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  1. Article ; Online: Persistence of Anti-SARS-CoV-2 Antibodies in Long Term Care Residents Over Seven Months After Two COVID-19 Outbreaks.

    Tanunliong, Guadalein / Liu, Aaron / Vijh, Rohit / Pidduck, Tamara / Kustra, Jesse / Márquez, Ana Citlali / Choi, Alexandra / McLennan, Meghan / Hayden, Althea / Kearney, Christy / Gantt, Soren / Krajden, Mel / Morshed, Muhammad / Jassem, Agatha N / Sekirov, Inna

    Frontiers in immunology

    2022  Volume 12, Page(s) 775420

    Abstract: Background: As part of the public health outbreak investigations, serological surveys were carried out following two COVID-19 outbreaks in April 2020 and October 2020 in one long term care facility (LTCF) in British Columbia, Canada. This study ... ...

    Abstract Background: As part of the public health outbreak investigations, serological surveys were carried out following two COVID-19 outbreaks in April 2020 and October 2020 in one long term care facility (LTCF) in British Columbia, Canada. This study describes the serostatus of the LTCF residents and monitors changes in their humoral response to SARS-CoV-2 and other human coronaviruses (HCoV) over seven months.
    Methods: A total of 132 serum samples were collected from all 106 consenting residents (aged 54-102) post-first outbreak (N=87) and post-second outbreak (N=45) in one LTCF; 26/106 participants provided their serum following both COVID-19 outbreaks, permitting longitudinal comparisons between surveys. Health-Canada approved commercial serologic tests and a pan-coronavirus multiplexed immunoassay were used to evaluate antibody levels against the spike protein, nucleocapsid, and receptor binding domain (RBD) of SARS-CoV-2, as well as the spike proteins of HCoV-229E, HCoV-HKU1, HCoV-NL63, and HCoV-OC43. Statistical analyses were performed to describe the humoral response to SARS-CoV-2 among residents longitudinally.
    Findings: Survey findings demonstrated that among the 26 individuals that participated in both surveys, all 10 individuals seropositive after the first outbreak continued to be seropositive following the second outbreak, with no reinfections identified among them. SARS-CoV-2 attack rate in the second outbreak was lower (28.6%) than in the first outbreak (40.2%), though not statistically significant (P>0.05). Gradual waning of anti-nucleocapsid antibodies to SARS-CoV-2 was observed on commercial (median Δ=-3.7, P=0.0098) and multiplexed immunoassay (median Δ=-169579, P=0.014) platforms; however, anti-spike and anti-receptor binding domain (RBD) antibodies did not exhibit a statistically significant decline over 7 months. Elevated antibody levels for beta-HCoVs OC43 (P<0.0001) and HKU1 (P=0.0027) were observed among individuals seropositive for SARS-CoV-2 compared to seronegative individuals.
    Conclusion: Our study utilized well-validated serological platforms to demonstrate that humoral responses to SARS-CoV-2 persisted for at least 7 months. Elevated OC43 and HKU1 antibodies among SARS-CoV-2 seropositive individuals may be attributed to cross reaction and/or boosting of humoral response.
    MeSH term(s) Aged ; Aged, 80 and over ; Antibodies, Viral/blood ; COVID-19/blood ; COVID-19/epidemiology ; Canada ; Disease Outbreaks ; Female ; Humans ; Long-Term Care ; Male ; SARS-CoV-2/metabolism ; Time Factors
    Chemical Substances Antibodies, Viral
    Language English
    Publishing date 2022-01-03
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2021.775420
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Characterizing Longitudinal Antibody Responses in Recovered Individuals Following COVID-19 Infection and Single-Dose Vaccination: A Prospective Cohort Study.

    Olmstead, Andrea D / Nikiforuk, Aidan M / Schwartz, Sydney / Márquez, Ana Citlali / Valadbeigy, Tahereh / Flores, Eri / Saran, Monika / Goldfarb, David M / Hayden, Althea / Masud, Shazia / Russell, Shannon L / Prystajecky, Natalie / Jassem, Agatha N / Morshed, Muhammad / Sekirov, Inna

    Viruses

    2022  Volume 14, Issue 11

    Abstract: Background: Investigating antibody titers in individuals who have been both naturally infected with SARS-CoV-2 and vaccinated can provide insight into antibody dynamics and correlates of protection over time.: Methods: Human coronavirus (HCoV) IgG ... ...

    Abstract Background: Investigating antibody titers in individuals who have been both naturally infected with SARS-CoV-2 and vaccinated can provide insight into antibody dynamics and correlates of protection over time.
    Methods: Human coronavirus (HCoV) IgG antibodies were measured longitudinally in a prospective cohort of qPCR-confirmed, COVID-19 recovered individuals (k = 57) in British Columbia pre- and post-vaccination. SARS-CoV-2 and endemic HCoV antibodies were measured in serum collected between Nov. 2020 and Sept. 2021 (n = 341). Primary analysis used a linear mixed-effects model to understand the effect of single dose vaccination on antibody concentrations adjusting for biological sex, age, time from infection and vaccination. Secondary analysis investigated the cumulative incidence of high SARS-CoV-2 anti-spike IgG seroreactivity equal to or greater than 5.5 log10 AU/mL up to 105 days post-vaccination. No re-infections were detected in vaccinated participants, post-vaccination by qPCR performed on self-collected nasopharyngeal specimens.
    Results: Bivariate analysis (complete data for 42 participants, 270 samples over 472 days) found SARS-CoV-2 spike and RBD antibodies increased 14-56 days post-vaccination (
    Conclusions: Our study confirms that vaccination post-SARS-CoV-2 infection provides multiple benefits, such as increasing anti-spike IgG titers and preventing decay up to 85 days post-vaccination.
    MeSH term(s) Humans ; COVID-19/prevention & control ; Antibody Formation ; SARS-CoV-2 ; Prospective Studies ; COVID-19 Vaccines ; Antibodies, Viral ; Vaccination ; Immunoglobulin G
    Chemical Substances COVID-19 Vaccines ; Antibodies, Viral ; Immunoglobulin G
    Language English
    Publishing date 2022-10-31
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2516098-9
    ISSN 1999-4915 ; 1999-4915
    ISSN (online) 1999-4915
    ISSN 1999-4915
    DOI 10.3390/v14112416
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Evaluation of a multisectoral intervention to mitigate the risk of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) transmission in long-term care facilities.

    Vijh, Rohit / Prairie, Jessica / Otterstatter, Michael C / Hu, Yumian / Hayden, Althea S / Yau, Brandon / Daly, Patricia / Lysyshyn, Mark / McKee, Geoff / Harding, John / Forsting, Sara / Schwandt, Michael

    Infection control and hospital epidemiology

    2021  Volume 42, Issue 10, Page(s) 1181–1188

    Abstract: Objective: A Canadian health authority implemented a multisectoral intervention designed to control severe acute respiratory coronavirus virus 2 (SARS-CoV-2) transmission during long-term care facility (LTCF) outbreaks. The primary objective was to ... ...

    Abstract Objective: A Canadian health authority implemented a multisectoral intervention designed to control severe acute respiratory coronavirus virus 2 (SARS-CoV-2) transmission during long-term care facility (LTCF) outbreaks. The primary objective was to evaluate the effectiveness of the intervention 14 days after implementation.
    Design: Quasi-experimental, segmented regression analysis.
    Intervention: A series of outbreak measures classified into 4 categories: case and contact management, proactive case detection, rigorous infection control practices and resource prioritization and stewardship.
    Methods: A mixed-effects segmented Poisson regression model was fitted to the incidence rate of coronavirus disease 2019 (COVID-19), calculated every 2 days, within each facility and case type (staff vs residents). For each facility, the outbreak time period was segmented into an early outbreak period (within 14 days of the intervention) and postintervention period (beyond 14 days following the intervention). Model outputs quantified COVID-19 incidence trend and rate changes between these 2 periods. A secondary model was constructed to identify effect modification by case type.
    Results: The significant upward trend in COVID-19 incidence rate during the early outbreak period (rate ratio [RR], 1.07; 95% confidence interval [CI], 1.03-1.11; P < .001) reversed during the postintervention period (RR, 0.73; 95% CI, 0.67-0.80; P < .001). The average trend did not differ by case type during the early outbreak period (P > .05) or the postintervention period (P > .05). However, staff had a 70% larger decrease in the average rate of COVID-19 during the postintervention period than residents (RR, 0.30; 95% CI, 0.10-0.88; P < .05).
    Conclusions: Our study provides evidence for the effectiveness of this intervention to reduce the transmission of COVID-19 in LTCFs. This intervention can be adapted and utilized by other jurisdictions to protect the vulnerable individuals in LTCFs.
    MeSH term(s) COVID-19 ; Canada/epidemiology ; Humans ; Long-Term Care ; SARS-CoV-2 ; Skilled Nursing Facilities
    Language English
    Publishing date 2021-01-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639378-0
    ISSN 1559-6834 ; 0195-9417 ; 0899-823X
    ISSN (online) 1559-6834
    ISSN 0195-9417 ; 0899-823X
    DOI 10.1017/ice.2020.1407
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Characterizing Longitudinal Antibody Responses in Recovered Individuals Following COVID-19 Infection and Single-Dose Vaccination in British Columbia, Canada: a Prospective Cohort Study

    Olmstead, Andrea D. / Nikiforuk, Aidan M. / Schwartz, Sydney / Márquez, Ana Citlali / Valadbeigy, Tahereh / Flores, Eri / Saran, Monika / Goldfarb, David M. / Hayden, Althea / Masud, Shazia / Jassem, Agatha N. / Morshed, Muhammad / Sekirov, Inna

    medRxiv

    Abstract: Background: Investigating antibody titres in individuals who have been both naturally infected with SARS-CoV-2 and vaccinated can provide insight into antibody dynamics and correlates of protection over time. Methods: Human coronavirus (HCoV) IgG ... ...

    Abstract Background: Investigating antibody titres in individuals who have been both naturally infected with SARS-CoV-2 and vaccinated can provide insight into antibody dynamics and correlates of protection over time. Methods: Human coronavirus (HCoV) IgG antibodies were measured longitudinally in a prospective cohort of PCR-confirmed, COVID-19 recovered individuals (k=57) in British Columbia pre- and post-vaccination. SARS-CoV-2 and endemic HCoV antibodies were measured in serum collected between Nov. 2020 and Sept. 2021 (n=341). Primary analysis used a linear mixed-effects model to understand the effect of single dose vaccination on antibody concentrations adjusting for biological sex, age, time from infection and vaccination. Secondary analysis investigated the cumulative incidence of high SARS-CoV-2 anti-spike IgG seroreactivity equal to or greater than 5.5 log10 AU/mL up to 105 days post-vaccination. No re-infections were detected in vaccinated participants, post-vaccination by qRT-PCR performed on self-collected nasopharyngeal specimens. Results: Bivariate analysis (complete data for 42 participants, 270 samples over 472 days) found SARS-CoV-2 spike and RBD antibodies increased 14-56 days post-vaccination (p<0.001) and vaccination prevented waning (B=1.66 [95%CI: 1.45-3.46]); while decline of nucleocapsid antibodies over time was observed (B=-0.24 [95%CI: -1.2-(-0.12)]). A non-significant trend towards higher spike antibodies against endemic beta-HCoVs was also noted. On average, SARS-CoV-2 anti-spike IgG concentration increased in participants who received one vaccine dose by 2.06 log10 AU/mL (95%CI: 1.45-3.46) adjusting for age, biological sex, and time. Cumulative incidence of high SARS-CoV-2 spike antibodies (>5.5 log10 AU/mL) was 83% greater in vaccinated compared to unvaccinated individuals. Conclusions: Our study confirms that vaccination post-SARS-CoV-2 infection provides multiple benefits, such as increasing anti-spike IgG titers and preventing decay up to 85 days post-vaccination.
    Keywords covid19
    Language English
    Publishing date 2022-09-29
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2022.09.28.22280429
    Database COVID19

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  5. Article ; Online: Characterizing Longitudinal Antibody Responses in Recovered Individuals Following COVID-19 Infection and Single-Dose Vaccination in British Columbia, Canada: a Prospective Cohort Study

    Olmstead, Andrea D. / Nikiforuk, Aidan M / Schwartz, Sydney / Marquez, Ana Citlali / Valadbeigy, Tahereh / Flores, Eri / Saran, Monika / Goldfarb, David M. / Hayden, Althea / Masud, Shazia / Jassem, Agatha N. / Morshed, Muhammad / Sekirov, Inna

    medRxiv

    Abstract: Background: Investigating antibody titres in individuals who have been both naturally infected with SARS-CoV-2 and vaccinated can provide insight into antibody dynamics and correlates of protection over time. Methods: Human coronavirus (HCoV) IgG ... ...

    Abstract Background: Investigating antibody titres in individuals who have been both naturally infected with SARS-CoV-2 and vaccinated can provide insight into antibody dynamics and correlates of protection over time. Methods: Human coronavirus (HCoV) IgG antibodies were measured longitudinally in a prospective cohort of PCR-confirmed, COVID-19 recovered individuals (k=57) in British Columbia pre- and post-vaccination. SARS-CoV-2 and endemic HCoV antibodies were measured in serum collected between Nov. 2020 and Sept. 2021 (n=341). Primary analysis used a linear mixed-effects model to understand the effect of single dose vaccination on antibody concentrations adjusting for biological sex, age, time from infection and vaccination. Secondary analysis investigated the cumulative incidence of high SARS-CoV-2 anti-spike IgG seroreactivity equal to or greater than 5.5 log10 AU/mL up to 105 days post-vaccination. No re-infections were detected in vaccinated participants, post-vaccination by qRT-PCR performed on self-collected nasopharyngeal specimens. Results: Bivariate analysis (complete data for 42 participants, 270 samples over 472 days) found SARS-CoV-2 spike and RBD antibodies increased 14-56 days post-vaccination (p<0.001) and vaccination prevented waning (B=1.66 [95%CI: 1.45-3.46]); while decline of nucleocapsid antibodies over time was observed (B=-0.24 [95%CI: -1.2-(-0.12)]). A non-significant trend towards higher spike antibodies against endemic beta-HCoVs was also noted. On average, SARS-CoV-2 anti-spike IgG concentration increased in participants who received one vaccine dose by 2.06 log10 AU/mL (95%CI: 1.45-3.46) adjusting for age, biological sex, and time. Cumulative incidence of high SARS-CoV-2 spike antibodies (>5.5 log10 AU/mL) was 83% greater in vaccinated compared to unvaccinated individuals. Conclusions: Our study confirms that vaccination post-SARS-CoV-2 infection provides multiple benefits, such as increasing anti-spike IgG titers and preventing decay up to 85 days post-vaccination.
    Keywords covid19
    Language English
    Publishing date 2022-09-29
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2022.09.28.22280429
    Database COVID19

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  6. Article ; Online: Environmental detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from medical equipment in long-term care facilities undergoing COVID-19 outbreaks.

    Nelson, Atiba / Kassimatis, Jennifer / Estoque, Jay / Yang, Cicely / McKee, Geoff / Bryce, Elizabeth / Hoang, Linda / Daly, Patricia / Lysyshyn, Mark / Hayden, Althea S / Harding, John / Boraston, Suni / Dawar, Meena / Schwandt, Michael

    American journal of infection control

    2020  Volume 49, Issue 2, Page(s) 265–268

    Abstract: Environmental sampling was conducted at long-term care facilities to determine the extent of surface contamination with severe acute respiratory syndrome coronavirus 2 virus. Medical equipment used throughout the facility was determined to be ... ...

    Abstract Environmental sampling was conducted at long-term care facilities to determine the extent of surface contamination with severe acute respiratory syndrome coronavirus 2 virus. Medical equipment used throughout the facility was determined to be contaminated.
    MeSH term(s) COVID-19/epidemiology ; COVID-19/transmission ; COVID-19/virology ; Canada/epidemiology ; Cross Infection/epidemiology ; Cross Infection/transmission ; Cross Infection/virology ; Disease Outbreaks ; Environmental Monitoring ; Equipment Contamination/statistics & numerical data ; Equipment and Supplies/virology ; Humans ; Long-Term Care ; RNA, Viral/isolation & purification ; Residential Facilities/statistics & numerical data ; SARS-CoV-2/isolation & purification
    Chemical Substances RNA, Viral
    Keywords covid19
    Language English
    Publishing date 2020-07-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 392362-9
    ISSN 1527-3296 ; 0196-6553
    ISSN (online) 1527-3296
    ISSN 0196-6553
    DOI 10.1016/j.ajic.2020.07.001
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  7. Article ; Online: SARS-CoV-2 serology: Validation of high-throughput chemiluminescent immunoassay (CLIA) platforms and a field study in British Columbia.

    Sekirov, Inna / Barakauskas, Vilte E / Simons, Janet / Cook, Darrel / Bates, Brandon / Burns, Laura / Masud, Shazia / Charles, Marthe / McLennan, Meghan / Mak, Annie / Chahil, Navdeep / Vijh, Rohit / Hayden, Althea / Goldfarb, David / Levett, Paul N / Krajden, Mel / Morshed, Muhammad

    Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology

    2021  Volume 142, Page(s) 104914

    Abstract: Background: SARS-CoV-2 antibody testing is required for estimating population seroprevalence and vaccine response studies. It may also increase case identification when used as an adjunct to routine molecular testing. We performed a validation study and ...

    Abstract Background: SARS-CoV-2 antibody testing is required for estimating population seroprevalence and vaccine response studies. It may also increase case identification when used as an adjunct to routine molecular testing. We performed a validation study and evaluated the use of automated high-throughput assays in a field study of COVID-19-affected care facilities.
    Methods: Six automated assays were assessed: 1) DiaSorin LIAISON
    Results: All assays had sensitivities >90% in the field study, while in the validation study, 5/6 assays were >90% sensitive and DiaSorin was 79% sensitive. Specificities and negative predictive values were >95% for all assays. Field study estimated positive predictive values at 1-10% disease prevalence were 100% for Siemens, Abbott and Roche, while DiaSorin and Ortho assays had lower PPVs at 1% prevalence, but PPVs increased at 5-10% prevalence. In the field study, addition of serology increased diagnoses by 16% compared to PCR testing alone.
    Conclusions: All assays evaluated in this study demonstrated high sensitivity and specificity for samples collected at least 14 days post-symptom onset, while sensitivity was variable 0-14 days after infection. The addition of serology to the outbreak investigations increased case detection by 16%.
    MeSH term(s) Antibodies, Viral ; British Columbia ; COVID-19 ; Humans ; Immunoassay ; SARS-CoV-2 ; Sensitivity and Specificity ; Seroepidemiologic Studies
    Chemical Substances Antibodies, Viral
    Language English
    Publishing date 2021-07-16
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1446080-4
    ISSN 1873-5967 ; 1386-6532
    ISSN (online) 1873-5967
    ISSN 1386-6532
    DOI 10.1016/j.jcv.2021.104914
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  8. Article ; Online: Abortion health services in Canada: Results of a 2012 national survey.

    Norman, Wendy V / Guilbert, Edith R / Okpaleke, Christopher / Hayden, Althea S / Steven Lichtenberg, E / Paul, Maureen / White, Katharine O'Connell / Jones, Heidi E

    Canadian family physician Medecin de famille canadien

    2017  Volume 62, Issue 4, Page(s) e209–e217

    Abstract: Objective: To determine the location of Canadian abortion services relative to where reproductive-age women reside, and the characteristics of abortion facilities and providers.: Design: An international survey was adapted for Canadian relevance. ... ...

    Abstract Objective: To determine the location of Canadian abortion services relative to where reproductive-age women reside, and the characteristics of abortion facilities and providers.
    Design: An international survey was adapted for Canadian relevance. Public sources and professional networks were used to identify facilities. The bilingual survey was distributed by mail and e-mail from July to November 2013.
    Setting: Canada.
    Participants: A total of 94 abortion facilities were identified.
    Main outcome measures: The number and location of services were compared with the distribution of reproductive-age women by location of residence.
    Results: We identified 94 Canadian facilities providing abortion in 2012, with 48.9% in Quebec. The response rate was 83.0% (78 of 94). Facilities in every jurisdiction with services responded. In Quebec and British Columbia abortion services are nearly equally present in large urban centres and rural locations throughout the provinces; in other Canadian provinces services are chiefly located in large urban areas. No abortion services were identified in Prince Edward Island. Respondents reported provision of 75 650 abortions in 2012 (including 4.0% by medical abortion). Canadian facilities reported minimal or no harassment, in stark contrast to American facilities that responded to the same survey.
    Conclusion: Access to abortion services varies by region across Canada. Services are not equitably distributed in relation to the regions where reproductive-age women reside. British Columbia and Quebec have demonstrated effective strategies to address disparities. Health policy and service improvements have the potential to address current abortion access inequity in Canada. These measures include improved access to mifepristone for medical abortion; provincial policies to support abortion services; routine abortion training within family medicine residency programs; and increasing the scope of practice for nurses and midwives to include abortion provision.
    MeSH term(s) Abortion, Induced/statistics & numerical data ; Adolescent ; Adult ; Ambulatory Care Facilities/statistics & numerical data ; Canada ; Cross-Sectional Studies ; Female ; Health Services Accessibility ; Healthcare Disparities ; Humans ; Physicians, Family ; Pregnancy ; Rural Population ; Surveys and Questionnaires ; Urban Population ; Young Adult
    Language English
    Publishing date 2017-02-10
    Publishing country Canada
    Document type Journal Article ; Multicenter Study
    ZDB-ID 2146676-2
    ISSN 1715-5258 ; 0008-350X
    ISSN (online) 1715-5258
    ISSN 0008-350X
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  9. Article ; Online: First-trimester medical abortion practices in Canada: National survey.

    Guilbert, Edith R / Hayden, Althea S / Jones, Heidi E / White, Katharine O'Connell / Steven Lichtenberg, E / Paul, Maureen / Norman, Wendy V

    Canadian family physician Medecin de famille canadien

    2017  Volume 62, Issue 4, Page(s) e201–e208

    Abstract: Objective: To understand the current availability and practice of first-trimester medical abortion (MA) in Canada.: Design: Using public sources and professional networks, abortion facilities across Canada were identified for a cross-sectional survey ...

    Abstract Objective: To understand the current availability and practice of first-trimester medical abortion (MA) in Canada.
    Design: Using public sources and professional networks, abortion facilities across Canada were identified for a cross-sectional survey on medical and surgical abortion. English and French surveys were distributed by surface or electronic mail between July and November 2013.
    Setting: Canada.
    Participants: A total of 94 abortion facilities were identified.
    Main outcome measures: Descriptive statistics on MA practice and facility and provider characteristics, as well as comparisons of MA practice by facility and provider characteristics using χ
    Results: A total of 78 of 94 (83.0%) facilities responded. Medical abortion represented 3.8% of first-trimester abortions reported (2706 of 70 860) in 2012. Among the facilities offering MA, 45.0% performed fewer than 500 first-trimester abortions a year, while 35.0% performed more than 1000. More MAs were performed in private offices or ambulatory health centres than in hospitals. Sixty-two physicians from 28 of 78 facilities reported providing first-trimester MA; 87.1% also provided surgical abortion. More than three-quarters of MA physicians were female and 56.5% were family physicians. A preponderance (85.2%) of providers offered methotrexate with misoprostol. Nearly all physicians (90.3%) required patients to have an ultrasound before MA, and 72.6% assessed the completion of the abortion with ultrasonography. Most physicians (74.2%) offered MA through 49 days after the onset of the last menstrual period, and 21.0% offered MA through 50 to 56 days; 37.1% reported providing MA to patients who lived more than 2 hours away. Four physicians from 1 site provided MA via telemedicine.
    Conclusion: In Canada, MA provision using methotrexate and misoprostol is consistent with best-practice guidelines, but MA is rare and its availability is unevenly distributed.
    MeSH term(s) Abortion, Induced/statistics & numerical data ; Ambulatory Care Facilities ; Canada ; Cross-Sectional Studies ; Female ; Humans ; Physicians, Family ; Pregnancy ; Pregnancy Trimester, First ; Private Facilities ; Surveys and Questionnaires ; Ultrasonography
    Language English
    Publishing date 2017-02-10
    Publishing country Canada
    Document type Journal Article ; Multicenter Study
    ZDB-ID 2146676-2
    ISSN 1715-5258 ; 0008-350X
    ISSN (online) 1715-5258
    ISSN 0008-350X
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  10. Article ; Online: Spatial-Temporal Epidemiology of the Syphilis Epidemic in Relation to Neighborhood-Level Structural Factors in British Columbia, 2005-2016.

    Salway, Travis / Gesink, Dionne / Lukac, Christine / Roth, David / Ryan, Venessa / Mak, Sunny / Wang, Susan / Newhouse, Emily / Hayden, Althea / Bharmal, Aamir / Hoyano, Dee / Morshed, Muhammad / Grennan, Troy / Gilbert, Mark / Wong, Jason

    Sexually transmitted diseases

    2019  Volume 46, Issue 9, Page(s) 571–578

    Abstract: Background: Spatial clusters of syphilis have been observed within several jurisdictions globally; however, the degree to which they are predicted by the spatial distributions of gay, bisexual, and other men who have sex with men (GBM) and testing ... ...

    Abstract Background: Spatial clusters of syphilis have been observed within several jurisdictions globally; however, the degree to which they are predicted by the spatial distributions of gay, bisexual, and other men who have sex with men (GBM) and testing remains unknown. We sought to describe the spatial-temporal epidemiology of infectious syphilis and identify associations between neighborhood-level factors and rates of syphilis, in British Columbia, Canada.
    Methods: We used ArcGIS to map infectious syphilis cases among men (2005 to 2016), SaTScan to detect areas with significantly elevated rates of syphilis, and spatial regression to identify associations between neighborhood-level factors and rates of syphilis.
    Results: Five clusters were identified: a core in downtown Vancouver (incidence rate ratio [IRR], 18.0; 2007-2016), 2 clusters adjacent to the core (IRR, 3.3; 2012-2016; and IRR, 2.2; 2013-2016), 1 cluster east of Vancouver (IRR, 2.1; 2013-2016), and 1 cluster in Victoria (IRR, 4.3; 2015-2016). Epidemic curves were synchronized across cluster and noncluster regions. Neighborhood-level GBM population estimates and testing rates were both associated with syphilis rates; however, the spatial distribution of syphilis was not fully explained by either of these factors.
    Conclusions: We identified two novel ecologic correlates of the spatial distribution of infectious syphilis-density of GBM and rates of syphilis testing-and found that these factors partially, though not entirely, explained the spatial distribution of clusters. Residual spatial autocorrelation suggests that greater syphilis testing coverage may be needed and low-barrier GBM-affirming testing should be expanded to regions outside the core.
    MeSH term(s) Adult ; British Columbia/epidemiology ; Epidemics ; Homosexuality, Male/statistics & numerical data ; Humans ; Incidence ; Male ; Residence Characteristics ; Sexual Behavior ; Sexual and Gender Minorities/statistics & numerical data ; Spatio-Temporal Analysis ; Syphilis/epidemiology ; Syphilis Serodiagnosis
    Language English
    Publishing date 2019-07-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 435191-5
    ISSN 1537-4521 ; 0148-5717
    ISSN (online) 1537-4521
    ISSN 0148-5717
    DOI 10.1097/OLQ.0000000000001034
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