TB IN NUNAVUT
Active TB disease is an airborne disease most commonly characterized by cough, weight loss, night sweats, and fever. If left untreated, it can result in serious health problems and can result in death. Timely and effective treatment results in better patient outcomes and prevents further exposure to the community thereby avoiding outbreaks.
In 2016 the TB incidence rates of active TB disease were:
Nunavut- 132 /100,000
Canada- 4.8/100,000
(Inuit Tapariit Kanatami, TB Elimination Framework, https://www.itk.ca/wp-content/uploads/2018/12/FINAL-ElectronicEN-Inuit-TB-Elimination-Framework.pdf).
Furthermore, among Canadian born Indigenous peoples, Inuit have a disproportionately high rate of TB compared to Canadian born non-Indigenous population:
Inuit – 182.9/100,000
Canadian born non-Indigenous population – 0.6 / 100,000
The rate of TB among Inuit living in Inuit Nunangat was over 300 times the rate of TB among non-Indigenous, Canadian born population in 2016.
(Inuit Tapariit Kanatami, TB Elimination Framework, https://www.itk.ca/wp-content/uploads/2018/12/FINAL-ElectronicEN-Inuit-TB-Elimination-Framework.pdf).
The number of new cases (incidence rate) of active tuberculosis (TB) disease among Inuit remains the highest in Canada and has been for the last 20 years. Over the past 20 years, the graph below (Figure 5) shows the TB incidence rate among all Inuit has been higher than all other people living in Canada. The rate is calculated using the numerator (number of active TB cases) divided by the denominator (total population). It should be noted that although the rate for Inuit is the highest, the number of active cases among Inuit is lower (numerator) than other groups such as foreign-born individuals (Table 5). However, the rate ends up being higher because it reflects a lower denominator (Inuit population).
Aboubakar Mounchili, Reshel Perera, Robyn S. Lee, Howard Njoo & James Brooks (2022) Chapter 1: Epidemiology of tuberculosis in Canada, Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 6:sup1, 8-21, DOI: 10.1080/24745332.2022.2033062. https://doi.org/10.1080/24745332.2022.2033062
Nunavut has a multifaceted Tuberculosis Prevention and Control Program that follows Canadian TB standards. The components are listed below.
- Management of cases of active TB disease
- Contact tracing and outbreak investigation
- Screening for latent tuberculosis infection (LTBI) and active TB disease
- Surveillance and data management
- Laboratory diagnostic capacity
- Education and training of health professionals
- Community-based awareness
- Monitoring and evaluation
- Measures in high-risk settings
