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author:("chitwood, S.")
1.  Disease manifestations of Helicobacter pylori infection in Arctic Canada: using epidemiology to address community concerns 
BMJ Open  2014;4(1):e003689.
Objectives
Helicobacter pylori infection, linked to gastric cancer, is responsible for a large worldwide disease burden. H pylori prevalence and gastric cancer rates are elevated among indigenous Arctic communities, but implementation of prevention strategies is hampered by insufficient information. Some communities in northern Canada have advocated for H pylori prevention research. As a first step, community-driven research was undertaken to describe the H pylori-associated disease burden in concerned communities.
Design
Participants in this cross-sectional study completed a clinical interview and gastroscopy with gastric biopsies taken for histopathological examination in February 2008.
Setting
Study procedures were carried out at the health centre in Aklavik, Northwest Territories, Canada (population ∼600).
Participants
All residents of Aklavik were invited to complete a clinical interview and gastroscopy; 194 (58% female participants; 91% Aboriginal; age range 10–80 years) completed gastroscopy and had gastric biopsies taken.
Primary and secondary outcome measures
This analysis estimates the prevalence of gastric abnormalities detected by endoscopy and histopathology, and associations of demographic and clinical variables with H pylori prevalence.
Results
Among 194 participants with evaluable gastric biopsies, 66% were H pylori-positive on histology. Among H pylori-positive participants, prevalence was 94% for acute gastritis, 100% for chronic gastritis, 21% for gastric atrophy and 11% for intestinal metaplasia of the gastric mucosa, while chronic inflammation severity was mild in 9%, moderate in 47% and severe in 43%. In a multivariable model, H pylori prevalence was inversely associated with previous gastroscopy, previous H pylori therapy and aspirin use, and was positively associated with alcohol consumption.
Conclusions
In this population, H pylori-associated gastric histopathology shows a pattern compatible with elevated risk of gastric cancer. These findings demonstrate that local concern about health risks from H pylori is warranted and provide an example of how epidemiological research can address health priorities identified by communities.
doi:10.1136/bmjopen-2013-003689
PMCID: PMC3902307  PMID: 24401722
2.  The prevalence of human papillomavirus and its impact on cervical dysplasia in Northern Canada 
Introduction
Certain types of the Human Papillomavirus (HPV) are sexually transmitted and highly associated with development of cervical dysplasia and cervical cancer but the distribution of HPV infection in the North, particularly amongst First Nations, Metis, and Inuit peoples, is little known. The purposes of the study are to identify the prevalence of type-specific HPV infections and the association of different HPV types with cervical dysplasia among women in Northern Canada.
Methods
This was a cross-sectional study with attendants of the routine or scheduled Pap testing program in the Northwest Territories (NWT), Nunavut, Labrador and Yukon, Canada. Approximately half of each sample was used for Pap test and the remaining was used for HPV genotyping using a Luminex-based method. Pap test results, HPV types, and demographic information were linked for analyses.
Results
Results from 14,598 specimens showed that HPV infection was approximately 50% higher among the Aboriginal than the non-Aboriginal population (27.6% vs. 18.5%). Although the most common HPV type detected was HPV 16 across region, the prevalence of other high risk HPV types was different. The age-specific HPV prevalence among Aboriginal showed a ‘U’ shape which contrasted to non-Aboriginal. The association of HPV infection with cervical dysplasia was similar in both Aboriginal and non-Aboriginal populations.
Conclusions
The HPV prevalence was higher in Northern Canada than in other Areas in Canada. The prevalence showed a higher rate of other high risk HPV infections but no difference of HPV 16/18 infections among Aboriginal in comparison with non-Aboriginal women. This study provides baseline information on HPV prevalence that may assist in surveillance and evaluation systems to track and assess HPV vaccine programs.
doi:10.1186/1750-9378-8-25
PMCID: PMC3728116  PMID: 23816397
Human papillomavirus; Prevalence; Pap abnormality; Northern region
5.  FOREWORD 
International Journal of Circumpolar Health  2012;71:10.3402/ijch.v71i0.18417.
doi:10.3402/ijch.v71i0.18417
PMCID: PMC3417582  PMID: 22973563
6.  Arthritis in the Canadian Aboriginal Population: North-South Differences in Prevalence and Correlates* *This article is part of a joint publication initiative between Preventing Chronic Disease and Chronic Diseases in Canada. Preventing Chronic Disease is the secondary publisher, while Chronic Diseases in Canada is the primary publisher.  
Preventing Chronic Disease  2010;8(1):A04.
Background
Information on arthritis and other musculoskeletal disorders among Aboriginal people is sparse. Survey data show that arthritis and rheumatism are among the most commonly reported chronic conditions and their prevalence is higher than among non-Aboriginal people.
Objective
To describe the burden of arthritis among Aboriginal people in northern Canada and demonstrate the public health significance and social impact of the disease.
Methods
Using cross-sectional data from more than 29 000 Aboriginal people aged 15 years and over who participated in the Aboriginal Peoples Survey 2006, we assessed regional differences in the prevalence of arthritis and its association with other risk factors, co-morbidity and health care use.
Results
The prevalence of arthritis in the three northern territories ("North") is 12.7% compared to 20.1% in the provinces ("South") and is higher among females than males in both the North and South. The prevalence among Inuit is lower than among other Aboriginal groups. Individuals with arthritis are more likely to smoke, be obese, have concurrent chronic diseases, and are less likely to be employed. Aboriginal people with arthritis utilized the health care system more often than those without the disease.
Conclusion:
Aboriginal-specific findings on arthritis and other chronic diseases as well as recognition of regional differences between North and South will enhance program planning and help identify new priorities in health promotion.
Keywords
arthritis, Aboriginal people, Northern Canada, Inuit, First Nations, Métis, North American Indians, Aboriginal Peoples Survey
PMCID: PMC3044015  PMID: 21159216

Results 1-6 (6)