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Background: Good nutrition and access to healthy foods are essential for child growth and development. However, there are concerns that Canadian children do not have a healthy diet, which may be related to dietary choices as well as lack of access to healthy foods. The FANS (Food and Nutrition Security for Children and Youth) study examined the nutrition and food security status of youth in the province of Manitoba, Canada. This paper describes methods, dietary intakes, and body mass index for the FANS study. Methods: This cross-sectional study included 1587 Manitoba grade nine students who completed a self-administered web-based survey. Data was collected on demographic characteristics, dietary intake (24-h recall), food behaviors, food security, and self-report health indicators. Dietary data was compared to national dietary guidelines (Dietary Reference Intakes and Canada's Food Guide). Mean and median nutrient and food group intakes were calculated with corresponding measures of variability. Chi-square tests compared percentage of respondents not meeting key nutrients and food groups. Significant differences in percentage of total servings for each food group were determined by a Kruskal–Wallis test, and differences between different caloric groups were assessed using Dunn's test for post-hoc comparisons. Results: Half of study respondents were female (50.5%). Median energy intake was higher in males (2281 kcal) compared with females (1662 kcal), with macronutrient distribution of 52%, 16%, and 32% for carbohydrates, protein, and fats respectively. Most participants consumed inadequate fibre (94%), vitamin D (90%), and calcium (73%), while median sodium intakes exceeded recommendations for males but not females. A majority of participants did not meet Health Canada's recommendations for food group servings: Vegetables and Fruit (93%), Milk and Alternatives (74%), Meat and Alternatives (57%) and Grain Products (43%). Other Foods, including sugar sweetened beverages and juice, were consumed by most participants. Higher energy consumers had a greater proportion of food servings coming from Other Foods. 72.1% of students were classified as having a healthy weight and 25% were classified as overweight or obese. Conclusion: Poor dietary intakes and body mass index values indicate an urgent need for policy and program strategies to support healthy eating habits and food awareness in Manitoba youth. [ABSTRACT FROM AUTHOR]

In this study, we describe the geospatial variation in the incidence of multiple sclerosis (MS) in Manitoba, Canada, and the sociodemographic characteristics associated with MS incidence. By using administrative health data, we identified all incident cases of MS in Manitoba from 1990 to 2006 (n = 2,290) and geocoded them to 230 neighborhoods in the City of Winnipeg and 268 municipalities in rural Manitoba. Age-standardized incidence rates for 1990–2006 (combined) were calculated for each region. By using the spatial scan statistic, we identified high-rate clusters in southwestern (incidence rate ratio (IRR) = 1.48) and central Winnipeg (IRR = 1.54) and low-rate clusters in north-central Winnipeg (IRR = 0.52) and northern Manitoba (IRR = 0.48). Multivariable Poisson regression showed a positive association between MS incidence rates and socioeconomic status. Despite our finding that MS incidence varied geographically and by socioeconomic status, the low Gini coefficient of 0.152 for MS incidence identified in this study suggests that the causes of MS are pervasive across all population groups. Searching for local-level causes of the disease may therefore not be as productive as investigating etiological factors operating at the population level. This may require an examination of macro-level differences in environmental exposures between high- and low-incidence regions of the world. [ABSTRACT FROM PUBLISHER]

The article presents a study which estimates herd seroprevalence with Maedi-Visna infection in Manitoba sheeps. The study selected herds for testing and an Aussie Vet calculator was used for prevalence estimation. Results show that herd level seroprevalence is 25.10% and animal level seroprevalence is 2.47%, and herd size is connected with seroprevalence herd status. The study concludes that there is a low seroprevalence stability in Manitoba even without a systematic disease control program.

The article discusses a study on the prevalence and distribution of Baylisascaris procyonis in urban raccoons in Winnipeg, Manitoba. The study suggested that carriage of Baylisascaris procyonis, a species-adapted ascarid and a cause of clinical larva migrans in animals, is widespread in raccoons in the urban ecosystem. It also proposed the treatment of raccoon latrines as infectious sites and the initiation of efforts on limiting access of pets and people at risk to the infected sites.

Background: The objectives of this study were to determine rates of prenatal care utilization in Winnipeg, Manitoba, Canada from 1991 to 2000; to compare two indices of prenatal care utilization in identifying the proportion of the population receiving inadequate prenatal care; to determine the association between inadequate prenatal care and adverse pregnancy outcomes (preterm birth, low birth weight [LBW], and small-for-gestational age [SGA]), using each of the indices; and, to assess whether or not, and to what extent, gestational age modifies this association. Methods: We conducted a population-based study of women having a hospital-based singleton live birth from 1991 to 2000 (N = 80,989). Data sources consisted of a linked mother-baby database and a physician claims file maintained by Manitoba Health. Rates of inadequate prenatal care were calculated using two indices, the R-GINDEX and the APNCU. Logistic regression analysis was used to determine the association between inadequate prenatal care and adverse pregnancy outcomes. Stratified analysis was then used to determine whether the association between inadequate prenatal care and LBW or SGA differed by gestational age. Results: Rates of inadequate/no prenatal care ranged from 8.3% using APNCU to 8.9% using RGINDEX. The association between inadequate prenatal care and preterm birth and LBW varied depending on the index used, with adjusted odds ratios (AOR) ranging from 1.0 to 1.3. In contrast, both indices revealed the same strength of association of inadequate prenatal care with SGA (AOR 1.4). Both indices demonstrated heterogeneity (non-uniformity) across gestational age strata, indicating the presence of effect modification by gestational age. Conclusion: Selection of a prenatal care utilization index requires careful consideration of its methodological underpinnings and limitations. The two indices compared in this study revealed different patterns of utilization of prenatal care, and should not be used interchangeably. Use of these indices to study the association between utilization of prenatal care and pregnancy outcomes affected by the duration of pregnancy should be approached cautiously. [ABSTRACT FROM AUTHOR]

Background: The study describes population level variations in campylobacter incidence within the Canadian province of Manitoba, and the relationship to sociodemographic and landscape related characteristics. Using data derived from the Manitoba Health Public Health Branch communicable disease surveillance database, the study applied a number of spatial and ecological techniques to visualize, explore and model campylobacter incidence for the years 1996 to 2004. Analytical techniques used in the study included spatial smoothing, the spatial scan statistic, the Gini coefficient, and Poisson regression analysis. Results: The study demonstrated marked and statistically significant geographic variability in the rates of campylobacter incidence in Manitoba.. The incidence of campylobacter was observed to be significantly higher in populations living in rural and agricultural areas of the province, with the highest rates occurring in populations living in proximity to high densities of farm animals (cows, pigs, chickens). The study also observed that the age specific pattern of campylobacter incidence in rural Manitoba was very different than the urban pattern, with the incidence rate in the 0-4 year age group seven times higher in rural Manitoba than in the City of Winnipeg. Conclusion: The study demonstrates the value of a deploying a diverse set of spatial techniques to better understand the dynamics of an enteric disease such as campylobacter infection. The study concludes that there may be three distinct mechanisms for the transmission of campylobacter in Manitoba which are operating simultaneously. These include broad population exposure to a centralized food system endemically infected with the campylobacter organism, exposure to local level factors such as farm animals or contaminated water, and exposure to campylobacter infection through foreign travel. [ABSTRACT FROM AUTHOR]

The objective of this research is to identify the sociodemographic, environmental, and lifestyle factors associated with the geographic variability of Diabetes Mellitus (DM) prevalence in the City of Winnipeg, Manitoba in Canada. An ecological regression study design was employed for this purpose. The study population included all prevalent cases of DM in 1998 for Winnipeg. Predictor and outcome data were aggregated for analysis using two methods. First, the spatial scan statistic was used to aggregate study data into highly probable diabetes prevalence clusters. Secondly, predictor and outcome data were aggregated to existing administrative health areas. Analysis of variance and spatial and non-spatial linear regression techniques were used to explore the relationship between predictor and outcome variables. The results of the two methods of data aggregation on regression results were compared. Mapping and statistical analysis revealed substantial clustering and small-area variations in the prevalence of DM in the City of Winnipeg. The observed variations were associated with variations in socioeconomic, environmental and lifestyle characteristics of the population. The two methods of data aggregation used in the study generated very similar results in terms of identifying the geographic location of DM clusters and of the population characteristics ecologically correlated to those clusters. High rates of DM prevalence are strongly correlated with indicators of low socioeconomic status, poor environmental quality and poor lifestyles. This analysis further illustrates what a useful tool the spatial scan statistic can be when used in conjunction with ecological regression to explore the etiology of chronic disease. [Copyright &y& Elsevier]

OBJECTIVE — This study provides an overview of the epidemiology of diabetes in the Manitoba First Nation population. RESEARCH DESIGN AND METHODS — The study uses data derived from the population-based Manitoba Diabetes Database to compare the demographic and geographic patterns of diabetes in the Manitoba First Nation population to the non-First Nation population. RESULTS — Although the prevalence of diabetes rose steadily in both the First Nation and the non-First Nation populations between 1989 and 1998, the epidemiological pattern of diabetes in these two populations differed significantly. The First Nation population was observed to have age-standardized incidence and prevalence rates of diabetes up to 4.5 times higher than those found in the non-First Nation population. The sex ratio and the geographic patterning of diabetes incidence and prevalence in the two study populations were reversed. CONCLUSIONS — The results of the study suggest that diabetes prevalence will likely continue to rise in the Manitoba First Nation population into the foreseeable future, and that the impact of this rising diabetes prevalence can only be effectively managed through a population-based public health approach focusing on primary and secondary prevention. The dramatically higher rates of diabetes in Manitoba First Nation population as compared with the non-First Nation population highlight the urgency of this activity. These prevention efforts need to be supported by further research into the reasons for the unique epidemiological patterns of diabetes incidence and prevalence in the First Nation population observed in this study. These include investigating why First Nation populations living in the Northern areas of the province seem to be protected from developing high rates of diabetes and why First Nation women experience much higher rates of the disease. [ABSTRACT FROM AUTHOR]

Purpose: The Food and Nutrition for Manitoba Youth (FANS) study examined dietary intakes, food behaviours, food security status, health indicators, and body mass index of a cohort of grade 9 students. This paper describes regional differences and similarities in dietary intake (food and nutrients) and quality of youth participants in the FANS study. Methods: Grade 9 students completed a web-based survey on dietary intakes (24-hour recall), food behaviours, self-reported health indicators, and sociodemographic variables. Nutrient intakes were compared with national guidelines and diet quality was assessed using a modified Healthy Eating Index. Results: A total of 1587 students participated from northern, rural, and urban regions in Manitoba. Northern and rural students had higher intakes of sugar, sodium, and saturated fat compared with urban. Northern students consumed fewer grain products compared to urban, and more servings of "other" foods compared with rural and urban. While most participants were classified into the "needs improvement" or "poor" Healthy Eating Index categories, significantly more northern participants were in the "poor" category. Conclusions: Most adolescents in the study are at nutritional risk; however, there are additional vulnerabilities for those in rural and northern communities. Dietitians can use results to advocate for and plan interventions to improve adolescent nutrition.

Adolescence is a vital period of growth and development, both of which are dependent on adequate nutrition; however, concerns persist about poor nutrition and inappropriate food behaviours. In addition to nutrition assessment, the context of food and health behaviour is necessary to understand how dietary choices are shaped and related to diet quality. This study describes food-related behaviours and health indicators associated with dietary quality among adolescents in Manitoba, Canada. A stratified two-stage sampling method was used to collect data on the diet, food behaviours and health indicators of 1587 grade nine students. Diet quality was analysed using the Healthy Eating Index-Canada. Several food behaviours and health indicators varied by gender and school region (urban, rural, northern). The Independent Samples t-test and one-way ANOVA (analysis of variance) assessed differences between groups on the Healthy Eating Index-Canada. Higher Healthy Eating Index-Canada scores were found for those eating family dinners more frequently; consuming breakfast and lunch more frequently; consuming breakfast at home; eating lunch and morning snacks at school; purchasing fewer meals and snacks from cafeterias and vending machines; believing that food and nutrition education is important; not attempting to lose weight; being classified as 'healthy weight'; and getting more sleep. Many Manitoba youth are exhibiting food and health behaviours that increase their risk of having a poor diet.

Objective: The Manitoba Infant Feeding Database (MIFD) is being piloted as a surveillance system leveraging infant vaccination visits as a point of contact to collect infant feeding data during the first year of life. The objective of this study was to assess data quality and acceptability of the MIFD as a sustainable population-based surveillance system., Methods: Internal completeness and internal validity were measured to assess data quality. Internal completeness was defined as the number of completed data fields out of the total number of data fields. Internal validity was defined as the proportion of translation errors from one level of the system, the paper questionnaire, to the next, the electronic database. A survey assessed staff's acceptance of data collection and submission processes., Results: A total of 947 records were reviewed. Data were 98.5% complete. Discrepancies were noted in 13.5% of data. The survey response rate was 78.4%. Nearly all respondents reported that the MIFD data collection tool was easy to use (96.6% agreed or strongly agreed). Whereas some challenges were identified, the majority were willing to continue with the MIFD data collection tool and process (93.1%)., Conclusion: Results from this evaluation suggest that the MIFD data collection process worked well; however, data validation will require human resources. The MIFD approach provides a sustainable mechanism for collecting data on infant feeding for surveillance and research purposes.

Disease associated with Maedi-Visna infection results in substantial economic losses in affected sheep producing areas of the world. A survey was conducted to estimate herd and individual seroprevalence in the province of Manitoba and evaluate risk factors for seropositive herds. Of 2207 sheep sampled from 77 selected sheep flocks, the animal level seroprevalence was 2.47% and herd level seroprevalence was 25.10%. The herd-level factors of presence of clinical skin disease, herd size of > 70, history of musculoskeletal/lameness abnormalities, and the purchase of new stock (> 50) in the last 1 to 5 y, showed significant associations with seropositive herd status. The study documented a remarkable stability of low seroprevalence in the province over a 20-year period in the absence of a systematic disease control program.

The prevalence of Baylisascaris procyonis was estimated in the urban raccoon population of Winnipeg through the fecal flotation of raccoon feces collected at active latrines and through gross postmortem and fecal flotation of samples collected from nuisance raccoons. Fecal flotation of latrine-collected feces was positive in 33 of 89 samples and, of 52 latrines identified, 26 were positive on 1 or more occasions. Trapped individual raccoons subjected to postmortem examination were positive in 57 of 114 animals captured. Comparing a single fecal flotation to the gold standard of finding adult worms in the small intestine had a sensitivity of 78.9% and specificity of 92.9%. This study suggests that carriage of Baylisascaris procyonis is widespread in raccoons in the Winnipeg urban ecosystem. Raccoon latrines in Winnipeg should be treated as infectious sites and efforts should be made to limit access of pets and people at risk to those sites.

The authors' objective in this study was to determine geographic variations in the incidence of inflammatory bowel disease (IBD), specifically Crohn's disease and ulcerative colitis, in the Canadian province of Manitoba and its association with the sociodemographic, geographic, and disease-related characteristics of the study population. Using the University of Manitoba IBD Epidemiology Database, the authors applied spatial and ecologic techniques to visualize, explore, and model the incidence of Crohn's disease and ulcerative colitis for the period 1990-2001. The study demonstrated marked, statistically significant geographic variability in rates of both Crohn's disease and ulcerative colitis associated with the characteristics of the study population. Incidences of Crohn's disease and ulcerative colitis were observed to be highest among non-Aboriginal persons, persons of high socioeconomic status, persons with the lowest rates of enteric infection, and persons with the highest rates of multiple sclerosis. The observation of an inverse association between IBD incidence and rates of reportable enteric infection at the population level is consistent with the "hygiene hypothesis," which suggests that early exposure to enteric agents affords protection against eventual development of IBD. The positive association between IBD incidence rates and multiple sclerosis suggests that these two chronic, immunologically mediated diseases may have a common environmental etiology. This study underscores the importance of environment in IBD causation.