Harper Sherilee L, Edge Victoria L, Ford James, Thomas M Kate, Pearl David, Shirley Jamal, McEwen Scott A
Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada;
Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada.
Int J Circumpolar Health. 2015 May 21;74:26290. doi: 10.3402/ijch.v74.26290. eCollection 2015.
The incidence of self-reported acute gastrointestinal illness (AGI) in Rigolet, Nunatsiavut, and Iqaluit, Nunavut, is higher than reported elsewhere in Canada; as such, understanding AGI-related healthcare use is important for healthcare provision, public health practice and surveillance of AGI.
This study described symptoms, severity and duration of self-reported AGI in the general population and examined the incidence and factors associated with healthcare utilization for AGI in these 2 Inuit communities.
Cross-sectional survey data were analysed using multivariable exact logistic regression to examine factors associated with individuals' self-reported healthcare and over-the-counter (OTC) medication utilization related to AGI symptoms.
In Rigolet, few AGI cases used healthcare services [4.8% (95% CI=1.5-14.4%)]; in Iqaluit, some cases used healthcare services [16.9% (95% CI=11.2-24.7%)]. Missing traditional activities due to AGI (OR=3.8; 95% CI=1.18-12.4) and taking OTC medication for AGI symptoms (OR=3.8; 95% CI=1.2-15.1) were associated with increased odds of using healthcare services in Iqaluit. In both communities, AGI severity and secondary symptoms (extreme tiredness, headache, muscle pains, chills) were significantly associated with increased odds of taking OTC medication.
While rates of self-reported AGI were higher in Inuit communities compared to non-Inuit communities in Canada, there were lower rates of AGI-related healthcare use in Inuit communities compared to other regions in Canada. As such, the rates of healthcare use for a given disease can differ between Inuit and non-Inuit communities, and caution should be exercised in making comparisons between Inuit and non-Inuit health outcomes based solely on clinic records and healthcare use.
努纳武特地区里戈莱特和伊卡卢伊特自我报告的急性胃肠道疾病(AGI)发病率高于加拿大其他地区;因此,了解与AGI相关的医疗保健使用情况对于医疗保健提供、公共卫生实践和AGI监测至关重要。
本研究描述了普通人群中自我报告的AGI的症状、严重程度和持续时间,并调查了这两个因纽特社区中与AGI医疗保健利用相关的发病率和因素。
使用多变量精确逻辑回归分析横断面调查数据,以检查与个体自我报告的与AGI症状相关的医疗保健和非处方(OTC)药物使用相关的因素。
在里戈莱特,很少有AGI病例使用医疗服务[4.8%(95%CI=1.5-14.4%)];在伊卡卢伊特,一些病例使用医疗服务[16.9%(95%CI=11.2-24.7%)]。因AGI而错过传统活动(OR=3.8;95%CI=1.18-12.4)以及因AGI症状服用非处方药(OR=3.8;95%CI=1.2-15.1)与在伊卡卢伊特使用医疗服务的几率增加相关。在两个社区中,AGI严重程度和继发症状(极度疲劳、头痛、肌肉疼痛、寒战)与服用非处方药的几率增加显著相关。
虽然与加拿大非因纽特社区相比,因纽特社区自我报告的AGI发病率更高,但与加拿大其他地区相比,因纽特社区中与AGI相关的医疗保健使用率较低。因此,因纽特社区和非因纽特社区中给定疾病的医疗保健使用率可能不同,在仅基于临床记录和医疗保健使用情况对因纽特人和非因纽特人的健康结果进行比较时应谨慎。