Syphilis in Greenland, 2015 to 2019.

BACKGROUND: An increase in the incidence of syphilis was reported in Greenland from 2011 to 2014, and notification rates kept rising in the following years in spite of focused efforts. To better understand the syphilis epidemic, this study was conducted to describe the syphilis epidemic in Greenland from 2015 to 2019. METHODS: Syphilis cases and their characteristics were identified through reviews of electronic medical records and laboratory results in 3 different data sets: notifications to the National Board of Health, electronic prescriptions for benzathine penicillin, and the national laboratory database. Annual incidences were calculated stratified by sex, age, and region. RESULTS: The incidence of syphilis in Greenland increased from 107.4 to 246.8 cases per 100,000 inhabitants from 2015 to 2019. The incidence increased in both sexes and in nearly all regions, although with large regional differences. Especially the age group 15 to 29 years showed a substantial increase in incidence in 2018 and 2019. More females than males were infected (245 female cases vs. 178 male cases). CONCLUSIONS: The burden of syphilis in Greenland is high, primarily among the age group 15 to 29 years. A higher incidence among females than among males was found, suggesting mainly heterosexual transmission, as seen for other sexually transmitted infections in Greenland.

[Infectious diseases with public health impact in Greenland].

Infectious diseases cause significant morbidity in Greenland. In the first part of the 20th century, the incidence of tuberculosis (TB) in Greenland was extremely high. While focused efforts led to marked reduction in incidence, TB is still a challenge. Likewise, the prevalence of chronic otitis media is very high in Greenland with significant developmental and social consequences from hearing loss and chronic ear discharge. Finally, while focused efforts have been made against sexually transmitted infections, the incidence of such diseases is still very high. This paper reviews these infections in Greenland.

Effective treatment with photodynamic therapy of cutaneous leishmaniasis: A case report.

Leishmaniasis is a vector borne disease transmitted by phlebotomine sandflies. Cutaneous leishmaniasis (CL) predominantly causes skin ulcers but may disseminate. CL may present a therapeutic challenge. The present study reports the case of a 15-year old boy with CL consisting of a single, ulcer on the leg, resistant to pentavalent antimony, oral fluconazole and topical ketoconazole therapy. Repeated photodynamic therapy using aminolevulinic acid resulted in complete healing of the ulcer, suggesting utility of this approach in resistant cases of CL.

Increased incidence of gonorrhoea and chlamydia in Greenland 1990-2012.

BACKGROUND: Since the 1970s, Greenland has presented the highest reported incidence rates of the sexually transmitted infections (STIs) gonorrhoea and chlamydia in the Arctic regions. OBJECTIVE: This study aims to describe sex- and age-specific incidence rates of gonorrhoea and chlamydia from 1990 to 2012 in Greenland, and to evaluate if changes in case definitions, diagnostic procedures and implementation of STI interventions during the period coincide with rate changes. DESIGN: Gonorrhoea and chlamydia cases were identified from the national STI surveillance. For 1990-2008, STI cases were identified from weekly notified aggregated data. For 2009-2012, cases were identified in person-identifiable national registers. We used log-linear Poisson regression to calculate incidence rates (IRs) and incidence rate ratios (IRRs) with 95% confidence intervals (95% CI). Analyses were stratified according to sex, age and calendar period. RESULTS: Gonorrhoea and chlamydia incidence rates have increased since 1995 to reach 2,555 per 100,000 person-years (PY) for gonorrhoea and 6,403 per 100,000 PY for chlamydia in 2012. From 2006 to 2012, the incidence rates among young adults aged 15-19 years were 8,187 and 22,515 per 100,000 PY for gonorrhoea and chlamydia, respectively. Changes in surveillance reporting did not seem to influence the incidence rates for either disease, whereas a change in diagnostic test coincided with an increased incidence of chlamydia. CONCLUSION: Overall, the incidence of chlamydia in Greenland increased during the study period, whereas the incidence of gonorrhoea decreased until 1995 but increased thereafter. Young adults aged 15-24 years were at highest risk of infection. The increase in incidence rates was independent of changes in case definitions, whereas an observed increase in chlamydia incidence in 2005 coincided with a change in diagnostic test. None of the STI interventions launched after 1995 seemed to coincide with decreasing national incidence rates.