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• An interrupted time series analysis of impact of USIVP in Manitoba. • Increased absolute change in SIV uptake percentage in the lowest income quintiles and with less healthcare utilization among 5–17-year-olds. • An upward annual trend in SIV uptake percentage among 5–17-year-olds. • A downward annual trend in SIV uptake percentage among 45–64-year-olds. • A downward annual trend across all strata of assessed population characteristics within all age groups in Northern Manitoba. Universal seasonal influenza vaccination policy (USIVP) was introduced in Manitoba, Canada in 2010. Its impact on seasonal influenza vaccine (SIV) uptake remains underexplored. We used population-wide data from Manitoba to assess the impact of the USIVP on SIV uptake. The study covered twenty influenza seasons (2000/01–2019/20). We summarized SIV uptake for influenza seasons before and after the USIVP. Utilizing a single-group interrupted time series analysis and appropriately accounting for autocorrelation, we estimated absolute change and annual trend in SIV uptake percentages among 5–17-, 18–44-, and 45–64-year-olds across strata of certain population socioeconomic and health-related characteristics following the USIVP. Average SIV uptake percentage in all age groups was significantly higher after compared with before the USIVP. Following the USIVP, there was no significant absolute change in SIV uptake percentage among 18–44- and 45–64-year-olds overall; however, a significant decrease was observed among 18–44-year-old males in the higher income quintiles, across healthcare utilization, and in some regions of residence. A significant increase was observed among 5–17-year-olds in the lowest income quintiles, in Northern Manitoba, and among those with less healthcare utilization, and no chronic disease. Overall, there was mostly no significant annual trend in SIV uptake percentage among 18–44-year-olds, and while a significant upward and downward trend was observed among 5–17-year-olds and 45–64-year-olds, respectively, a significant downward trend was observed across all strata of population characteristics within all age groups in Northern Manitoba. The USIVP in Manitoba was followed by an absolute increase in SIV uptake percentage only in some socioeconomically disadvantaged subpopulations among 5–17-year-olds. While there was mostly an upward annual trend in SIV uptake percentage among 5–17-year-olds, a downward trend was observed among 45–64-year-olds and across all age groups and subpopulations in socioeconomically disadvantaged Northern Manitoba. These findings are novel for Manitoba and require investigation and public health attention. [ABSTRACT FROM AUTHOR]

• Assessed impact of universal seasonal influenza vaccination policy on seasonal influenza vaccine uptake in Manitoba, Canada. • Significantly increased odds of vaccination 5-years post-policy relative to pre-policy among age groups except ≥65-year-olds. • Mostly homogeneous effect estimates within age groups across strata of assessed socioeconomic/health-related characteristics. • Largely consistent findings irrespective of sex and region of residence. In 2010, the government of the province of Manitoba, Canada introduced universal seasonal influenza vaccination policy (USIVP), providing free-of-charge vaccination to all registered residents of the province at least six months of age. Impact of the policy on seasonal influenza vaccine (SIV) uptake (receipt of vaccine) in Manitoba remains unclear, as there is a lack of published evaluations. We conducted an ecological study, utilizing population-wide data from several linked de-identified Manitoba Health and Seniors Care administrative health databases. The study period was from 2000/01–2019/20 influenza seasons. The primary exposure was USIVP (five influenza seasons pre-policy [2005/06–2009/10] compared with post-policy [2010/11–2014/15]). The outcome was SIV uptake. We conducted pre/post logistic regression analysis stratified by age group (<5-, 5–17-, 18–44-, 45–64-, ≥65-year-olds) and certain population socioeconomic and health-related characteristics. Results are adjusted odds ratios with associated 95 % confidence intervals. We observed significantly increased adjusted odds of SIV uptake post-policy relative to pre-policy in all age groups except ≥65-year-olds already covered from inception of the vaccination programme. The adjusted odds ratios ranged from 0.76 (0.75–0.76) among ≥65-year-olds to 2.15 (2.13–2.18) among 5–17-year-olds, and were largely homogeneous within age groups across sex, income quintiles, regions of residence, and categories of number of visits to primary care physician/hospitalization one year prior to an influenza season except among <5- and 5–17-year-olds. These findings were mostly consistent irrespective of sex and region of residence although there was variability across income quintiles in Northern Manitoba region. Introduction of the USIVP in Manitoba was followed by a significant increase in SIV uptake in the five years post policy among <65-year-olds, with similar increased relative odds of vaccination observed within age groups across subpopulations. The observed variations in the relative odds of vaccination across income quintiles in Northern Manitoba region requires administrative attention. [ABSTRACT FROM AUTHOR]

Objective: There is a lack of published evidence on factors associated with adherence (maintenance of cumulative vaccination) to seasonal influenza vaccination (SIV) in Manitoba, Canada. We sought to assess the associations., Methods: A cohort study utilizing Manitoba administrative health databases. Participants received SIV in 2010/11 influenza season, remained registered Manitoba residents and received at least one SIV during the 2011/12‒2019/20 seasons. We dichotomized adherence into "more adherent" (6‒9 SIVs) and "less adherent" (1‒5 SIVs) and used multivariable adjusted generalized estimating equation logistic regression models to assess association between adherence and socioeconomic, health-related, and primary care physician (PCP) characteristics, stratified by age group (< 5, 5‒17, 18‒44, 45‒64, ≥ 65) and sex. Results are adjusted odds ratios with 95% confidence intervals., Results: There were 152,493 participants. Males had lower odds of being more adherent except among ≥ 65-year-olds (1.03, 95% CI 1.01‒1.05). Compared with the lowest income quintile, those in higher income quintiles had higher odds of being more adherent. The odds mostly increased with increase in income quintile. Those with more contact with their PCP/hospitalization one year prior had higher odds of being more adherent. The odds increased with increased contact among those 18‒44, 45‒64 and ≥ 65 years old. Those who had PCP with more years of practice had higher odds of being more adherent. The odds increased as years of practice increased. These observations were mostly consistent irrespective of sex., Conclusion: Female gender, having higher income, having more contact with the health system, and having an experienced PCP may determine increased adherence to SIV in Manitoba. These findings require attention., (© 2024. The Author(s) under exclusive license to The Canadian Public Health Association.)

Background: Better CLL patient survival has been reported for specialized CLL clinics/hematologists (compared to other CLL patients). It is possible that improved survival is driven by a better prognosis of referred patients., Methods: We used logistic regression to calculate the odds ratios (ORs) and 95 % confidence intervals 95 %CIs) of the association between patient characteristics and CLL referral of all persons diagnosed in 2005-2016 with a pathologically-confirmed CLL or SLL., Results: Two-thirds of 1293 patients were referred to the CLL clinic. Referred patients were younger (16 % vs 44 % were 80 +) and in better health (47 % vs 56 % with a chronic diseases) than non-referred patients. Referral increased over time: in 2005-2010, about 60 % of patients were referred; in 2011-2016, this increased to 76 %. Gender did not affect referral (the OR for females is 1.0, 95 %CI 0.8-1.2), but age played a major role; CLL patients diagnosed at age 80 + were less likely to be referred than patients diagnosed < 60, 0.2 (0.1-0.3)., Conclusion: Because referral to Manitoba's specialized CLL clinic is associated with age and the patient's overall health before referral, one should be careful in interpreting differences in outcomes between CLL patients based on referral status alone., Competing Interests: Disclosure of financial relationships CHR has received an unrestricted research grant from Pfizer for an unrelated study. JBJ and VB have received unrestricted research grants from Lundbeck, Gilead and Janssen Pharmaceuticals for unrelated studies and sit on advisory boards for Gilead, Janssen, and Abbvie Pharmaceuticals. VB received consulting fees from AstraZeneca. SMM received research funding from Assurex, GSK, Merck, Pfizer, Roche and Sanofi for unrelated studies and is/was a member of advisory boards for GSK, Merck, Sanofi and Seqirus. None of the other authors have a financial relationship to disclose., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

We assessed Clostridioides difficile toxin testing and positivity for all patients in Manitoba hospitals during June 2016-November 2018. The testing rate was 30 per 10,000 patient bed days (95% confidence interval [CI], 30-31) and the incidence rate was 3.5 per 10,000 patient bed days (95% CI, 3.3-3.7). The context of testing is essential to the interpretation of data among jurisdictions.

Background: Several epidemiological studies have shown a positive association between diabetes and increased risk of non-Hodgkin lymphoma (NHL), but the effect of diabetic treatment drugs such as metformin on the risk is unknown. Methods: We conducted a population-based nested case-control study involving 878 NHL cases and 4,364 controls diagnosed with diabetes. Use of metformin and other medications before diagnosis and medical condition histories were assessed using administrative databases. We used conditional logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for use of metformin, adjusting for confounders. Results: Risk of total NHLs is not associated with ever use of metformin (OR, 0.93; 95% CI, 0.79-1.10) among diabetic patients. NHL subtypes were also not associated with metformin use. Conclusions: Metformin use is not associated with overall or subtype NHL risk among diabetic patients. Impact: NHLs are etiologically heterogeneous and larger scale studies are warranted to test the potential effect of metformin by NHL subtype. Cancer Epidemiol Biomarkers Prev; 27(5); 610-2. ©2018 AACR ., (©2018 American Association for Cancer Research.)