Spatio-temporal analysis of Chlamydia trachomatis in Newfoundland and Labrador and an exploratory analysis into employment traits as risk factors

Sexually transmitted infections are an important health concern in Canadian society due to their negative impact on sexual and reproductive health, as well as their social and fiscal ramifications. Chlamydia trachomatis is the most common reported sexually transmitted infection in Canada and has been consistently on the rise since 1997. The province of Newfoundland and Labrador routinely publishes case counts of infectious diseases, including chlamydia, but there is minimal examination into age, sex, the regional distributions of cases, the etiology of these infections, or what populations are most at risk. There is also little information on the role of migratory employment in infectious disease risk in Canada. The spatial and temporal distribution of chlamydia in Newfoundland and Labrador between 2007 and 2013 was examined, in addition to an exploration into migratory employment as a contributory cause. Case data were obtained from the Regional Health Authorities and population information from Statistics Canada. Differences in incidence rates for age, sex, and geography were evaluated over time. A linear increase in incidence occurred over the study period. Distinct areas of high incidence were observed and spatial clusters were identified in northern Labrador and St. John’s. Using the 2006 Census of Population and 2011 National Household Survey, associations between work-related commuting demographics and chlamydia incidence were found in the province. Understanding the distribution of chlamydia as well as the behaviours of migratory workers can help direct health policy to prevent chlamydial and other infections from occurring, and improve overall sexual health practices of Canadians