An epidemiological survey of chlamydial and gonococcal infections in a Canadian arctic community.
BACKGROUND
Sexually transmitted infections are leading causes of morbidity for Canadian Aboriginal women. To date, very few initiatives have been successful in screening, treating, and limiting these infections among these populations.


OBJECTIVE
To evaluate the efficacy of universal screening, treatment and contact tracing as a means of capturing a more accurate count of chlamydia and gonorrhea prevalence and limiting transmission among Inuit communities.


METHODS
181 participants were screened for chlamydia and gonorrhea and interviewed in a cross-sectional survey (Aug-Sept/03). Information was collected on demographics, use of health services, sexual histories and STI knowledge among others. A random sample (n = 100) from the cross-sectional group was selected for the longitudinal cohort. Individuals were followed every two months post baseline for four visits (Oct/03-May/04). At each visit, participants were screened for chlamydia/gonorrhea. All positive cases and their partners were treated and contact tracing completed. Logistic Regression analysis and the McNemar Test of Correlated Proportions were used to analyze the data.


RESULTS
Overall, 35 cases of chlamydia were detected, with 21 detected at baseline and 14 during follow-up. The baseline prevalence was 11.6% in comparison with 2.7% that was previously estimated. No gonorrhea was detected. The strongest factor associated with a positive chlamydia was having recent STI (OR 9.82, CI: 2.70, 35.77).


CONCLUSIONS
Consistent with the literature, the results support the use of universal screening followed by prompt treatment and contact tracing in populations with greater than 10% chlamydia prevalence.
Steenbeek
Audrey
A
School of Nursing, Dalhousie University, NS, Canada. a.steenbeek@dal.ca
Tyndall
Mark
M
Sheps
Samuel
S
Rothenberg
Richard
R
D000328:Adult; D002170:Canada / Q000453:epidemiology; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D002692:Chlamydia trachomatis; D016358:Contact Tracing; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D006801:Humans; D007407:Interviews as Topic; D004930:Inuit; D008297:Male; D008403:Mass Screening / Q000379:methods; D009344:Neisseria gonorrhoeae; D015995:Prevalence; D015231:Sexually Transmitted Diseases, Bacterial / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D055815:Young Adult