Canada communicable disease report = Releve des maladies transmissibles au Canada最新文献

{"title":"Surveillance of laboratory exposures to human pathogens and toxins, Canada, 2024.","authors":"Emily F Tran, Audrey Gauthier, Antoinette N Davis, Christine Abalos, Samuel Bonti-Ankomah","doi":"10.14745/ccdr.v51i101112a04","DOIUrl":"10.14745/ccdr.v51i101112a04","url":null,"abstract":"<p><strong>Background: </strong>Exposure incidents to human pathogens and toxins (HPTs) in licensed facilities in Canada are monitored by Laboratory Incident Notification Canada (LINC), a surveillance system that describes and identifies trends among exposure incidents in Canada using quantitative and qualitative data.</p><p><strong>Methods: </strong>Confirmed exposure incidents reported to LINC in 2024 were analyzed. The exposure incident rate was calculated and compared to previous years. A seasonality analysis compared monthly trends. Exposure incidents were described by sector, implicated HPTs, main activity, occurrence types, root causes, affected individuals and reporting delay. Text-based descriptions of exposure incidents underwent qualitative analysis.</p><p><strong>Results: </strong>In 2024, there were 71 confirmed exposure incidents affecting 132 individuals. There were 67.5 incidents per 1,000 active licences. Bacteria was the most commonly implicated HPT (64%). Microbiology (67.6%) was the primary activity during confirmed exposures. The public health sector had the highest incident rate and mean number of affected persons per active licence. The most frequently reported occurrence type and root cause was procedure-related (21.4%) and human factors (62%), respectively. Most affected individuals were technicians/technologists (76.5%). The median time between incident and reporting was five days.</p><p><strong>Conclusion: </strong>The exposure incident rate was higher in 2024 compared to the previous year. The public health sector had the highest incident rate between 2016-2024. Qualitative analysis revealed that working with cultures outside the biological safety cabinet and insufficient face-related personal protective equipment were common factors involved in confirmed exposure incidents.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"51 10-11/12","pages":"401-412"},"PeriodicalIF":0.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12798773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of tuberculosis infection among immigrants in southern New Brunswick, Canada: A cross-sectional study.","authors":"Isdore Chola Shamputa, Duyen Thi Kim Nguyen, Hope Mackenzie, Derek J Gaudet, Alicia Harquail, Kim Barker, Duncan Webster","doi":"10.14745/ccdr.v51i1011a03","DOIUrl":"10.14745/ccdr.v51i1011a03","url":null,"abstract":"<p><strong>Background: </strong>Treating individuals with tuberculosis (TB) infection (TBI) is an important aspect of the global strategy to eliminate TB as a public health problem, as it would help reduce the pool of individuals with TBI who are at risk of developing TB disease (TBD). Understanding factors that impact effective management of patients with TBI is helpful in informing policy.</p><p><strong>Objective: </strong>To assess the proportion of immigrants with TBI accepting and completing TB preventive treatment (TPT), variables potentially related to accepting and completing TPT were examined and healthcare provider (HCP)-related factors that impact TBI management were identified.</p><p><strong>Methods: </strong>Tuberculosis preventive treatment was offered to TBI-positive immigrants without a history or treatment of TBD from a pilot TBI screening study conducted in southern New Brunswick, Canada between November 2021 and November 2023. Tuberculosis preventive treatment acceptance and completion rates were calculated, and the HCP completed a questionnaire to identify factors that affected TBI management. Participant characteristics were summarized using descriptive statistics, while Fisher's exact tests were conducted to test for independence between demographics and treatment acceptance and completion. The HCP questionnaire data were analyzed using thematic analysis.</p><p><strong>Results: </strong>Of the 49 participants who screened positive for TBI, 11 (22.4%) were lost to follow-up prior to being assessed and offered TPT and 38 (77.6%) were offered TPT, of whom 3 (7.9%) declined, 35 (92.1%) accepted and initiated TPT, and 30 (85.7%) completed treatment. Treatment acceptance and completion were found to be independent from the participant demographics examined. Thematic analysis revealed five emerging themes regarding the management of TBI participants (i.e., supports, collaboration, communication, time, and satisfaction).</p><p><strong>Conclusion: </strong>This study demonstrates the feasibility of treating TBI in immigrants and highlights HCP-related factors that impact the management of TBI among immigrants in southern New Brunswick. Our findings may assist programs aimed at improving TBI screening and treatment.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"51 10-11/12","pages":"389-400"},"PeriodicalIF":0.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12795580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Summary of the National Advisory Committee on Immunization (NACI) Statement: Recommendations on the use of pneumococcal vaccines in adults, including Pneu-C-21.","authors":"Eva Wong, Oliver Baclic, Marina I Salvadori, Kyla Hildebrand","doi":"10.14745/ccdr.v51i1011a01","DOIUrl":"10.14745/ccdr.v51i1011a01","url":null,"abstract":"<p><strong>Background: </strong>Pneumococcal disease in adults includes invasive pneumococcal disease (IPD), an acute and serious communicable disease with manifestations such as meningitis, bacteremia and bacteremic pneumococcal pneumonia. There are more than 100 different serotypes, and the extent of protection provided by a pneumococcal vaccine depends on the vaccine formulation. In July 2024, Health Canada authorized a 21-valent pneumococcal conjugate vaccine (Pneu-C-21), which followed the recent introduction of a 20-valent vaccine (Pneu-C-20) authorized in 2022.</p><p><strong>Methods: </strong>The National Advisory Committee on Immunization (NACI) reviewed evidence on the epidemiology of IPD in Canada, immunogenicity and safety of Pneu-C-21, and the cost-effectiveness of different pneumococcal vaccines in adult immunization programs. NACI has also considered additional factors, including ethics, equity, feasibility, and acceptability (EEFA).</p><p><strong>Results: </strong>Differences in the distribution of serotypes causing IPD have been observed before and after the COVID-19 pandemic. The Pneu-C-21 demonstrated comparable immunogenicity to Pneu-C-20 for shared serotypes and higher responses for unique serotypes. The safety profiles of both vaccines are expected to be similar to other pneumococcal vaccines, and the cost-effectiveness of Pneu-C-21 and Pneu-C-20 will depend on regional serotype distribution. The overall impact of Pneu-C-21 compared to Pneu-C-20 is uncertain, but likely to vary over time with age, risk factors, and geography.</p><p><strong>Conclusion: </strong>NACI now recommends including at least one of Pneu-C-20 or Pneu-C-21 in adult pneumococcal immunization programs. One dose should be given to adults 65 years and older and those 18 to under 65 years at increased IPD risk, regardless of previous pneumococcal vaccination history.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"51 10-11/12","pages":"375-380"},"PeriodicalIF":0.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12795405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Summary of the National Advisory Committee on Immunization (NACI) Seasonal Influenza Vaccine Statement for 2025-2026.","authors":"Katarina Gusic, Winnie Siu, Angela Sinilaite, Jesse Papenburg","doi":"10.14745/ccdr.v51i09a01","DOIUrl":"10.14745/ccdr.v51i09a01","url":null,"abstract":"<p><strong>Background: </strong>The National Advisory Committee on Immunization (NACI) reviews the evolving evidence on influenza immunization and provides annual recommendations regarding the use of seasonal influenza vaccines. The NACI <i>Statement on seasonal influenza vaccines for 2025-2026</i> updates the NACI recommendations from the previous year.</p><p><strong>Objective: </strong>To summarize the 2025-2026 NACI seasonal influenza vaccine recommendations and to highlight new and updated information.</p><p><strong>Methods: </strong>For the development of the <i>Statement on seasonal influenza vaccines for 2025-2026</i>, the NACI Influenza Working Group applied the NACI evidence-based process to assess available evidence and formulate recommendations. These recommendations were evaluated and approved by NACI based on the available evidence.</p><p><strong>Results: </strong>Key updates for the 2025-2026 influenza season include: 1) removal of the preferential recommendation for quadrivalent influenza vaccines in children; 2) reiteration of the safety of concurrent administration of seasonal influenza vaccines and other vaccines, including COVID-19, based on updated evidence; 3) new evidence on the protective effects of influenza vaccination on cardiovascular events; 4) updated language for Indigenous populations; and 5) addition of individuals at higher risk of avian influenza A(H5N1) exposure as a group for whom influenza vaccination is particularly important.</p><p><strong>Conclusion: </strong>NACI recommends that seasonal influenza vaccine should be offered annually to anyone six months of age and older who does not have a contraindication to the vaccine. Influenza vaccination is particularly important for people at high risk of influenza-related complications or hospitalization, people capable of transmitting influenza to those at high risk, and others as outlined in the Statement.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"51 9","pages":"324-330"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145777038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimum data cleaning recommendations for infection prevention and control acute care surveillance reporting: A solution for \"garbage in, garbage out\".","authors":"Kathryn Bush, Joelle Cayen, Christine Blaser, Blanda Chow, Jennifer Ellison, Jennifer Happe, Caroline Quach, Christian Tsang, Olivia Varsaneux, Kristen Versluys, Victoria Williams, Robyn Mitchell","doi":"10.14745/ccdr.v51i09a03","DOIUrl":"10.14745/ccdr.v51i09a03","url":null,"abstract":"<p><strong>Background: </strong>Outcome surveillance is an important component of infection prevention and control (IPAC) programs to guide healthcare decisions. It is crucial that the reported data are of the highest quality. Reviewing completeness, accuracy and timeliness of the data is important to reduce data inconsistencies. However, many IPAC staff do not have training in data cleaning or data quality activities.</p><p><strong>Methods: </strong>Expert epidemiologists across Canada have created best practice guidance for data quality activities to provide sufficient detail to improve this important patient safety activity. Most of these activities are simple checks to review the accuracy of the data without requiring additional review of the patient record or linkage to other datasets.</p><p><strong>Results: </strong>Based on consensus by surveillance experts across jurisdictions, comprehensive recommendations for data quality in IPAC surveillance programs were developed to improve completeness (22%), accuracy (68%), and timeliness (10%) of the data.</p><p><strong>Conclusion: </strong>The data quality activities list may be used in Canadian IPAC surveillance activities to support or improve existing surveillance data quality activities for IPAC programs.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"51 9","pages":"344-351"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12699955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the population size of people who inject drugs in Canada, 2021.","authors":"Anson Williams, Justin Sorge, Simone Périnet, Qiuying Yang, Joseph Cox, Matthew Bonn, Ashley Smoke, Nashira Popovic","doi":"10.14745/ccdr.v51i09a06","DOIUrl":"10.14745/ccdr.v51i09a06","url":null,"abstract":"<p><strong>Background: </strong>People who inject drugs are disproportionately affected by HIV and hepatitis C infections. Estimating the size and distribution of this population is essential in monitoring infectious diseases rates and progress towards elimination.</p><p><strong>Objective: </strong>This study aims to estimate the population sizes of people in Canada who have ever injected drugs, stratified by sex (assigned at birth), province/region and steroid injection, and those who have recently injected drugs (past 12 months), stratified by sex and steroid injection. While a previous national study reported estimates of recent injection by province, this study provides the first estimates of people who have ever injected drugs at both the national and provincial/regional levels. It is also the first to incorporate stratification by sex and steroid injection, using the most currently available data.</p><p><strong>Methods: </strong>Using combined cycles (2017-2021) of the Canadian Community Health Survey (CCHS), a nationally representative population-based survey, we applied the weighted prevalence of injection drug use to the 2021 Statistics Canada national population size estimate of individuals aged 15 years or more. To this, further adjustments were made using additional data to account for populations not sampled in the CCHS and under-reporting of injection drug use in surveys.</p><p><strong>Results: </strong>In 2021, an estimated 388,400 (95% CI: 338,900-436,500) people in Canada had ever injected drugs, representing 1.22% of the Canadian population 15 years of age and older. Among these, 75% were male and 25% were female. These estimates varied across regions, ranging from 0.92% to 2.47%. The estimated number of people who have recently injected drugs was 100,300 (95% CI: 82,300-119,200) or 0.31% of the population, of which 74% were male and 26% were female.</p><p><strong>Conclusion: </strong>Estimates of people who inject drugs at the national and provincial/regional levels can be used to track key epidemiological metrics that inform public health policy and programming.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"25 9","pages":"364-373"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12704403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does influenza vaccination contribute to the prevention of cardiovascular events? An umbrella review.","authors":"Fazia Tadount, Nadine Sicard, Winnie Siu, Pamela Doyon-Plourde, Angela Sinilaité","doi":"10.14745/ccdr.v51i09a02","DOIUrl":"10.14745/ccdr.v51i09a02","url":null,"abstract":"<p><strong>Background: </strong>There is a growing body of evidence on the potential benefit of influenza vaccination against the occurrence of cardiovascular (CV) events.</p><p><strong>Objective: </strong>This umbrella review of systematic reviews and meta-analyses (SRMAs) aims to summarize the available evidence on the risk of CV events in adults after receipt of influenza vaccine.</p><p><strong>Methods: </strong>Four electronic databases were searched (CINAHL, PubMed, SYSVAC and Cochrane Library) for SRMAs published in English or French, between January 1, 2000, and January 14, 2025. Eligible SRMAs included those with a quantitative synthesis of data examining the association between influenza vaccination and the risk of CV events in adults. Data from the included SRMAs were extracted using predefined variables. The quality of each SRMA was assessed by two independent reviewers using the AMSTAR 2 tool.</p><p><strong>Results: </strong>The review included 25 SRMAs published between 2012 and 2024. Overall, 15 SRMAs were deemed to be of moderate or high quality and were further considered in the evidence synthesis. The most frequently evaluated clinical outcomes were myocardial infarction (MI), all-cause and CV mortality, and major adverse cardiovascular events (MACE). In vaccinated individuals at high-risk for CV events, the risk of CV death was significantly reduced by 23% to 47%, MACE by 26% to 37%, MI by 29% to 34%, and stroke by 13% to 19% compared to unvaccinated individuals.</p><p><strong>Conclusion: </strong>High-quality evidence from the existing literature supports influenza vaccination as an effective preventive measure for reducing CV disease burden. Highlighting this benefit to patients could increase vaccine uptake and improve both influenza and CV outcomes, especially where coverage remains suboptimal.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"51 9","pages":"331-343"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12699956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First reported Canadian case of <i>Trichophyton mentagrophytes</i> genotype VII infection among men who have sex with men (MSM).","authors":"Tatiana Lapa, Anna Banerji, Julianne Kus, Kendall Billick","doi":"10.14745/ccdr.v51i09a05","DOIUrl":"10.14745/ccdr.v51i09a05","url":null,"abstract":"<p><p>Over the past 20 years, <i>Trichophyton mentagrophytes</i> (<i>T. mentagrophytes</i>) infections affecting the genital and pubic regions, with suspected sexual transmission, have been increasingly reported in South Asia and Europe. The first case in the United States was reported in 2024. We describe the first confirmed case of <i>T. mentagrophytes</i> genotype VII infection causing Majocchi granuloma in a Canadian male who had recently travelled to Mexico, with suspected sexual transmission. Raising awareness among healthcare professionals is critical for early diagnosis and preventing long-term sequelae. Tinea corporis presenting with deep lesions in the pubogenital region and not responding to topical medications should prompt consideration of sexually transmitted fungal infection and extended testing including molecular identification by DNA sequencing of fungal cultures.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"51 9","pages":"359-363"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12700202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The innovative and purpose-built veterinary antimicrobials sales reporting system.","authors":"Shamir Mukhi, Manisha Mehrotra, Carolee A Carson, Xian-Zhi Li, Mark Reist, Angelina L Bosman, Annika Flint, Valentine Usongo, Ben Gammon, Tim Beattie","doi":"10.14745/ccdr.v51i09a04","DOIUrl":"10.14745/ccdr.v51i09a04","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) is one of the major public health threats of our time. Human activities across the One Health spectrum, such as the misuse and overuse of antimicrobials, can accelerate the resistance threat. A variety of antimicrobials used in veterinary medicine are also important in human medicine. As part of Canada's commitment to address AMR and antimicrobial use (AMU), and to align with international best practices aimed to minimize the impacts of AMR and preserve the effectiveness of existing antimicrobials, regulatory controls and enhanced surveillance initiatives have been implemented in veterinary medicine and animal health to improve intelligence on the quantities of antimicrobials available for use in animals. These efforts include the implementation of the national Veterinary Antimicrobial Sales Reporting (VASR) system in Canada, in 2018. The focus of this article is to describe the VASR data collection system and platform.</p><p><strong>Methods: </strong>A custom-built data collection and analytical system was developed to enhance understanding of the volume of antimicrobials available for use in animals and contribute to the broader surveillance of trends in AMU and AMR in an effort to support stewardship. Partners from Health Canada's Veterinary Drugs Directorate, the Public Health Agency of Canada's Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, and the Canadian Network for Public Health Intelligence worked together to envision, develop, and implement the national-scale, purpose-built technological intervention, the VASR system.</p><p><strong>Results: </strong>The VASR surveillance system provides a robust data collection and analytical informatics platform to improve intelligence on antimicrobial sales available for veterinary use in Canada.</p><p><strong>Conclusion: </strong>An innovative, purpose-built national antimicrobial sales reporting system was developed. This web-based platform is effective for data submission by the participants and facilitates analysis to provide a comprehensive picture of medically important antimicrobials available for use in animals in Canada, thereby supporting AMR and AMU surveillance and stewardship.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"51 9","pages":"352-358"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12700125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of the COVID-19 antiviral therapy Nirmatrelvir/Ritonavir (Paxlovid^TM) across Canada in 2022: A qualitative analysis of key facilitating factors and challenges.","authors":"Aklile Workneh, Camilia Thieba, Nadine Sicard","doi":"10.14745/ccdr.v51i08a03","DOIUrl":"10.14745/ccdr.v51i08a03","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 antiviral Nirmatrelvir/Ritonavir (Paxlovid^TM, N/R) was approved for use in Canada in January 2022, with the Government of Canada assuming a procurement role and provinces, territories, and federal departments implementing usage within their respective healthcare systems. The objective of this analysis is to describe how N/R was implemented across various jurisdictions in the first six months after it was available for use and identify promising implementation practices.</p><p><strong>Methods: </strong>Fourteen semi-structured discussions in small group settings were conducted with jurisdictional representatives involved in the implementation of N/R. A descriptive analysis of the eligibility criteria and service delivery model was conducted. A thematic analysis using the Consolidated Framework for Implementation Research and cluster analysis of the codes were then undertaken on NVivo 12 to identify key themes.</p><p><strong>Results: </strong>Overall, the eligibility criteria were similar across jurisdictions, and three types of service delivery models were identified. Ten main themes emerged as facilitators and eight as challenges to the implementation. Partnership, collaboration, communication and flexibility were among the facilitators identified, while the complexity of the intervention (e.g., drug-drug interactions), perceived evidence gaps in effectiveness by prescribers, and resource limitations were identified as key implementation challenges.</p><p><strong>Conclusion: </strong>While there were jurisdictional variations in the implementation of N/R, communication and collaboration, and the availability of rapid testing for COVID-19 emerged as key facilitators. Drug-drug interactions, resource pressures and limited evidence were some of the key challenges. Overall, these facilitators and challenges were similar across jurisdictions and may help inform future therapeutic implementation plans for pandemic preparedness.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"51 8","pages":"303-311"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}