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Pignedoli C, Rivest P. The gender of PrEP: Transgender men negotiating legitimacy in France. Soc Sci Med 2024; 348:116842. [PMID: 38593613 DOI: 10.1016/j.socscimed.2024.116842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/05/2024] [Accepted: 03/26/2024] [Indexed: 04/11/2024]
Abstract
Transmasculine people (TM) constitute an invisibilized group within the transgender population. Little is known about their relationship to sexuality in transgender medicine. Their presence and needs are still unacknowledged within HIV prevention research and services. Pre-exposure prophylaxis (or PrEP) is an oral medication that prevents HIV in HIV-negative individuals at risk of infection with the virus. This paper proposes to bring TM back into the focus of PrEP research by questioning how they navigate and situate themselves in relation to existing PrEP categorization and services, and how they think about and (re)shape the meanings of PrEP. It is based on the "interpretative descriptive" method and a transfeminist theoretical framework applied to the analysis of ten semi-structured interviews with TM conducted in France between 2019 and 2023. Findings show that PrEP is gendered. We identify specific barriers to getting PrEP as well as to access healthcare and we show that a cisnormative and homonormative approach to prevention generates them. PrEP use and PrEP disclosure are embedded in structural and symbolic power relations between cisgender and transgender MSM that are reflected in the intimate sphere. TM use PrEP to prevent sexual assault and to alleviate the difficulty of condom negotiation. PrEP comes into play following major changes in TM's sexualities and is integrated post-exposure.
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Affiliation(s)
- Clark Pignedoli
- Université d'Aix-Marseille, SESSTIM - SanteRCom, Faculté de Médecine, 27 Bd Jean Moulin, 13385, Marseille, Cedex 5, France.
| | - Paul Rivest
- Université d'Aix-Marseille, Ideas, 5 rue du Château de l'Horloge, 13090, Aix-en-Provence, France.
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Diefenbach-Elstob T, Rivest P, Benedetti A, Gordon C, Palayew M, Menzies D, Schwartzman K, Greenaway C. Patterns and characteristics of TB among key risk groups in Canada, 1993–2018. Int J Tuberc Lung Dis 2022; 26:1041-1049. [DOI: 10.5588/ijtld.22.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Canada has a low incidence of TB, although certain groups are disproportionately affected.OBJECTIVE: To describe and compare the epidemiology, trends and characteristics of TB in Quebec, Canada, among all patients reported during 1993–2018.METHODS:
Demographics and risk factors were compared for the three groups accounting for most TB diagnoses reported in Quebec (foreign-born, Canadian-born non-Indigenous and Inuit). Average annual incidence and incidence rate ratios (IRRs) were estimated and compared using Poisson regression.RESULTS:
Of 6,941 persons with a first episode of TB, 4,077 (59%) were foreign-born, 2,314 (33%) were Canadian-born non-Indigenous and 389 (6%) were Inuit. The average annual incidence for foreign-born, Canadian-born non-Indigenous and Inuit was respectively 17.0, 1.4 and 137.1 per 100,000 population.
Compared to Canadian-born non-Indigenous, the IRR for foreign-born and Inuit was respectively 12.3 (95% CI 11.6–12.9) and 98.7 (95% CI 88.6–109.9). There was evidence of community transmission among the Inuit, with more than 80% of patients having a TB contact (2012–2018
data) and 65% (251/389) of diagnoses in those aged <25 years.CONCLUSION: Although TB rates among the Canadian-born non-Indigenous are extremely low, there are persistent and distinct TB epidemics among the foreign-born and Inuit. Tailored approaches to TB prevention and care
are needed to address TB among high-risk populations in low TB incidence settings.
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Affiliation(s)
- T. Diefenbach-Elstob
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada, Department of Medicine, McGill University, Montreal, QC, Canada
| | - P. Rivest
- Département de médecine sociale et préventive, École de santé publique de l´Université de Montréal, Montréal, QC, Canada, Direction régionale de santé publique, Centre intégré
universitaire de santé et de services sociaux du Centre-Sud-de-l´Île-de-Montréal, Montréal, QC, Canada
| | - A. Benedetti
- Department of Medicine, McGill University, Montreal, QC, Canada, Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, QC, Canada
| | - C. Gordon
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - M. Palayew
- Department of Medicine, McGill University, Montreal, QC, Canada, Respiratory Division, Sir Mortimer B Davis (SMBD)- Jewish General Hospital, Montreal, QC, Canada
| | - D. Menzies
- Respiratory Division, Department of Medicine, McGill University, Montreal, QC, Canada, McGill International TB Centre, Montreal, QC, Canada, Montreal Chest Institute, Montreal, QC, Canada, Research Institute of the McGill University Health Centre,
Montreal, QC, Canada
| | - K. Schwartzman
- Respiratory Division, Department of Medicine, McGill University, Montreal, QC, Canada, McGill International TB Centre, Montreal, QC, Canada, Montreal Chest Institute, Montreal, QC, Canada, Research Institute of the McGill University Health
Centre, Montreal, QC, Canada
| | - C. Greenaway
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada, Department of Medicine, McGill University, Montreal, QC, Canada, McGill International TB Centre, Montreal, QC, Canada, Division of Infectious
Diseases, SMBD Jewish General Hospital, Montreal, QC, Canada
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Chakravarti A, Soualhine H, Sharma M, Rivest P, Poirier L, Lavallée C. Indigenous Transmission of Mycobacterium africanum in Canada: A Case Series and Cluster Analysis. Open Forum Infect Dis 2019; 6:ofz088. [PMID: 30949534 PMCID: PMC6441568 DOI: 10.1093/ofid/ofz088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 03/04/2019] [Indexed: 11/15/2022] Open
Abstract
Mycobacterium africanum is an important cause of human tuberculosis and is found almost exclusively in West Africa. We identified a cluster of patients in Montreal, Canada, with M africanum disease that share identical genotypic signatures by mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing and a putative epidemiological link, thus providing evidence of possible local transmission of M africanum in Montreal over a 10-year period.
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Affiliation(s)
- Arpita Chakravarti
- Department of Microbiology and Adult Infectious Diseases, Centre Hospitalier de l’Université de Montréal, Canada
| | - Hafid Soualhine
- National Reference Centre for Mycobacteriology, Public Health Agency of Canada, Winnipeg
| | - Meenu Sharma
- National Reference Centre for Mycobacteriology, Public Health Agency of Canada, Winnipeg
| | - Paul Rivest
- Direction de Santé Publique, Centre Intégré Universitaire de Soins et de Services Sociaux du Centre-Sud-de-l’Île-de-Montréal, Canada
| | - Louise Poirier
- Department of Microbiology, Maisonneuve-Rosemont Hospital, Montreal, Canada
| | - Christian Lavallée
- Department of Microbiology and Adult Infectious Diseases, Maisonneuve-Rosemont Hospital, Montreal, Canada
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Rivest P, Sinyavskaya L, Brassard P. Burden of HIV and tuberculosis co-infection in Montreal, Quebec. Can J Public Health 2014; 105:e263-7. [PMID: 25166128 DOI: 10.17269/cjph.105.4269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 06/04/2014] [Accepted: 05/05/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Define the burden of HIV-TB co-infection and predictors of HIV screening among incident TB cases. METHODS Analysis of surveillance data on TB incident cases reported to Montreal's Public Health Department from 2004 to 2009. Among all reported TB cases, proportions of cases with HIV testing and HIV infection were calculated by patient characteristics. A test for linear trends was performed on the annual proportions of HIV-tested and HIV-positive cases. Adjusted odds ratios (AOR) for HIV testing at time of TB diagnosis were computed. RESULTS A total of 778 incident TB cases were included in the analysis. HIV testing was reported for 50.8% (n=395) of cases. The proportion of HIV-tested cases increased significantly from 43% in 2004 to 70% in 2009. HIV-TB co-infection was found in 9.3% of patients with reported HIV status or in 4.2% of the overall cohort. HIV prevalence was high in men, individuals aged 40-59, those originating from Sub-Saharan Africa and the Caribbean, and the homeless. Multivariate analysis revealed that HIV testing at time of TB diagnosis was performed mainly for subjects born in the Caribbean, Central or South America, or Sub-Saharan Africa, those with pulmonary disease, and injection drug users. CONCLUSIONS Although reporting of HIV testing among incident TB patients increased, targeted HIV testing still occurs. HIV prevalence in TB cases remained stable during the study period; however, it may be underestimated due to missed opportunities for HIV testing and under-reporting.
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Rivest P, Street MC, Allard R. Completion rates of treatment for latent tuberculosis infection in Quebec, Canada from 2006 to 2010. Can J Public Health 2013; 104:e235-9. [PMID: 23823888 DOI: 10.17269/cjph.104.3643] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 05/22/2013] [Accepted: 01/05/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Treatment of latent TB infection (LTBI) in high-risk populations has been identified as a priority activity for reducing TB incidence. Treatment completion rates are usually far from the 80% target. The objective of this study was to evaluate the proportion of individuals who obtained enough medication for standard LTBI treatment. METHODS Using the Régie de l'assurance maladie du Québec database, we extracted data on all prescriptions filled as part of the free anti-tuberculosis medication program. We calculated the proportion of patients who had obtained at least 270 doses among patients who had started treatment with isoniazid (INH), and the proportion of patients who had obtained at least 120 doses among patients who had started treatment with rifampin (RMP). RESULTS Among the 2,895 patients who had started INH, 907 (31.3%) obtained at least 270 doses. Among the 373 patients who had started RMP, 242 (64.9%) obtained at least 120 doses. Women were more likely to stop INH treatment before acquiring 270 doses of the medication than men (hazard ratio [HR] = 1.08; 95% confidence interval [CI]: 1.01-1.17). CONCLUSION Only 31.3% of patients who started treatment with INH had procured at least 270 doses. Completion rates are far below target values.
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Affiliation(s)
- Paul Rivest
- Direction de santé publique, Agence de la santé et des services sociaux, Montréal, QC, Canada.
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Rossi C, Zwerling A, Thibert L, Rivest P, McIntosh F, Behr MA, Benedetti A, Menzies D, Schwartzman K. Mycobacterium tuberculosis transmission over an 11-year period in a low-incidence, urban setting. Int J Tuberc Lung Dis 2012; 16:312-8. [DOI: 10.5588/ijtld.11.0204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Thibeault C, Tanguay F, Lacroix C, Menzies R, Rivest P. A Case of Active Tuberculosis in a Cabin Crew: The Results of Contact Tracing. ACTA ACUST UNITED AC 2012; 83:61-3. [DOI: 10.3357/asem.3135.2012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tan de Bibiana J, Rossi C, Rivest P, Zwerling A, Thibert L, McIntosh F, Behr MA, Menzies D, Schwartzman K. Tuberculosis and homelessness in Montreal: a retrospective cohort study. BMC Public Health 2011; 11:833. [PMID: 22034944 PMCID: PMC3229542 DOI: 10.1186/1471-2458-11-833] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 10/28/2011] [Indexed: 11/10/2022] Open
Abstract
Background Montreal is Canada's second-largest city, where mean annual tuberculosis (TB) incidence from 1996 to 2007 was 8.9/100,000. The objectives of this study were to describe the epidemiology of TB among homeless persons in Montreal and assess patterns of transmission and sharing of key locations. Methods We reviewed demographic, clinical, and microbiologic data for all active TB cases reported in Montreal from 1996 to 2007 and identified persons who were homeless in the year prior to TB diagnosis. We genotyped all available Mycobacterium tuberculosis isolates by IS6110 restriction fragment length polymorphism (IS6110-RFLP) and spoligotyping, and used a geographic information system to identify potential locations for transmission between persons with matching isolates. Results There were 20 cases of TB in homeless persons, out of 1823 total reported from 1996-2007. 17/20 were Canadian-born, including 5 Aboriginals. Homeless persons were more likely than non-homeless persons to have pulmonary TB (20/20), smear-positive disease (17/20, odds ratio (OR) = 5.7, 95% confidence interval (CI): 1.7-20), HIV co-infection (12/20, OR = 14, 95%CI: 4.8-40), and a history of substance use. The median duration from symptom onset to diagnosis was 61 days for homeless persons vs. 28 days for non-homeless persons (P = 0.022). Eleven homeless persons with TB belonged to genotype-defined clusters (OR = 5.4, 95%CI: 2.2-13), and ten potential locations for transmission were identified, including health care facilities, homeless shelters/drop-in centres, and an Aboriginal community centre. Conclusions TB cases among homeless persons in Montreal raise concerns about delayed diagnosis and ongoing local transmission.
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Affiliation(s)
- Jason Tan de Bibiana
- Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, Quebec, Canada
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9
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Merrett P, Schwartzman K, Rivest P, Greenaway C. Strategies to prevent varicella among newly arrived adult immigrants and refugees: a cost-effectiveness analysis. Clin Infect Dis 2007; 44:1040-8. [PMID: 17366446 DOI: 10.1086/512673] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2006] [Accepted: 12/09/2006] [Indexed: 11/03/2022] Open
Affiliation(s)
- Patrick Merrett
- Respiratory Division and Respiratory Epidemiology Unit, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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10
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Rivest P, Grenier L, Lonergan G, Bédard L. Varicella vaccination for grades 4 and 5 students: from theory to practice. Can J Public Health 2005. [PMID: 15913084 DOI: 10.1007/bf03403690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND In 2002-2003, as part of a pilot project, varicella vaccination was offered to susceptible students in grades 4 and 5 in schools whose health services are provided by a local community services centre in Montréal. This immunization campaign was merged with the hepatitis B immunization programme. OBJECTIVES To calculate the proportion of grade 4 and 5 students susceptible to varicella; to calculate the proportion of susceptible students who agree to be vaccinated; to compare the proportion of susceptibles who agree to be vaccinated when varicella vaccination is offered with the first or the second dose of hepatitis B; and to assess whether a catch-up varicella immunization programme would affect the vaccine coverage of a concurrent hepatitis B vaccination programme. METHODS The proportions of susceptible students and of parents of susceptibles who consented to vaccination were calculated. The proportions of parents of susceptibles who consented to vaccination were compared for both immunization strategies: varicella vaccination given with the first or second dose of hepatitis B vaccine. Logistic regression was performed to identify possible associations between consent to varicella vaccination and the various variables collected. Rates of vaccine coverage against hepatitis B after two doses were compared for the years 2000-2001 and 2002-2003. RESULTS Of 3,856 registered students, 3,486 (90.4%) returned consent forms. Among the 3,272 students for whom information was available, 441 (13.5%) were susceptible, including 394 (89.3%) who consented to vaccination. The rates of vaccine coverage in the schools after two doses of hepatitis B vaccine were exactly the same for the 2000-2001 and 2002-2003 school years. CONCLUSION Varicella vaccination of susceptible grade 4 and 5 students associated with a coincident hepatitis B vaccination campaign can be performed without negative impact on the hepatitis B vaccination programme.
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Affiliation(s)
- Paul Rivest
- Institut national de santé publique du Québec, Ste-Foy, QC.
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11
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Rivest P, Grenier L, Lonergan G, Bédard L. Varicella vaccination for grades 4 and 5 students: from theory to practice. Can J Public Health 2005; 96:197-200. [PMID: 15913084 PMCID: PMC6975916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/01/2004] [Accepted: 01/19/2005] [Indexed: 05/02/2023]
Abstract
BACKGROUND In 2002-2003, as part of a pilot project, varicella vaccination was offered to susceptible students in grades 4 and 5 in schools whose health services are provided by a local community services centre in Montréal. This immunization campaign was merged with the hepatitis B immunization programme. OBJECTIVES To calculate the proportion of grade 4 and 5 students susceptible to varicella; to calculate the proportion of susceptible students who agree to be vaccinated; to compare the proportion of susceptibles who agree to be vaccinated when varicella vaccination is offered with the first or the second dose of hepatitis B; and to assess whether a catch-up varicella immunization programme would affect the vaccine coverage of a concurrent hepatitis B vaccination programme. METHODS The proportions of susceptible students and of parents of susceptibles who consented to vaccination were calculated. The proportions of parents of susceptibles who consented to vaccination were compared for both immunization strategies: varicella vaccination given with the first or second dose of hepatitis B vaccine. Logistic regression was performed to identify possible associations between consent to varicella vaccination and the various variables collected. Rates of vaccine coverage against hepatitis B after two doses were compared for the years 2000-2001 and 2002-2003. RESULTS Of 3,856 registered students, 3,486 (90.4%) returned consent forms. Among the 3,272 students for whom information was available, 441 (13.5%) were susceptible, including 394 (89.3%) who consented to vaccination. The rates of vaccine coverage in the schools after two doses of hepatitis B vaccine were exactly the same for the 2000-2001 and 2002-2003 school years. CONCLUSION Varicella vaccination of susceptible grade 4 and 5 students associated with a coincident hepatitis B vaccination campaign can be performed without negative impact on the hepatitis B vaccination programme.
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Affiliation(s)
- Paul Rivest
- Institut national de santé publique du Québec, Ste-Foy, QC.
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12
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Rivest P, Proulx M, Lonergan G, Lebel MH, Bédard L. Hospitalisations for gastroenteritis: the role of rotavirus. Vaccine 2004; 22:2013-7. [PMID: 15121314 DOI: 10.1016/j.vaccine.2003.10.029] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2003] [Revised: 10/09/2003] [Accepted: 10/09/2003] [Indexed: 11/20/2022]
Abstract
To determine the proportion of hospitalisations for gastroenteritis caused by rotavirus, we tested for rotavirus stool samples of all children under the age of five hospitalised for gastroenteritis between 1 December 1999 and 30 May 2000 in seven community and specialised hospitals in Quebec. Of 944 children hospitalised, 565 (59.9%) were screened for rotavirus and 405 (71.7%) tested positive. From December to April, the proportion of positive results rose from 51.6 to 78.1%. Compared with children whose test results were negative, children who tested positive presented vomiting more frequently upon admission (88.9 versus 60.4%) and needed IV fluids in greater proportion (94.1 versus 78.0%), but spent less time in hospital (2.8 versus 3.3 days). Aside from dehydration, no complications were noted. In Quebec, a large majority of winter and spring hospitalisations for gastroenteritis in children is attributable to rotavirus.
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Affiliation(s)
- Paul Rivest
- Direction de santé publique de Montréal-Centre, 1301 rue Sherbrooke Est, Montréal, Qué., Canada H2L 1M3.
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Rivest P, Richer F, Bédard L. Difficulties associated with pertussis surveillance. Can Commun Dis Rep 2004; 30:29-33, 36. [PMID: 15004998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- P Rivest
- Santé publique de Montréal-Centre, Montreal, Quebec
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Abstract
Serogroup C meningococcal vaccine effectiveness was estimated from routine surveillance data, based on a comparison of the proportion of vaccine and non-vaccine serogroups in vaccinated and unvaccinated reported cases. Between 1 April 1993 and 31 March 1998, 109 eligible cases were reported. Among the 54 cases caused by serogroup C, 38 had been vaccinated. Among the 55 cases caused by non-vaccine serogroups, 49 had been vaccinated. Vaccine effectiveness was estimated at 71% (95% CI: 21-89%), a value similar to that obtained in the same population by a cohort study. Effectiveness was lower in children immunized before the age of 10. This demonstrates that meningococcal vaccine effectiveness can be estimated from information obtained routinely from cases only, as an alternative to the more expensive cohort or case-control designs.
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Affiliation(s)
- Paul Rivest
- Direction de la Santé publique, Régie régionale de la santé et des services sociaux de Montréal-Centre, Montreal, Que., Canada.
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Affiliation(s)
- P Rivest
- Direction de la Santé publique, Régie régionale de la santé et des services sociaux de Montréal-Centre
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Rivest P, Tannenbaum T, Bédard L. Epidemiology of tuberculosis in Montreal. CMAJ 1998; 158:605-9. [PMID: 9526474 PMCID: PMC1229003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To identify the epidemiologic characteristics of tuberculosis (TB) in Montreal and the patterns of resistance to antituberculous drugs in order to improve TB control in the region. DESIGN Descriptive analysis of surveillance data for TB cases reported in Montreal by physicians and laboratories between 1992 and 1995. SETTING Region of Montreal, population 1,775,889. PARTICIPANTS All cases of active TB among Montreal residents reported to the Department of Public Health between Jan. 1, 1992, and Dec. 31, 1995. OUTCOME MEASURES Epidemiologic characteristics, proportion of cases resistant to antituberculous drugs and types of resistance. RESULTS A total of 798 cases of TB (mean annual incidence 11.2 per 100,000) were reported in Montreal during the study period. Of these patients, 617 (77.3%) were born outside Canada. The annual incidence of TB in the foreign-born population (37.5 per 100,000) was 10 times the rate in the Canadian-born population, and the highest rate among foreign-born residents (62.8 per 100,000) occurred in those 15-29 years of age. In general, annual incidence in Montreal's foreign-born population reflected the reported incidence of TB in their regions of birth. In 8.7% of all cases, the disease was resistant to isoniazid, and the proportion of cases resistant to this drug was greater than 4% in almost all age groups, among both foreign-born and Canadian-born patients. CONCLUSIONS TB remains a major problem in Montreal, as in other large cities. Surveillance data give opportunities to public health agencies to adapt their prevention and control strategies to local situations and can also help clinicians in their clinical decision-making.
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Affiliation(s)
- P Rivest
- Direction de la santé publique, Régie régionale de la santé et des services sociaux de Montréal-centre, Montreal, Que.
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18
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Rivest P, Bédard L, Arruda H, Trudeau G, Remis RS. Risk factors for measles and vaccine efficacy during an epidemic in Montreal. Can J Public Health 1995; 86:86-90. [PMID: 7757898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES 1) to identify potential risk factors for measles and 2) to assess the efficacy of the measles vaccine. METHODS Cases of measles reported from primary and secondary schools in Montreal during the 1989 epidemic were compared with classroom and sibling controls with respect to age at vaccination against measles, time since vaccination, type of vaccination, type of providers and age of the mother. RESULTS Subjects vaccinated at 12 months had an OR of 3.9 (CI 95%: 2.1 to 7.0) of contracting measles when compared with subjects vaccinated at 15 months or later. Vaccination at age 13 or 14 months was not associated with an increased risk. Subjects vaccinated before June 1979 had an OR of 5.8 (CI 95%: 2.8 to 12.1) of developing measles compared with subjects vaccinated after June 1980. Vaccine efficacy was 96.1%. DISCUSSION In highly vaccinated populations, vaccination at 12 months and vaccination before 1980 are probably two reasons why outbreaks still occur. The two-dose schedule could reduce the proportion of vaccinated persons who remain susceptible.
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Affiliation(s)
- P Rivest
- Unité Maladies infectieuses, Direction de la santé publique, Régie régionale de la santé et des services sociaux de Montréal-Centre, Québec
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Rivest P. [Tuberculin screening in a secondary school in Montreal following a case of pulmonary tuberculosis]. Can J Public Health 1993; 84:303-6. [PMID: 8269375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We planned a tuberculin testing in a secondary school, following student exposure to a fellow student suffering from pulmonary tuberculosis. A first group of 71 students for whom exposure seemed greater, had an intradermal Mantoux test. Of these 71 students, 18 (25.3%) had a > or = 5 mm reactions; 52 went through a second test three months later, six of whom had a > or = 5 mm reaction. In light of the results of the screening in this first group, the tuberculin testing was offered to a second group of 108 students. In this second group, the result of the skin test was > or = 5 mm for 10 (9.3%) students. Out of 179 students, 34 (19.0%) had a significative reaction. A > or = 5 mm reaction was significantly associated with being male, being born outside of Québec and being a member of the first group screened.
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Affiliation(s)
- P Rivest
- Unité de santé publique, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
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Héroux O, Pagé E, Leblanc J, Leduc J, Gilbert R, Villemaire A, Rivest P. Nonshivering thermogenesis and cold resistance in rats under severe cold conditions. J Appl Physiol (1985) 1975; 38:436-42. [PMID: 1150558 DOI: 10.1152/jappl.1975.38.3.436] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Following either chronic exposure to 6 degrees C, or outdoor winter exposure, or chronic treatment with tyramine rats were exposed to -40 degrees C and their oxygen consumption and colonic temperature monitored. Fall in body temperature with time of exposure followed a sigmoid curve which had an inflection point around 32.9 degrees C. Both the time required for body temperature to reach this point and hypothermic resistance defined as the total O2 consumed up to the inflection time were useful indices of resistance to severe cold; Three days before the cold tests, capacity for norepinephrine-induced nonshivering thermogenesis was measured in all animals by examination of their metabolic response to tyraminemthe magnitude of response to tyramine correlated well with hypothermic resistance only for those rats chroncally treated with tyramine. It is concluded that it is impossible to predict with any reasonable degree of confidence the cold resistance of a rat from its tyramine response. In cold-acclimated rats, factors in addition to norepinephrine sensitivity are significantly involved in cold resistance and deserve further studies.
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Leduc J, Rivest P. [Effects of ablation of interscapular brown fat on cold acclimation in rats]. Rev Can Biol 1969; 28:49-66. [PMID: 5770981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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