An Investigation of the Potential Impact of Climate Change on Infectious Gastroenteritis in the Canadian Arctic

Regions: Inuvialuit Settlement Region

Tags: health, climate change, traditional food, microbiology

Principal Investigator: Pardhan, Aliya (1)
Licence Number: 14439
Organization: University of Guelph
Licenced Year(s): 2009
Issued: Nov 20, 2008
Project Team: Jeff Wilson (Supervisor, University of Guelph), Chris Furgal (Committee member, Trent University), Scott McEwen (Co-Supervisor, University of Guelph), Victoria Edge (Committee member, University of Guelph, Public Health Agency of Cana), Richard Reid-Smith (Committee member, University of Guelph, Public Health Agency of Cana)

Objective(s): The objectives of this research are: i) to define the burden of infectious GI illness including incidence of specific diseases, symptoms, hospitalizations ii) to characterize risk factors for exposure including geographic distribution of disease, impact of weather variables and potential impact of climate change iii) to determine the distribution of resistant enteric pathogens in traditional and retail meats; and iv) to develop recommendations for improvement of infectious gastroenteritis surveillance including integration of relevant cultural issues into knowledge translation strategies.

Project Description: This license has been issued for the scientific research application #928.

The objectives of this research are: i) to define the burden of infectious GI illness including incidence of specific diseases, symptoms, hospitalizations ii) to characterize risk factors for exposure including geographic distribution of disease, impact of weather variables and potential impact of climate change iii) to determine the distribution of resistant enteric pathogens in traditional and retail meats; and iv) to develop recommendations for improvement of infectious gastroenteritis surveillance including integration of relevant cultural issues into knowledge translation strategies. Results from this study will be useful to inform policy making decisions, to strengthen public health infrastructure and services within each region, and to enhance the capacity to protect communities and help them to adapt to the potential health impacts of climate change.

The data sources to be used to address this objective will include record level hospitalization discharge data from the Canadian Institute of Health Information (CIHI), record level Notifiable Disease data from the regional health boards and data obtained from testing of traditional and retail foods for enteric pathogens and antimicrobial resistance (AMR).

The CIHI data has already been obtained through the Graduate Student Data Access Program which provides data to graduate students at no cost based on a successful application. Elements such as admission and discharge dates, geo-locator, age, gender, ICD-10 code, symptoms, treatment code, and mortality, will be extracted.

The Notifiable Disease data is being acquired through the regional health boards. The process includes submitting an application to the regional research ethics board to obtain a research license followed by approval from the Chief Medical Officer of Health to release the data. Research proposals have been submitted to each of the four regional health boards for review and licenses for both the Inuvialuit Settlement Region and Nunavut
have already been obtained. Elements such as report date, community, age, gender, etiologic agent and subtype, symptoms and hospitalizations, will be extracted.

Notifiable Disease and CIHI data will be analyzed using simple descriptive statistics to define the incidence of specific and non-specific GI diseases as well as the frequency of potential risk factors for infection (e.g. age, gender, reported exposures) and health outcomes (e.g. hospitalization, symptoms, health care utilization). Associations between infection and specific risk factors (e.g. age, gender, geographic location) will be tested using logistic regression analysis. The geographic distribution of specific and non-specific GI diseases will be determined using a Geographic Information System (GIS). The latter will also be used to undertake spatial regression analysis to identify additional risk factors for which spatial data are available (e.g. demographic data, health care access) and to identify clusters of GI illness in space and time. Seasonal and temporal patterns of infection will be assessed and the relationship between illness and weather variables will be examined using time series analysis. Outputs of weather variable analysis will be linked to existing climate prediction models to estimate the potential impact of climate change on the incidence of infectious GI diseases. Results of microbiologic analysis of traditional and retail meat samples for enteric bacteria (and their resistance patterns) will be analyzed using descriptive statistics and will be reported by source and type of product, geographic location and time.

Results of this analysis will be used to create a series of practical recommendations for the improvement of infectious GI disease surveillance (including a linkage to disease prevention initiatives) for each region. This will be done in collaboration with appropriate local and regional representatives as well as other stakeholders and will address issues such as engagement of communities and influencers, identification of relevant messages, media, language, and an understanding of the relevant cultural context including customs, beliefs, practices and existing programs. Results of this investigation will also be provided in written format (PhD Thesis and Regional Reports), through presentation at relevant conferences as well as through workshops with local and regional stakeholders.

The study will be conducted from January 01 to December 31, 2009 through access to notifiable disease data that has been reported from Aklavik, Holman, Inuvik, Paulatuk, Sachs Harbour and Tuktoyatuk. This project has been reviewed and and the release of data has been approved by the Department of Health and Social Services.