Hepatitis B virus(HBV) infection is a disease with a highly variable course. Chronic HBV infection may cause end-stage liver disease including cirrhosis and hepatocellular carcinoma, which is the 3rd most common cause...Hepatitis B virus(HBV) infection is a disease with a highly variable course. Chronic HBV infection may cause end-stage liver disease including cirrhosis and hepatocellular carcinoma, which is the 3rd most common cause of cancer related death due to the poor prognosis. The prevalence of HBV infection is low in many countries. Still, it remains important due to the potential consequences of the disease. HBV is endemic in the Arctic with serologic markers of chronic HBV infection in up to 29% of the population in some areas in Greenland. Interestingly, Inuit populations rarely show signs of liver disease despite the fact that around half of all Inuit has been exposed to HBV and around 8% of Inuit are chronically infected with HBV. These findings have been consistent in surveys conducted for more than four decades among Arctic Inuit. We thus review HBV infection in the Arctic with focus on Greenland Inuit and compared with Inuit in Canada, Alaska and Siberia. The aspects described include epidemiology and monitoring of the disease, as well as treatment and the risk of liver cancer.展开更多
Unusual incidents are being reported across the Arctic.Inuit(因纽特人)families going off on snowmobiles to prepare their summer hunting camps have found themselves cut off from home by a sea of mud.There are also repo...Unusual incidents are being reported across the Arctic.Inuit(因纽特人)families going off on snowmobiles to prepare their summer hunting camps have found themselves cut off from home by a sea of mud.There are also reports of sea ice breaking up earlier than usual,carrying seals beyond the reach of hunters.Climate change may still be a rather abstract(抽象的)idea to most of us,but in the Arctic it is already having great effects-if summertime ice continues to shrink at展开更多
Tuberculosis(TB)continues to disproportionately affect Inuit populations in Canada with some communities having over 300 times higher rate of active TB than Canadian-born,non-Indigenous people.Inuit Tuberculosis Elimi...Tuberculosis(TB)continues to disproportionately affect Inuit populations in Canada with some communities having over 300 times higher rate of active TB than Canadian-born,non-Indigenous people.Inuit Tuberculosis Elimination Framework has set the goal of reducing active TB incidence by at least 50%by 2025,aiming to eliminate it by 2030.Whether these goals are achievable with available resources and treatment regimens currently in practice has not been evaluated.We developed an agent-based model of TB transmission to evaluate timelines and milestones attainable in Nunavut,Canada by including case findings,contact-tracing and testing,treatment of latent TB infection(LTBI),and the government investment on housing infrastructure to reduce the average house-hold size.The model was calibrated to ten years of TB incidence data,and simulated for 20 years to project program outcomes.We found that,under a range of plausible scenarios with tracing and testing of 25%e100%of frequent contacts of detected active cases,the goal of 50%reduction in annual incidence by 2025 is not achievable.If active TB cases are identified rapidly within one week of becoming symptomatic,then the annual incidence would reduce below 100 per 100,000 population,with 50%reduction being met between 2025 and 2030.Eliminating TB from Inuit populations would require high rates of contacttracing and would extend beyond 2030.The findings indicate that time-to-identification of active TB is a critical factor determining program effectiveness,suggesting that investment in resources for rapid case detection is fundamental to controlling TB.展开更多
文摘Hepatitis B virus(HBV) infection is a disease with a highly variable course. Chronic HBV infection may cause end-stage liver disease including cirrhosis and hepatocellular carcinoma, which is the 3rd most common cause of cancer related death due to the poor prognosis. The prevalence of HBV infection is low in many countries. Still, it remains important due to the potential consequences of the disease. HBV is endemic in the Arctic with serologic markers of chronic HBV infection in up to 29% of the population in some areas in Greenland. Interestingly, Inuit populations rarely show signs of liver disease despite the fact that around half of all Inuit has been exposed to HBV and around 8% of Inuit are chronically infected with HBV. These findings have been consistent in surveys conducted for more than four decades among Arctic Inuit. We thus review HBV infection in the Arctic with focus on Greenland Inuit and compared with Inuit in Canada, Alaska and Siberia. The aspects described include epidemiology and monitoring of the disease, as well as treatment and the risk of liver cancer.
文摘Unusual incidents are being reported across the Arctic.Inuit(因纽特人)families going off on snowmobiles to prepare their summer hunting camps have found themselves cut off from home by a sea of mud.There are also reports of sea ice breaking up earlier than usual,carrying seals beyond the reach of hunters.Climate change may still be a rather abstract(抽象的)idea to most of us,but in the Arctic it is already having great effects-if summertime ice continues to shrink at
基金support from Natural Sciences and Engineering Research Council of Canada through Individual Discovery Grant.
文摘Tuberculosis(TB)continues to disproportionately affect Inuit populations in Canada with some communities having over 300 times higher rate of active TB than Canadian-born,non-Indigenous people.Inuit Tuberculosis Elimination Framework has set the goal of reducing active TB incidence by at least 50%by 2025,aiming to eliminate it by 2030.Whether these goals are achievable with available resources and treatment regimens currently in practice has not been evaluated.We developed an agent-based model of TB transmission to evaluate timelines and milestones attainable in Nunavut,Canada by including case findings,contact-tracing and testing,treatment of latent TB infection(LTBI),and the government investment on housing infrastructure to reduce the average house-hold size.The model was calibrated to ten years of TB incidence data,and simulated for 20 years to project program outcomes.We found that,under a range of plausible scenarios with tracing and testing of 25%e100%of frequent contacts of detected active cases,the goal of 50%reduction in annual incidence by 2025 is not achievable.If active TB cases are identified rapidly within one week of becoming symptomatic,then the annual incidence would reduce below 100 per 100,000 population,with 50%reduction being met between 2025 and 2030.Eliminating TB from Inuit populations would require high rates of contacttracing and would extend beyond 2030.The findings indicate that time-to-identification of active TB is a critical factor determining program effectiveness,suggesting that investment in resources for rapid case detection is fundamental to controlling TB.
