Indigenous Health: Infectious Diseases

Question 1

Name common infections affecting the Indigenous population in Canada (8)

Answer 1

1. Acute otitis media
2. Influenza
3. COVID-19
4. Pneumococcus infection (Strep. pneumoniae)
5. STIs
6. Hepatitis C
7. Dental caries
8. H. pylori
9. Impetigo

Question 2

Acute otitis media can cause conductive …

Answer 2

hearing loss

Question 3

Consider … in Indigenous children with chronic otorrhea

Answer 3

pseudomonas

Question 4

4 ways to prevent acute otitis media

Answer 4

1. Avoid daycare
2. Avoid baby bottle/pacifier
3. No smoking/second hand smoke exposure
4. Encourage breastfeeding

Question 5

2 causes of impetigo (superficial skin infection)

Answer 5

1. Staphylococcus aureus
2. Streptococcus pyogenes (GAS)

Question 6

T/F: Influenza rates are much higher among First Nations peoples than non-Indigenous popultion

Answer 6

T

Question 7

T/F: First Nations peoples in Canada are much more likely to require hospitalization for influenza

Answer 7

T

Question 8

T/F: First Nations peoples in Canada are much more likely to have severe influenza (i.e. requiring ICU care)

Answer 8

T

Question 9

T/F: First Nations peoples living on a reserve in Canada are much more likely to have influenza every year

Answer 9

T

Question 10

Name some risk factors for influenza (10)

Answer 10

1. Belonging to First Nations community
2. Poverty
3. Female
4. Obesity, BMI>30
5. Pregnancy
6. Underlying lung disease
7. Diabetes
8. Malignancy
9. Kidney disease
10. Immune suppression

Question 11

T/F: Globally, Indigenous Peoples have increased hospitalization rates, increased ICU rates and increased mortality rates for Covid-19

Answer 11

T

Question 12

T/F: Both the Covid-19 case rate and fatality rate for First Nations living on reserve was higher than the Canadian rate

Answer 12

F: The case rate was higher, but the fatality rate was lower than the Canadian rate

Question 13

How come the case rate for Covid-19 was higher in FN living on reserve, but the fatality rate was lower than the Canadian rate

Answer 13

The Indigenous population is younger!

Question 14

T/F: The cause specific mortality rate for Covid was higher for FN living on reserve than for Canadians

Answer 14

T

Question 15

All of these are common infections/conditions seen among Indigenous peoples except one. Which one?
1. Invasive pneumococcal disease
2. Fungal infections
3. MRSA
4. Acute otitis media
5. HIV

Answer 15

2. Fungal infections

Question 16

Name some rare infectious diseases in Indigenous populations

Answer 16

1. Acute rheumatic fever
2. Botulism
3. Congenital Syphilis
4. Toxoplasmosis

Question 17

Acute rheumatic fever is a consequence of untreated…

Answer 17

group A strep infection (S. pyogenes)

Question 18

Acute rheumatic fever is primarily a disease of … linked to …

Answer 18

primarily a disease of children and teens linked to poverty and poor housing

Question 19

2 typical features of acute rheumatic fever of physical exam

Answer 19

1. Erythema marginatum
2. Subcutaneous nodules

Question 20

Late finding of rheumatic fever: abrupt, involuntary movements of the body

Answer 20

Sydenham chorea

Question 21

Describe Sydenham chorea (late finding ofrheumatic fever)

Answer 21

• Abrupt involuntary movements
• May present 1-8 months later
• Movements go away during sleep
• Pt may display atypical, emotional behaviour

Question 22

Rheumatic fever treatment

Answer 22

Penicillin for 10 days

Question 23

Botulism is caused by…

Answer 23

Clostridium botulinum

Question 24

Clostridum boulinum, the bacterium that causes botulism, is mainly … borne

Answer 24

food-borne

Question 25

T/F: Incidence of botulism is much greater in Nunavik compared to Canada

Answer 25

T: Mainly due to poorly stored marine mammal meat

Question 26

Botulism presentation

Answer 26

Descending neurologic symptoms: - cranial nerve palsies - proximal weakness - diaphragmatic paralysis - constipation - urinary retention - LE paralysis

Question 27

Botulism treatment

Answer 27

IV botulinum anti-toxin (no need for antimicrobial therapy - does not affect the toxin)

Question 28

What spirochete causes syphillis?

Answer 28

Treponema pallidum

Question 29

Syphilis is curable with...

Answer 29

penicillin

Question 30

Describe the manifestations in the 3 syphilis stages

Answer 30

Primary: sores Secondary: rash, systemic symptoms Tertiary: Neurosyphilis, CVS disease, gummatous lesions

Question 31

Because syphilis is rampant in Nunavik, we must perform ... on pregnant women

Answer 31

serial serology during pregnancy and delivery

Question 32

As in non-Indigenous populations, ... make up the majority of cases of HIV a) females b) males

Answer 32

b) males

Question 33

T/F: Women constitute a larger proportion of HIV cases compared to non-Indigenous females

Answer 33

T

Question 34

T/F: Indigenous peoples get infected with HIV at younger ages than the non-Indigenous population

Answer 34

T

Question 35

This infection is usually seen in people who have contact with cats

Answer 35

Toxoplasmosa gondii

Question 36

T/F: Toxoplasmosis has an increased prevalence in the Init of Northern Quebec

Answer 36

T

Question 37

This bacterial infection is related to a bacteria that used to be a major cause of meningitis and epiglottitis among Indigenous children

Answer 37

Haemophilus influenza type a

Question 38

T/F: Being a First Nations person seems to be an independent risk factor for influenza

Answer 38

T: But not because of common ancestry, but rather Canadian Aboriginal people and Australian Aboriginals and Torres Strait Islanders have in common is a history of colonization, combined with historic and continuing social inequities that have led to significant health disparities

Question 39

What is a preventative measure to avoid acute otitis media in infants?

Answer 39

Avoid using baby bottles