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PubMed2003

A canine distemper outbreak in Alaska: diagnosis and strain characterization using sequence analysis.

Vaccination with modified-live vaccines has been very effective in reducing the incidence of canine distemper, a disease that can be devastating in unvaccinated populations. A diagnostic submission to the Animal Health Diagnostic Laboratory at Michigan State University, East Lansing, Michigan, involved a case in which several hundred dogs in an Alaskan town died in a suspected canine distemper outbreak. Cytoplasmic and intranuclear eosinophilic inclusion bodies, consistent with canine distemper virus (CDV) infection, were found in urinary bladder, spleen, lung, and salivary gland. Direct fluorescent antibody test gave results that could be considered positive for canine distemper. Because of the condition of the tissues received, the histopathology and fluorescent antibody-staining results were suggestive but not conclusive of CDV. In this study, immunohistochemistry, reverse transcriptase-polymerase chain reaction (RT-PCR), and DNA sequencing were used to confirm the presence of canine distemper virus in these tissues and to perform molecular characterization of the virus. Immunohistochemistry showed the presence of the virus in spleen, lung, and salivary gland. Viral RNA was detected by RT-PCR in brain, spleen, liver, lung, and kidney, both with nucleoprotein and phosphoprotein (P)-gene-specific primers. Sequence alignment and phylogenetic analysis of a 540-bp P-gene fragment of the Alaskan strain with corresponding sequences of 2 vaccine and 7 wild-type CDV strains showed that the virus responsible for the outbreak was closely related to a virulent strain of distemper virus from Siberia.

Alaska↗
PubMed2006

Research and educational approaches to reducing health disparities among American Indians and Alaska Natives.

Research and educational programs have the potential to improve health care. American Indians (AIs) suffer from considerable health disparities as compared with the general U.S. population, including significantly higher incidence and prevalence of preventable diseases like diabetes, alcoholism, and their complications. Underfunding of health programs, including the Indian Health Service, and lower socioeconomic status among AIs contribute to these disparities. Improvements in disease prevention and treatment potentially offered by research and health education programs could help to reduce health disparities. However, a history of nonparticipation in the research process and a history of dishonest research practices have raised barriers to conducting research in AI communities. Additional barriers are generated from a shortage of AI researchers and health care professionals. A research paradigm that includes the community as a full partner is necessary to promote research and education in AI communities and to translate health research into reductions in health disparities.

Alaska↗
PubMed2004

"Here's what I'd do...": condom promotion strategies proposed by high-risk women in Anchorage, Alaska.

Women drug users are at significant risk of sexually transmitted HIV; however, interventions aimed at increasing condom use by this population have been relatively ineffective. The authors conducted a series of focus groups with 17 current and former drug-using women to identify (a) reasons for using versus not using condoms, (b) intervention strategies they believed would be most effective at increasing condom use, and (c) previous ineffective intervention strategies. Risk of HIV, sexually transmitted diseases, and pregnancy was the main reason given for using condoms. Many factors were identified that limited condom use, including lack of availability, substance use, and cost. Participants enthusiastically endorsed condom availability and AIDS awareness interventions, and suggested that no intervention was a waste of money. The authors discuss the limitations of the suggested interventions and recommend additional research to evaluate the efficacy of these strategies.

Adult↗
PubMed2006

California American Indian and Alaska natives tribal groups' care access and utilization of care: policy implications.

Background. We used the 2001 California Health Interview Survey (CHIS) to examine differences in cancer care access and utilization by subgroups of American Indian and Alaskan Natives (AIAN). Methods. The CHIS 2001 includes over 55,000 Californian households, with an oversampling of California American Indian, non-California AIAN, and unknown AIAN tribal groups. Results. We found significant differences among the 3 tribal subgroups for various measures of health care coverage and utilization. Conclusions. AIAN must be disaggregated to provide appropriate data for public health and policy making.

Adolescent↗
PubMed1996

Inhalant use patterns among Eskimo school children in western Alaska.

An inhalant use survey was administered to 376 school children in 14 isolated villages. Questions in the survey elicited gender and ethnic distribution, frequency and duration of use, age of onset, reasons for using and inhalant of choice. These characteristics were further examined by dividing users into 2 groups based on use frequency and duration, i.e., Light Users and Heavy Users. Lifetime prevalence was 48%. Most inhalant use appeared to be sporadic, transient and occurring in social context. Heavy Users differed from Light Users in that they were more likely to be male, have an earlier age of onset, have different ethnic distribution and use inhalants in response to affect. These children may represent an inhalant dependent subgroup. This finding of user heterogeneity has important implications for the development of effective prevention and treatment programs.

Adhesives↗
PubMed2006

Asthma hospitalizations among American Indian and Alaska Native people and for the general US population.

STUDY OBJECTIVES: Asthma is one of the most common chronic diseases in the United States. High rates of asthma hospitalization have been reported for some ethnic minorities; however, asthma hospitalization rates for American Indian/Alaska Native (AI/AN) populations of all ages have not been studied. In this study, we examined and compared hospitalization rates for AI/AN populations and the general population in the United States. DESIGN: Hospital discharge records with a first-listed diagnosis of asthma were evaluated for AI/AN populations and the US general population of all ages from 1988 to 2002. RESULTS: The asthma hospitalization rate for AI/AN populations decreased from 17.8/10,000 per year in 1988 to 1990 to 12.9/10,000 per year in 2000 to 2002. The overall age-adjusted rate for 2000 to 2002 was slightly lower than that for the general US population (12.9/10,000 and 16.4/10,000, respectively). However, AI/AN populations living in the Southwest region (17.6/10,000) had the highest asthma hospitalization rate among the Indian Health Service regions and the rate from 2000 to 2002 was similar to that for the general US population. The 2000 to 2002 asthma hospitalization rate for AI/AN populations < 1 year of age (infants) was higher than that in US infants, and the rates for AI/AN age groups > or = 1 year were similar to or lower than those for the general US population. CONCLUSIONS: While asthma was rarely reported among AI/AN populations before 1975, the average annual age-adjusted asthma hospitalization rate was only slightly lower for AI/AN populations than that for the US general population from 2000 to 2002. Furthermore, the asthma hospitalization rates for AI/AN populations living in the Southwest and East regions were similar to the rate for the general US population. Efforts to further increase asthma awareness and symptom recognition among AI/AN populations should be implemented to help to reduce asthma hospitalizations.

Adolescent↗
PubMed2004

Surveillance systems monitoring HIV/AIDS and HIV risk behaviors among American Indians and Alaska Natives.

Few published reports describe patterns of occurrence of HIV/AIDS among American Indian/Alaska Native (AI/AN) people nationally. Data from national surveillance systems were examined to describe the spread of HIV/AIDS and the prevalence of HIV-related risk behaviors among AI/AN people. These data indicate that HIV/AIDS is a growing problem among AI/AN people and that AI/AN youth and women are particularly vulnerable to the continued spread of HIV infection.

Adolescent↗
PubMed2004

Health and support service utilization patterns of American Indians and Alaska Natives diagnosed with HIV/AIDS.

The purpose of this analysis is twofold: to examine the types of health and support services provided by CARE Act funded providers to American Indians/Alaska Natives and to compare the characteristics and service utilization patterns for this group with those of individuals from other racial/ethnic groups. We present an analysis of the demographic characteristics, service utilization, and health outcomes of all HIV-infected clients who received services in five geographic areas at agencies that were funded through the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. Standard chi-square tests were used to test for statistically significant differences (p <.05) between the demographic characteristics and service utilization patterns of matched pairs of HIV-positive American Indian/Native Alaskans with HIV-positive individuals of other racial and ethnic backgrounds. Individuals were matched on gender, age, insurance, AIDS diagnosis, and site. Other data examined include client characteristics (income, homelessness, HIV exposure category, and source of health care), health indicators (CDC-defined disease stage, CD4+ counts, substance abuse and psychiatric illness) and service utilization (medical care; mental health treatment/counseling; substance abuse treatment/counseling; case management; dental care; housing, food, emergency financial, and transportation assistance, and buddy/companion and client advocacy services). There were no statistically significant differences between the two groups for HIV exposure category, CD4 count, substance abuse problem, and being homeless and in their likelihood to receive medical care, mental health or substance abuse treatment/counseling, dental care, food, emergency financial, and transportation assistance, as well as buddy/companion and client advocacy services. They were more likely (55% vs. 46%) to receive case management services than the matched individuals from other racial/ethnic groups. They were also more likely to receive housing assistance (35% vs. 25%). The analysis provides evidence that when individuals are matched on key demographic and health characteristics, few differences remain between HIV-positive American Indians/Native Alaskans and other racial/ethnic groups. The two exceptions are case management and housing assistance. The significantly higher use of case management is not surprising, given the emphasis by American Indians/Alaska Natives on traditional Native American case management case management. In contrast, the significantly higher use of housing assistance by American Indians/Alaska Natives was unexpected. Exploring the potential need for housing assistance among all American Indians/Alaska Natives served by the Ryan White CARE Act needs to be considered.

Adult↗
PubMed2005

Gastroenteritis outbreak among mountaineers climbing the West Buttress route of Denali - Denali National Park, Alaska, June 2002.

OBJECTIVE: To determine the burden of and risk factors for diarrheal illness among mountaineers climbing Denali during the spring of 2002. METHODS: We conducted a retrospective cohort study of all willing and available climbers who returned to base camp from June 11 to 14, 2002. We used a questionnaire that addressed illness status, demographics, and potential risk factors for illness. A case of diarrhea was defined as self-reported diarrhea (loose stool) in a Denali climber who did not have diarrhea before arrival at base camp. RESULTS: Thirty-eight (29%) of the 132 climbers who were interviewed reported experiencing diarrhea at some point on the mountain. Spending 8 or more days at the 17 200-foot high camp; being a member of a climbing party in which at least 1 other person also had diarrhea, especially if tent occupancy was 3 or more; and not receiving education about disease risk-reduction techniques among climbers who were on a guided expedition were associated with increased risk of illness. CONCLUSIONS: To prevent infectious diarrheal outbreaks among mountaineers climbing Denali (and other highly trafficked alpine routes), we recommend that park staff provide climbers with detailed information related to minimizing disease risk and develop more effective strategies for preventing climbers from depositing fecal material directly into snow along the route, such as establishing and enforcing firmer penalties for noncompliance with existing human waste disposal regulations and requiring the use of personal stool-hauling devices.

Adolescent↗
PubMed2004

Polycyclic aromatic hydrocarbon levels in mussels from Prince William Sound, Alaska, USA, document the return to baseline conditions.

Bioavailable hydrocarbons in the Exxon Valdez oil spill zone in Prince William Sound (PWS; AK, USA) shorelines were at or near background levels in 2002, as indicated by low concentrations of polycyclic aromatic hydrocarbons (PAHs) in mussels (Mytilus trossulus) collected from sites throughout PWS. Total PAH (TPAH) minus parent naphthalene concentrations in mussels collected in 1998 to 2002 from sites oiled in 1989 were at or near reference-site values. Both oiled and reference sites included locations associated with past human and industrial activity (HA). Inclusion of the unoiled HA sites in the range of reference sites that define prespill conditions is consistent with federal regulations. For the period from 1998 to 2002, the geometric mean of TPAH concentrations for 218 mussel samples collected from 72 sites, including four HA sites that had been heavily oiled in 1989, is 54 ng/g dry weight (range, 2-1,190 ng/g). The maximum mussel TPAH concentrations are equivalent to a weathered-oil exposure dose to intertidal foragers that is one to three orders of magnitude less than the doses shown to cause sublethal effects in surrogate species. The geometric mean of TPAH concentrations for mussel samples from 28 locations not oiled in 1989 and unaffected by human use (NHA sites) is 28 ng/g (range, 3-355 ng/g), whereas the geometric mean of TPAH concentrations for mussel samples from 14 locations not oiled in 1989 and affected by human use (HA sites) is 106 ng/g (range, 2-12,056 ng/g). The range of data for the unoiled HA and NHA sites defines the background of bioavailable PAHs to mussels on western PWS shorelines that would have prevailed if the oil spill had not occurred. The low PAH concentrations in mussels from sites known to have subsurface oil residues demonstrates the low bioavailability of these spill remnants and, thus, are a low additional risk to foraging wildlife. The present study shows continuous exposure from four- to six-ring PAHs originating at HA sites in western PWS. At low concentrations, these PAHs are known to cause adverse biological effects. However, in the context of PWS, oiled and HA sites represent a small percentage (approximately 0.1-0.2%) of the total PWS shoreline.

Accidents↗
PubMed2005

Tuberculosis among American Indians and Alaska Natives in the United States, 1993-2002.

OBJECTIVES: I examined trends in and epidemiological and clinical characteristics of tuberculosis (TB) within the American Indian/Alaska Native (AIAN) population of the United States and compared TB trends and characteristics in that population with TB trends and characteristics within other racial/ethnic groups. METHODS: I analyzed all verified cases of TB reported to the US National Tuberculosis Surveillance System from January 1, 1993, to December 31, 2002. RESULTS: From 1993 through 2002, 196133 TB cases were reported, 2612 (1.3%) of which were in the AIAN population. During this period, TB case rates declined 40.4% among AIAN peoples, the smallest decrease among any US-born racial/ethnic group. In 2002, 15075 TB cases (5.2 per 100000 population) were reported, 180 of which were in the AIAN population (8.4 per 100000 population)-almost 6 times the rate for non-Hispanic Whites (1.5 per 100000 population). CONCLUSIONS: TB continues to be a significant health problem for the AIAN population. Vigilance and collaboration among local, state, federal, AIAN, and tribal TB control programs are essential to TB elimination among the AIAN population.

Adolescent↗
PubMed2005

Causes of visual impairment and common eye problems in Northwest American Indians and Alaska Natives.

OBJECTIVES: Little information exists regarding the causes of visual impairment and the most common eye problems in American Indians/Alaska Natives. METHODS: We randomly sampled American Indians/Alaska Natives older than 40 years from 3 tribes within the Northwest region. RESULTS: We found a higher prevalence of visual impairment and normal-tension glaucoma, as well as a lower prevalence of ocular hypertension, in American Indians/Alaska Natives compared with previous results in other racial/ethnic groups. CONCLUSIONS: American Indians/Alaska Natives have a need for vision correction. Future interventions in American Indians/Alaska Natives should include providing spectacles for refractive error, detecting glaucoma, and preventing visual impairment from age-related maculopathy and cataracts.

Adult↗