work and of the study of the effects of antibiotic treatment of venereal infection. In Reiter's syndrome patients, treatment of venereal infections by erythromycin or tetracycline was associated with a significant reduction in the rate of postvenereal arthritic flares.

Anti-Bacterial Agents↗
PubMed1975

Conjunctival papillomas in norther Canadian natives.

Cases of conjunctival papilloma evaluated at a hospital that acts as a referral centre for native people (Indian and Inuit) from northern Alberta and the Northwest Territories were compared with those from other hospitals in the same region whose referral base is primarily non-native. When the data were standardized for population unitsof 100,000 the tumours appeared to be occurring with a greater frequency among lnuit of the Western Arctic. These findings are supported statistically, although it is possible that bias may have been introduced by the small number of cases and other related factors.

Adolescent↗
PubMed1990

Atherosclerosis in native Greenlanders. An ultrasonographic investigation.

A low frequency of ischemic heart disease in Eskimos (Inuit) has been regarded as an expression of absent or low atherosclerosis. The true extent of atherosclerosis in the Eskimo populations of the World is not known due to low autopsy activity. In order to register atherosclerotic changes in the carotid and femoral arteries 61 Native Greenlanders from two settlements with a traditional Eskimo life style in the Uummannaq district of Northwestern Greenland were examined ultrasonographically with a portable scanner (Aloka) using a 7.5 MHz 4 cm linear array transducer. The results obtained were compared to an age and sex matched urban control group of 122 Danes from Copenhagen. The investigation showed that the Native Greenlanders had almost the same degree and extent of atherosclerosis in the carotid and femoral arteries as the Danes. Thus, the low incidence of ischemic heart disease in Native Greenlanders may not be attributed to lesser atherosclerosis. Further studies, particularly autopsy studies are needed.

Adult↗
PubMed1985

Food-borne botulism in Canada, 1971-84.

Sixty-one outbreaks of food-borne botulism involving a total of 122 cases, of which 21 were fatal, were recorded from 1971 to 1984 in Canada. Most occurred in northern Quebec, the Northwest Territories or British Columbia. Of the 122 victims 113 were native people, mostly Inuit. Most of the outbreaks (59%) were caused by raw, parboiled or "fermented" meats from marine mammals; fermented salmon eggs or fish accounted for 23% of the outbreaks. Three outbreaks were attributed to home-preserved foods, and one outbreak was attributed to a commercial product. The causative Clostridium botulinum type was determined in 58 of the outbreaks: the predominant type was E (in 52 outbreaks), followed by B (in 4) and A (in 2). Renewed educational efforts combined with a comprehensive immunization program would significantly improve the control of botulism in high-risk populations.

Animals↗
PubMed1988

Haemophilus influenzae meningitis in Manitoba and the Keewatin District, NWT: potential for mass vaccination.

A community-based surveillance study of all central nervous system infections was carried out in Manitoba and the Keewatin District, NWT, between Apr. 1, 1981, and Mar. 31, 1984. There were 201 cases of bacterial meningitis in Manitoba over the study period, 81 (40%) caused by Haemophilus influenzae; all but one isolate tested were type b (Hib). There were nine cases of H. influenzae meningitis in the Keewatin District. The overall annual incidence rate of H. influenzae meningitis in Manitoba was 2.5/100,000; for children under 5 years the rate was 32.1/100,000. For the Keewatin District the corresponding rates were 69.6/100,000 and 530/100,000. A total of 85% and 100% of the cases of H. influenzae meningitis occurred by 24 months of age in Manitoba and the Keewatin District respectively. The age at onset was earlier in native Indian children (22 cases) and Inuit children (9 cases) than in non-native children (59 cases) (p less than 0.005); thus, vaccine prevention of Hib meningitis will likely be more difficult in native Indian and Métis children. Without evaluating the increased potential of H. influenzae vaccines to prevent nonmeningitic forms of disease, we concluded that mass childhood vaccination with polyribosylribitolphosphate (PRP) vaccine is not warranted in Manitoba or the Keewatin District. Immunogenicity studies suggest that administration of conjugated Hib vaccines such as PRP-D in infancy may prevent approximately one-third to two-thirds of cases of H. influenzae meningitis; these vaccines warrant consideration for use in mass childhood vaccination programs.

Age Factors↗
PubMed1986

The seal finger: an unusual case of monoarticular sepsis.

We describe a case of monoarthritis in an Inuit seal hunter which progressed to joint destruction of the distal interphalangeal joint despite early and aggressive sequential antibiotic therapy with ampicillin, cloxacillin and penicillin G. In retrospect, had the entity of seal finger been diagnosed at the onset, appropriate antibiotic therapy with tetracycline may have prevented permanent joint damage.

Adult↗
PubMed1985

High prevalence of myopia among young adult Yupik Eskimos.

Myopia is common in Western populations but is considered rare in nonindustrialized population groups. However, studies in undeveloped areas of the Arctic and sub-Arctic have demonstrated increased rates of myopia among young Inuit adults indigenous to the region. We examined the refractive status of Yupik Eskimos, a group that had not previously been evaluated. Our subjects were young adults born between November 1960 and December 1962 to persons living in 10 villages in southwestern Alaska. The refractive status was obtained for 92% of these persons. The prevalence of myopia (refractive error -0.50 D or greater) was 68%, a rate among the highest reported for a general population anywhere in the world. The young women were significantly more myopic than the young men (mean refractive errors -1.91 and -1.36 D respectively). Astigmatism and myopia were positively correlated (r = 0.20, p less than 0.01). The etiology of myopia in this population is under study.

Alaska↗
PubMed1981

Arctic audiology: trials, tribulations, and occasional successes.

Efforts to provide audiologic services to the Inuit population of the Baffin Zone have frequently resulted in unexpected problems and frustrations. Often these are the product of two very different cultures coming together. This paper reviews the author's personal experiences in this regard with special reference to hearing aid attitudes, noise exposure, and the making of instructional audio-visual materials. A brief description of a recently revised hearing conservation program at Frobisher Bay is provided.

Arctic Regions↗
PubMed1984

Undifferentiated carcinoma with lymphoid stroma of the parotid gland.

Six cases of undifferentiated carcinoma of the parotid gland with heavy lymphocytic infiltration have been treated at Montreal General Hospital over the past 23 years. A thorough review of the literature revealed another 31 similar cases which are discussed. For unknown reasons, these malignant tumors seem to be more common in North American Inuit. Their relatively better prognosis may be attributed to the protective function of the heavy lymphocytic infiltration. Surgery has been the treatment of choice with postoperative radiotherapy in indicated cases. Longer follow-up is necessary to assess the role of lymphocytic infiltration in improving survival.

Adolescent↗
PubMed1995

Drug prescription to children living in the Arctic. An investigation from Nuuk, Greenland.

The prescription pattern to children living in an arctic environment (Nuuk, Greenland) is similar to the pattern seen in other countries e.g. Sweden, Norway or the US, but the prescription rate of both anti-infectives and the total number of drugs is 2-3 times larger. This may reflect differences both in socioeconomic factors, in disease patterns and in sickness rate in children living in the Arctic. Inuit children are known to have a disease pattern that partly differs from the one seen elsewhere. Most drugs were prescribed to the youngest children who also received less phenoxymethylpenicillin and more other anti-infectives. 2/3 of all drugs were prescribed during the winter (November to April). A small group of large scale consumers, 116 children or 7% of the children prescribed drugs, were prescribed anti-infective drugs 3 times or more and were prescribed more than 1/5 of all drugs to children in Nuuk in the year surveyed.

Adolescent↗
PubMedDate not supplied

Proceedings of the Alaskan and Russian Natives' Health and Social Issues Conference Alaska.

An Alaska-Russia Native People's Health and Social Issues Conference, sponsored by the Alaska Department of Health and Social Services, the Alaska Native Foundation, the University of Anchorage Institute for Circumpolar Health Studies, The International Scientific Center 'ARTIKA' (Magadan, Russia), the Associations of Native People of Chukotka and Kolyma, and the Magadan Native Association, was held in Wasilla, Alaska in May, 1992. The conference brought together Native people, primarily health and social services workers, to discuss differences and similarities in issues and approaches, and to lay the foundation for future collaboration. The primary participants came mostly from rural villages and small regional cities, and represented Native Health Corporations, Native Associations, and villages. Additional participants came form the University of Alaska, the Alaska Department of Health and Social Services, the Indian Health Service, the Magadan Health Department, the Inuit Circumpolar Conference, and the International Circumpolar Health Union. A total of 39 people participated, including: eight Russian Natives (Chukchi, Even, and Siberian Yup'ik); three non-Native Russians; 18 Alaska Natives (Aleut, Athabaskan, Inupiat, Siberian Yup'ik, Yup'ik); nine non-Native Alaskans; one Canadian. The issues discussed in individual and panel presentations, and in small groups, included history, demography, settlement patterns, the cash and subsistence economies, mental and physical health (epidemiology, etiology, treatment and prevention), education, governance, culture and language.(ABSTRACT TRUNCATED AT 250 WORDS)

Alaska↗
PubMed1994

Congenital and hereditary visual impairment in Greenland.

Thirty-eight cases of congenital visual impairment (CVI) were reported in the Inuit population of Greenland over a period of 40 years (1950-1989), corresponding to a frequency of 86 per 100,000 live born children. The two most common causes of blindness were optic atrophy and cerebral visual impairment due to brain disorders of various etiologies. This finding is in accordance with recently published data from the Nordic countries. On the other hand, retinopathy of prematurity and congenital cataract were rare causes of CVI in Greenland. Fifteen out of the 38 cases had unknown etiology. Genetic disorders accounted for 7/38 of the cases. A separate examination of registered cases with probable genetic visual impairment, irrespective of birth year, disclosed 25 patients. New mutations seemed to be the most reasonable explanation for isolated cases of aniridia, lens ectopia, and Down syndrome, while inbreeding was a possible contributory factor in a few autosomal recessive conditions.

Adolescent↗