In Nunavik, the battle against bacterial sexually transmissible and blood-borne infections (STBBIs) has become increasingly urgent. In the wake of mass interventions in the 1990s, and despite more recent efforts, the region has been unable to lower its incidence curves, particularly for gonococcal infection, which has reached epidemic proportions since fall 2007. In this context, and spurred by the renewed interest of medical teams on the ground, the Direction de santé publique (department of public health: DSP) of the Régie régionale de la santé et des services sociaux du Nunavik / Nunavik Regional Board of Health and Social Services (NRBHSS) has asked the Institut national de santé publique (Québec's national public health institute: INSPQ) to support a group of experts in an attempt to optimize the regional program for clinical prevention of STBBIs. Accordingly, a meeting was held on October 2010. In attendance were representatives of the two CSSS organizations (physicians, a consulting microbiologist, the director of professional services, the head of the laboratory, heads of community health services, and clinical nurses), two experts from INSPQ, and professionals from the DSP. Various aspects of the regional program to combat STBBIs were discussed in light of epidemiological trends, region-specific organizational obstacles such as delays in obtaining results and high turnover of clinical teams, and the characteristics of at-risk populations. This meeting was preceded by a training session for physicians who are working in the Hudson's Bay Region (interactive workshop on blood-borne and sexually transmitted infections).
This action was followed up with a number of teleconference meetings and email exchanges, mainly between the consulting microbiologist and the professionals at INSPQ and the DSP. The main outcomes are as follows:
- Reflections on potential action avenues for improving STBBI prevention and control.
- A set of questions and answers for use in screening and detecting chlamydia and gonorrhea.
- Syndromic management algorithms for presenting and facilitating case management according to sex.
- Descriptions of the appropriate materials required for detecting Chlamydia trachomatis and Neisseria gonorrhoeae infections for the Ungava Bay and Hudson Bay regions, and the associated preanalytical information.
