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 2018.","authors":"D. Choucrallah, L. Sarmiento, S. Ettles, F. Tanguay, M. Heisz, E. Falardeau","doi":"10.14745/ccdr.v45i09a04","DOIUrl":"https://doi.org/10.14745/ccdr.v45i09a04","url":null,"abstract":"Background\u0000The Laboratory Incident Notification Canada (LINC) surveillance system monitors laboratory incidents reported under the Human Pathogens and Toxins Act. The year 2018 marks the third complete year of data.\u0000\u0000\u0000Objective\u0000To describe the laboratory exposure and laboratory-acquired infection incidents that occurred in Canada in 2018 compared to previous years, and then by sector, human pathogens and toxins involved, number of affected persons, incident type and root causes.\u0000\u0000\u0000Methods\u0000Laboratory incidents that occurred in 2018 were reported through the LINC system. The number of laboratory incidents, people exposed and laboratory-acquired infections were compared to previous years, then the incidents were analyzed by sector, human pathogen or toxin involved, the type of incident, people exposed, route of exposure and root causes. Microsoft Excel 2016 was used for descriptive analysis.\u0000\u0000\u0000Results\u0000In 2018, there were 89 exposure incidents to human pathogens and 235 people were exposed. There were five suspected and one confirmed laboratory-acquired infections. This was approximately twice the number of exposure incidents that were reported in 2017 (n=44) and 2016 (n=46). The highest number of exposure incidents occurred in the academic and hospital sectors, and the ratio of incidence to licences was the lowest in the private sector. The majority of incidents (n=50; 56%) involved Risk Group 2 human pathogens that were manipulated in a Containment Level 2 laboratory. Most exposures were related to sharps or procedures and the most common people exposed were laboratory technicians. Human interaction and standard operating procedures were the leading root causes.\u0000\u0000\u0000Conclusion\u0000Although overall the annual incidence of laboratory exposures in Canada remains relatively low, the incidence was higher in 2018 than in previous years. Whether this is a true increase in incidence or an increase in reporting is not known at this time as baseline estimates are still being established.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"92 1","pages":"244-251"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88990634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of a case-control study and control bank to investigate an outbreak of locally acquired cyclosporiasis in Canada, 2016.","authors":"V. Morton, K. Meghnath, M. Gheorghe, A. Fitzgerald-Husek, J. Hobbs, L. Honish, S. David","doi":"10.14745/ccdr.v45i09a01","DOIUrl":"https://doi.org/10.14745/ccdr.v45i09a01","url":null,"abstract":"Background\u0000Cyclospora is an intestinal parasite that is not endemic in Canada. However, national outbreaks of locally acquired cases have been reported since 2013. These outbreaks were suspected to be associated with consumption of produce imported from countries where Cyclospora is endemic. Identification of the source can be challenging because of reporting delays and limited traceability of produce.\u0000\u0000\u0000Objective\u0000To report on a national outbreak of locally acquired cyclosporiasis, highlight the challenges of investigating these outbreaks and document the first time use of a control bank to recruit controls for a national outbreak case-control study in Canada.\u0000\u0000\u0000Methods\u0000Cases of cyclosporiasis were identified through provincial laboratory testing and reported through provinces to the national level. Cases were interviewed about food exposures using a questionnaire and food exposures reported by cases were compared to Foodbook reference values. To narrow down the food items of interest, a matched case-control study was conducted. Controls for the study were recruited primarily from a control bank, that is, a list of individuals who had previously agreed to participate in public health-related surveys.\u0000\u0000\u0000Results\u0000In total, 87 cases of locally acquired cyclosporiasis with onset or report dates between May 19, 2016 and August 10, 2016 were reported by four provinces. Comparing case exposures to Foodbook reference values identified several food items of interest, including blackberries, other berries, herbs and leafy greens. The case-control study identified only blackberries and mesclun greens as significantly more frequently consumed by cases than controls. Due to lack of product details for blackberries and mesclun greens, the source of the outbreak was not conclusively identified.\u0000\u0000\u0000Conclusion\u0000Blackberries were the primary food item of interest, but could not be identified as the conclusive source due to lack of traceability. The control bank was found to be a useful tool for control recruitment.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"13 1","pages":"225-229"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82206796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shiga toxin-producing Escherichia coli in British Columbia, 2011-2017: Analysis to inform exclusion guidelines.","authors":"K. Noftall, K. Noftall, M. Taylor, L. Hoang, L. Hoang, E. Galanis, E. Galanis","doi":"10.14745/ccdr.v45i09a03","DOIUrl":"https://doi.org/10.14745/ccdr.v45i09a03","url":null,"abstract":"Background\u0000Shiga toxin-producing Escherichia coli (STEC) can cause severe illness including bloody diarrhea and hemolytic-uremic syndrome (HUS) through the production of Shiga toxins 1 (Stx1) and 2 (Stx2). E. coli O157:H7 was the most common serotype detected in the 1980s to 1990s, but improvements in laboratory methods have led to increased detection of non-O157 STEC. Non-O157 STEC producing only Stx1 tend to cause milder clinical illness. Exclusion guidelines restrict return to high-risk work or settings for STEC cases, but most do not differentiate between STEC serogroups and Stx type.\u0000\u0000\u0000Objective\u0000To analyze British Columbia (BC) laboratory and surveillance data to inform the BC STEC exclusion guideline.\u0000\u0000\u0000Methods\u0000For all STEC cases reported in BC in 2011-2017, laboratory and epidemiological data were obtained through provincial laboratory and reportable disease electronic systems, respectively. Incidence was measured for all STEC combined as well as by serogroup. Associations were measured between serogroups, Stx types and clinical outcomes.\u0000\u0000\u0000Results\u0000Over the seven year period, 984 cases of STEC were reported. A decrease in O157 incidence was observed, while non-O157 rates increased. The O157 serogroup was significantly associated with Stx2. Significant associations were observed between Stx2 and bloody diarrhea, hospitalization and HUS.\u0000\u0000\u0000Conclusion\u0000The epidemiology of STEC has changed in BC as laboratories increasingly distinguish between O157 and non-O157 cases and identify Stx type. It appears that non-O157 cases with Stx1 are less severe than O157 cases with Stx2. The BC STEC exclusion guidelines were updated as a result of this analysis.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"10 1","pages":"238-243"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72677830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular surveillance of hepatitis C virus genotypes identifies the emergence of a genotype 4d lineage among men in Quebec, 2001-2017.","authors":"DG Murphy, R. Dion, M. Simard, ML Vachon, Valérie Martel-Laferrière, B. Serhir, J. Longtin","doi":"10.14745/ccdr.v45i09a02","DOIUrl":"https://doi.org/10.14745/ccdr.v45i09a02","url":null,"abstract":"Background\u0000Molecular phylogenetics are generally used to confirm hepatitis C virus (HCV) transmission events. In addition, the Laboratoire de santé publique du Québec (LSPQ) has been using molecular phylogenetics for surveillance of HCV genotyping since November 2001.\u0000\u0000\u0000Objectives\u0000To describe the emergence of a specific lineage of HCV genotype 4d (G4d) and its characteristics using molecular phylogenetics as a surveillance tool for identifying HCV strain clustering.\u0000\u0000\u0000Methods\u0000The LSPQ prospectively applied Sanger sequencing and phylogenetic analysis to determine the HCV genotype on samples collected from November 2001 to December 2017. When a major G4d cluster was identified, demographic information, HIV-infection status and syphilis test results were analyzed.\u0000\u0000\u0000Results\u0000Phylogenetic analyses performed on approximately 22,000 cases identified 122 G4d cases. One major G4d cluster composed of 37 cases was singled out. Two cases were identified in 2010, 10 from 2011-2014 and 25 from 2015-2017. Cases in the cluster were concentrated in two urban health regions. Compared to the other G4d cases, cluster cases were all male (p<0.001) and more likely to be HIV-positive (adjusted risk ratio: 4.4; 95% confidence interval: 2.5-7.9). A positive syphilis test result was observed for 27 (73%) of the cluster cases. The sequences in this cluster and of four outlier cases were located on the same monophyletic lineage as G4d sequences reported in HIV-positive men who have sex with men (MSM) in Europe.\u0000\u0000\u0000Conclusion\u0000Molecular phylogenetics enabled the identification and surveillance of ongoing transmission of a specific HCV G4d lineage in HIV-positive and HIV-negative men in Quebec and its cross-continental spread. This information can orient intervention strategies to avoid transmission of HCV in MSM.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"11 1","pages":"230-237"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74594171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Toxoplasma gondii</i>: How an Amazonian parasite became an Inuit health issue.","authors":"S J Reiling,&nbsp;B R Dixon","doi":"10.14745/ccdr.v45i78a03","DOIUrl":"https://doi.org/10.14745/ccdr.v45i78a03","url":null,"abstract":"<p><p><i>Toxoplasma gondii</i> is a protozoan parasite that originated in the Amazon. Felids (mammals in the cat family) are the only definitive hosts. These animals shed large numbers of infectious oocysts into the environment, which can subsequently infect many intermediate hosts, including birds, mammals and, possibly, fish. Human <i>T. gondii</i> seroprevalence is high in some parts of the Canadian Arctic and is associated with adverse health consequences among Inuit population. Since the range of felids does not extend to the Arctic, it is not immediately obvious how this parasite got from the Amazon to the Arctic. The objectives of this overview are to summarize the health impacts of <i>T. gondii</i> infection in Inuit in Canada's North and to consider how this infection could have reached them. This article reviews the prevalence of <i>T. gondii</i> infection in terrestrial and marine animals in the Canadian Arctic and discusses their potential role in the foodborne transmission of this parasite to humans. Two distribution factors seem plausible. First, felids in more southern habitats may release infectious oocysts into waterways. As these oocysts remain viable for months, they can be transported northward via rivers and ocean currents and could infect Arctic fish and eventually the marine mammals that prey on the fish. Second, migratory terrestrial and marine intermediate hosts may be responsible for carrying <i>T. gondii</i> tissue cysts to the Arctic, where they may then pass on the infection to carnivores. The most likely source of <i>T. gondii</i> in Inuit is from consumption of traditionally-prepared country foods including meat and organs from intermediate hosts, which may be consumed raw. With climate change, northward migration of felids may increase the prevalence of <i>T. gondii</i> in Arctic wildlife.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"45 7-8","pages":"183-190"},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615440/pdf/ccdr-45-183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224687","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":"A public health enhanced surveillance system for a mass gathering event.","authors":"C. Huot, A. Paradis, K. Hammond-Collins, M. Bélair, J. Villeneuve, Nicholas Brousseau, I. Goupil-Sormany, J. Riffon","doi":"10.14745/CCDR.V45I78A05","DOIUrl":"https://doi.org/10.14745/CCDR.V45I78A05","url":null,"abstract":"Background\u0000From June 7 to June 9, 2018, a G7 Summit was held in the Canadian province of Quebec. This international political mass gathering event posed a number of potential risks to public health.\u0000\u0000\u0000Objective\u0000To assess three additional monitoring strategies to detect public health threats during a mass gathering event.\u0000\u0000\u0000Intervention\u0000In addition to routine public health monitoring, a partnership was created and three monitoring strategies were put in place three days before, during and six days after the G7 event: the analysis of data on the presenting complaint and discharge diagnosis from 11 emergency departments in the area using the logical Early Aberration Reporting System; the daily polling of key health partners with an online questionnaire; and the analysis of calls to Info-Santé, a government-run telephone consultation service for the public regarding health and social issues.\u0000\u0000\u0000Results\u0000Emergency room data produced 78 alerts from the presenting complaints and 39 alerts from the discharge diagnoses. Of these 117 alerts, two were investigated (one in the respiratory and one in the neurological-muscular categories) and no other interventions were required. With a few exceptions, all of the health partners completed the online survey each day and no signal of concern was generated. Compared with historical data, no increase or differences in calls to Info-Santé were detected during the monitoring period.\u0000\u0000\u0000Conclusion\u0000The three additional monitoring strategies developed to detect events of public health importance during the 2018 G7 Summit in Quebec were successful in gathering timely data for analysis. Close collaboration and good participation from the different partners were essential to this project. However, because no public health event occurred, it was not possible to determine whether the enhanced surveillance system had sufficient speed and sensitivity for timely detection and response.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"26 1","pages":"212-224"},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88044251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human rabies postexposure prophylaxis and rabid terrestrial animals in Ontario, Canada: 2014-2016.","authors":"D. Middleton, L. Friedman, S. Johnson, S. Buchan, B. Warshawsky","doi":"10.14745/CCDR.V45I78A02","DOIUrl":"https://doi.org/10.14745/CCDR.V45I78A02","url":null,"abstract":"Background\u0000The number of rabid terrestrial animals in Ontario has decreased markedly since the 1970s and 1980s. However, the number of recommended rabies postexposure prophylaxis (RPEP) courses has not decreased proportionally. The decision to recommend RPEP for terrestrial animal exposures should be based on a risk assessment that considers the prevalence of rabies in these animals within a jurisdiction, among other factors.\u0000\u0000\u0000Objective\u0000To explore trends in RPEP recommendations for exposures to terrestrial animals in Ontario in relation to the recency of terrestrial animal rabies cases by public health unit (PHU) jurisdiction.\u0000\u0000\u0000Methods\u0000RPEP recommendation data for the 36 Ontario PHUs were obtained from the Ontario integrated Public Health Information System and animal rabies data by PHU were obtained from the Ministry of Natural Resources and Forestry. We calculated the annual RPEP recommendation rates for terrestrial animals by PHU for 2014 to 2016, and plotted the 2016 rates in relation to the year of the most recently identified rabid terrestrial animal in the PHU.\u0000\u0000\u0000Results\u0000Between 2014 and 2016, the annual RPEP recommendation rates for terrestrial animal exposures by PHU ranged from 3.0 to 35.2 per 100,000 persons, with a median of 11.9 RPEP recommendations per 100,000 persons. In 2016, ten PHUs had not identified a rabid terrestrial animal in their jurisdiction for more than15 years. Five of these PHUs had RPEP recommendation rates above the provincial median.\u0000\u0000\u0000Conclusion\u0000Along with other factors, consideration of the occurrence of rabies in terrestrial animals in a jurisdiction can assist in the risk assessment of dogs, cats or ferrets that are not available for subsequent observation.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"16 1","pages":"177-182"},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79778397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of <i>Clostridioides difficile</i> infection in Canada: A six-year review to support vaccine decision-making.","authors":"Y Xia,&nbsp;M C Tunis,&nbsp;C Frenette,&nbsp;K Katz,&nbsp;K Amaratunga,&nbsp;S Rhodenizer Rose,&nbsp;A House,&nbsp;C Quach","doi":"10.14745/ccdr.v45i78a04","DOIUrl":"https://doi.org/10.14745/ccdr.v45i78a04","url":null,"abstract":"<p><strong>Background: </strong>Two vaccines against <i>Clostridioides difficile</i> infections (CDI) are currently in phase III trials. To enable decision-making on their use in public health programs, national disease epidemiology is necessary.</p><p><strong>Objectives: </strong>To determine the epidemiology of hospital-acquired CDI (HA-CDI) and community-associated CDI (CA-CDI) in Canada using provincial surveillance data and document discrepancies in CDI-related definitions among provincial surveillance programs.</p><p><strong>Methods: </strong>Publicly-available CDI provincial surveillance data from 2011 to 2016 that distinguished between HA-CDI and CA-CDI were included and the most common surveillance definitions for each province were used. The HA-, CA-CDI incidence rates and CA-CDI proportions (%) were calculated for each province. Both HA- and CA-CDI incidence rates were examined for trends. Types of disparities were summarized and detailed discrepancies were documented.</p><p><strong>Results: </strong>Canadian data were analyzed from nine provinces. The HA-CDI rates ranged from 2.1/10,000 to 6.5/10,000 inpatient-days, with a decreasing trend over time. Available data on CA-CDI showed that both rates and proportions have been increasing over time. Discrepancies among provincial surveillance definitions were documented in CDI case classifications, surveillance populations and rate calculations.</p><p><strong>Conclusion: </strong>In Canada overall, the rate of HA-CDI has been decreasing and the rate of CA-CDI has been increasing, although this calculation was impeded by discrepancies in CDI-related definitions among provincial surveillance programs. Nationally-adopted common definitions for CDI would enable better comparisons of CDI rates between provinces and a calculation of the pan-Canadian burden of illness to support vaccine decision-making.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"45 7-8","pages":"191-211"},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615439/pdf/CCDR-45-191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224688","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":"Surveillance of Echinococcus tapeworm in coyotes and domestic dogs in Winnipeg, Manitoba: Abstract.","authors":"Cck Tse, J. Bullard, R. Rusk, D. Douma, PJ Plourde","doi":"10.14745/CCDR.V45I78A01","DOIUrl":"https://doi.org/10.14745/CCDR.V45I78A01","url":null,"abstract":"Background\u0000The Echinococcus species, including E. multilocularis and E. canadensis, are tapeworms that primarily infect canids such as dogs, foxes and coyotes, but which can also infect humans. In humans, E. multilocularis can cause alveolar echinococcosis; a serious condition that mimics metastatic malignancy and has a poor prognosis. It is known that coyotes in rural Manitoba are infected with Echinococcus species, but it is not known if coyotes in peri-urban areas are also infected.\u0000\u0000\u0000Objectives\u0000To document and map Echinococcus species in wild canids and domestic dogs in Winnipeg, Manitoba (Canada).\u0000\u0000\u0000Methods\u0000There were 169 fecal samples collected between April 18 and June 1, 2018. These included 44 samples of domestic dog feces, 122 of coyote scat, one of fox scat and two of coyote colonic tissue specimens. Samples were frozen (-80°C) for at least 72 hours to inactivate tapeworm ova. Polymerase chain reaction analyses of E. multilocularis and E. canadensis were performed on all frozen samples.\u0000\u0000\u0000Results\u0000Echinococcus multilocularis-positive samples were detected in nine (10.6%) of 85 locations, with one positive sample in a suburban Winnipeg dog park and two positive samples in a popular provincial park. No dog samples were positive for E. multilocularis; one sample was positive for E. canadensis. In contrast, nine coyote samples (7.3%) were positive for E. multilocularis and eight samples (6.5%) were positive for E. canadensis. The one fox sample was positive for each. Overall, six samples (3.6%) were positive for both infections.\u0000\u0000\u0000Conclusion\u0000This is the first confirmation of the presence of E. multilocularis in coyote feces in the metropolitan area of Winnipeg, Manitoba. In light of the risk this could pose to domestic dogs and human health, periodic surveillance that maps the distribution of this tapeworm could inform the need for additional public health actions.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"44 1","pages":"171-176"},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86111405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence for optimal HIV screening and testing intervals in HIV-negative individuals from various risk groups: A systematic review.","authors":"K. Timmerman, M. Weekes, G. Traversy, P. Prabakhar, T. Austin, S. Ha, B. Anwar","doi":"10.14745/CCDR.V44I12A05","DOIUrl":"https://doi.org/10.14745/CCDR.V44I12A05","url":null,"abstract":"Background\u0000Human immunodeficiency virus (HIV) testing plays a crucial role in Canada's HIV prevention and treatment efforts and is the first step to achieving the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets; however, how often Canadians, including populations at increased risk of HIV exposure, should be tested is unclear. We conducted a systematic literature review to determine the optimal HIV screening and testing intervals.\u0000\u0000\u0000Objective\u0000To examine the current evidence on HIV testing intervals in HIV-negative individuals from various risk groups and to assess the potential harms and patients' values and preferences associated with different testing frequencies.\u0000\u0000\u0000Methods\u0000We searched MEDLINE/PubMed, Scopus, Embase, the Cochrane Library, PsychINFO and EconLit for studies on different frequencies of HIV testing published between January 2000 and September 2016. An additional search was conducted for grey literature published between January 2000 and October 2016. Data extraction included study characteristics, participants, exposure, outcomes and economic variables. The quality of the studies was assessed and results summarized.\u0000\u0000\u0000Results\u0000Of the 2,702 articles identified from the searches, 27 met the inclusion criteria for review. This included assessments of HIV testing intervals among the general population, men who have sex with men, people who use injection drugs and sex workers. Optimal testing intervals across risk groups ranged from one-time testing to every three months. Data from modelling studies may not be representative of the Canadian context. Few studies identified potential harms of increased screening, specifically an increase in both false positive and false negative results. There were only two studies that addressed patient values and preferences concerning HIV screening, which suggested that the majority of participants were amenable to routine screening through their primary care provider.\u0000\u0000\u0000Conclusion\u0000There was insufficient evidence to support optimal HIV screening and testing intervals for different populations. Context-specific factors, such as budget allocation, human resources, local epidemiology, socioeconomic factors and risk behaviours, along with clinical judgement, inform whom and how often to screen, suggesting the need for research specific to Canada. Research on patient preferences as well as the benefits and harms of more frequent screening are also indicated.","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"13 1","pages":"337-347"},"PeriodicalIF":0.0,"publicationDate":"2018-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89743003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}