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Bocking N, Matsumoto CL, Loewen K, et al. High Incidence of Invasive Group A Streptococcal Infections in Remote Indigenous Communities in Northwestern Ontario, Canada. Open Forum Infect Dis. 2016;4(1):ofw243doi: 10.1093/ofid/ofw243.
Bocking, N., Matsumoto, C. L., Loewen, K., Teatero, S., Marchand-Austin, A., Gordon, J., Fittipaldi, N., & McGeer, A. (2017). High Incidence of Invasive Group A Streptococcal Infections in Remote Indigenous Communities in Northwestern Ontario, Canada. Open forum infectious diseases, 4(1), ofw243. https://doi.org/10.1093/ofid/ofw243
Bocking, Natalie, et al. "High Incidence of Invasive Group A Streptococcal Infections in Remote Indigenous Communities in Northwestern Ontario, Canada." Open forum infectious diseases vol. 4,1 (2017): ofw243. doi: https://doi.org/10.1093/ofid/ofw243
Bocking N, Matsumoto CL, Loewen K, Teatero S, Marchand-Austin A, Gordon J, Fittipaldi N, McGeer A. High Incidence of Invasive Group A Streptococcal Infections in Remote Indigenous Communities in Northwestern Ontario, Canada. Open Forum Infect Dis. 2016 Dec 07;4(1):ofw243. doi: 10.1093/ofid/ofw243. eCollection 2017. PMID: 28480241; PMCID: PMC5414009.
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Open Forum Infect Dis. 2016 Dec 07;4(1):ofw243. doi: 10.1093/ofid/ofw243. eCollection 2017.

High Incidence of Invasive Group A Streptococcal Infections in Remote Indigenous Communities in Northwestern Ontario, Canada.

Open forum infectious diseases

Natalie Bocking, Cai-Lei Matsumoto, Kassandra Loewen, Sarah Teatero, Alex Marchand-Austin, Janet Gordon, Nahuel Fittipaldi, Allison McGeer

Affiliations

  1. Sioux Lookout First Nations Health Authority, Canada.
  2. Anishinaabe Bimaadiziwin Research Program, Sioux Lookout, Canada.
  3. Public Health Ontario, Toronto, Canada.
  4. Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Canada.

PMID: 28480241 PMCID: PMC5414009 DOI: 10.1093/ofid/ofw243

Abstract

BACKGROUND: Worldwide, indigenous populations appear to be at increased risk for invasive group A streptococcal (iGAS) infections. Although there is empirical evidence that the burden of iGAS disease is significant among remote First Nations communities in Northwestern Ontario, Canada, the epidemiology of iGAS infections in the area remains poorly characterized.

METHODS: Individuals that met case definition for iGAS disease and whose laboratory specimens were processed by Meno Ya Win Health Centre in Sioux Lookout, Canada or who were reported to Thunder Bay District Health Unit, Canada were identified for the period 2009 to 2014. Case demographics, clinical severity, comorbidities, and risk factors were collected through chart review. Strain typing and antibiotic susceptibility were determined when possible. Basic descriptive statistics were calculated.

RESULTS: Sixty-five cases of iGAS disease were identified, for an annualized incidence of 56.2 per 100 000. Primary bacteremia was present in 26.2% of cases, and cellulitis was identified in 55.4% of cases. The most common comorbidities identified were diabetes (38.5%) and skin conditions (38.5%). Prevalent risk factors included alcohol dependence (25%). Fourteen different

CONCLUSIONS: Rural and remote First Nations communities in Northwestern Ontario experience iGAS infections at a rate 10 times the provincial and national average. Compared with other North American series, a lower proportion of isolates causing infection were of

© The Author 2016. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

Keywords: health equity; indigenous health; invasive group A Streptococcus.

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