Sexually Transmitted Infections in Northern Saskatchewan From 1990 to 1998

Purpose: The purpose of this study was to provide a detailed picture of the descriptive epidemiology of STIs in northern Saskatchewan from 1990 to 1998. Methods: Between 1990 and 1998, the Northern Health Services Branch compiled a database of all laboratory confirmed cases of gonorrhea, chlamydia, syphilis and herpes in northern Saskatchewan. This data was used to calculate incidence rates of STIs in the north as a whole and by health district, and 1998 incidence rates by community. All identifying factors for individuals and communities received in this data were encrypted with codes, ensuring confidentiality of all cases, contacts and communities. Results: Incidence rates of gonorrhea, chlamydia and infectious syphilis in northern Saskatchewan between 1990 and 1998 were considerably higher than in Saskatchewan as a whole. Overall rates of STI in northern Saskatchewan have fallen 30% over the period of study, to 2216 cases per 100,000 population, likely related to improved testing, treatment and screening practices. From 1996 to 1998, the age standardized incidence rate of all STIs combined in northern Saskatchewan was 4.6 times higher than in Saskatchewan. 82% of cases reported in the north were chlamydia, with rates 7 times those of gonorrhea by 1996 to 1998. On average, females had STI rates 2.4 times those of males. Females aged 15 to 24 and males aged 15 to 29 typically had the highest rates of infection. Rates of infectious syphilis appear low when compared to other infections in the north, but they are considerably higher than Saskatchewan rates. Herpes rates appear to be increasing, but this is likely unreliable due to incomplete data. High STI rates in northern Saskatchewan are thought to be related to high risk sexual behaviors, the high efficiency of screening and reporting practices in the north, and social inequities in this region of the province. Significance: Results of this study may be used to assist in program planning, targeting and development for future northern initiatives, as a baseline STI assessment for the three northern health districts and may also assist in the future evaluation and monitoring of interventions