Publications

The children immunisation programme in Greenland correlates to the one in Denmark with the addition of the Bacille Calmette–Guerin (BCG)-vaccine and the immunisation against Hepatitis B (HBV). The immunisation rate among children in Greenland has been and is currently unknown and this study aims to estimate the immunisation rates among children in Nuuk from 1 July 2015 until 30 June 2016. We did an observational cross-sectional study based on a statistical extraction identifying all children in Nuuk eligible for an immunization in the children immunisation programme from 1 July 2015 until 30 June 2016 and a review of their medical records. We found acceptable coverage rates among children younger than 12 months, but coverage rates lower than recommended by the World Health Organization (WHO) among older children. Among children between 15 months and 4 years the coverage dropped as low as 33.9 %. Increased awareness of child immunisation rates is suggested including continuously monitoring and adjusting of the organisation of the immunisation programme.

A prospective national cohort study assessed the development of health‐related quality of life (HRQoL) and symptoms in adult patients undergoing treatment and care for advanced cancer in Greenland. HRQol was examined by EORTC QLQ‐C30 version 3.0 questionnaire monthly for 4 months. Changes over time and between‐group comparisons were examined. Of 58 patients included in the study, 47% completed the questionnaire four times. Functioning was generally high, and improved social functioning was observed after 1 and 2 months. The highest symptom score was for fatigue followed by pain and nausea/vomiting. A high score for financial problems remained unchanged during the entire period. Patients with higher income had reduced pain intensity (p = .03) and diarrhoea (p = .05) than patients with income below the poverty line. After 1 month, reduction in pain intensity was observed for Nuuk citizens compared with non‐Nuuk citizens (p = .05). After 2 months, non‐Nuuk citizens reported improved social functioning compared with Nuuk citizens (p = .05). After 3 months, Global Health in Nuuk citizens was improved compared with non‐Nuuk citizens (p = .05). An important clinical finding was that patients’ needs for support are related to social status, and geographical factors should be taken into account when planning palliative care.

For decades the spread of sexually transmitted infections (STIs) has been a health concern in Greenland, especially within the age group of 15–34 year olds. However, no overview exists of the potential differences in regional incidence and management of STIs. This study investigates the age, gender and region specific diagnostic activity and incidence of gonorrhoea in Greenland in 2015. The study design was an observational cross sectional register study with inclusion of patients tested for gonorrhoea in 2015. Patients above 15 years of age were included. Data was obtained from the laboratory system used at The Central Laboratory at Queen Ingrid’s Hospital in Nuuk. We found, in 2015, a total of 17,911 tests for gonorrhoea were performed on both men and women. Women accounted for 68% of the tests, while men accounted for 32%. The positivity rate was 7,878 pr. 100,000 of which 56% were women and 44% were men. The regional distribution showed a disparity of the testing rate and the rate of positive gonorrhoea tests.. Thus, we have documented a high diagnostic activity and high incidence of gonorrhoea in Greenland in 2015 among both women and men. We also found significant regional differences in both diagnostic activity and gonorrhoea incidence.

Diabetes mellitus is a large and growing worldwide health issue. Prior to this publication, a direct comparison of the prevalence of persons treated with anti-diabetic medicine in Greenland and Denmark has not been found. Therefore, the aim of this study is to estimate and compare the age- and gender-specific prevalence of patients treated with anti-diabetic medicine comparing Greenland and Denmark. The study was performed as a cross-sectional register study using data from population and medical registers in Greenland and Denmark. A total of 784 Greenlandic and 215,580 Danish patients treated with anti-diabetic medicine were included. The prevalence of patients aged 20–79 years treated with anti-diabetic medicine in Greenland was 2.6% (95% CI 2.4–2.8), much lower (p < 0.001) compared to Denmark with 5.2% (95% CI 5.2–5.2). The difference was less pronounced after excluding those treated with insulin and women below 45 years treated with metformin. In conclusion, this study showed a lower prevalence of patients treated with anti-diabetic medicine in Greenland than Denmark. The main reason may be a much higher prevalence of undiagnosed diabetes in Greenland, particularly among the middle-aged. Differences in awareness of diabetes and access to continued primary healthcare may be contributing factors.

Objective: Type 2 diabetes (T2D) may develop slowly with few symptoms and may remain undetected for many years, leading to severe complications that potentially could have been prevented with timely diagnosis and treatment. Undiagnosed diabetes has been reported high in Greenland. However, awareness and knowledges about diabetes in the general population remains unexplored.

Methods: This study was performed as an observational cross sectional study based on telephone interview among a random sample of Greenlanders. The interview was performed in Greenlandic or Danish according to participant’ preference and included information about age, gender, place of birth, place of residence, medical history of diabetes, awareness of the diabetes, risk factors, symptoms, complications, and local possibilities to get tested for diabetes.

Results: In total, telephone contact was established with 196 adults. Of those, 161 participants completed the interview while 35 were unwilling to participate in the interview corresponding to a response rate of 82% (161/196). The majority of responders, 85.7%, were aware of diabetes and local testing possibilities. However, only around 65% were aware of risk factors of diabetes. Also, the knowledge about common symptoms of diabetes was quite low, around 50%, and in particular low, around 40%, among males and inhabitants in settlements.

Conclusions: The vast majority of the population was aware of diabetes. However, the present study revealed shortage of knowledge of common risk factors, symptoms, and complications to diabetes. This is challenging the effort to prevent diabetes and new alternative information strategies are needed. Furthermore, the shortage of knowledges of risk factors may not be isolated to diabetes and further studies on health literacy in Greenland are recommended.