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Free Content A population-based study of tuberculosis epidemiology and innovative service delivery in Canada

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Abstract:

OBJECTIVE: To compare and interpret tuberculosis (TB) incidence rates in a Canadian population across two decennials (1989–1998 and 1999–2008) as a benchmark for World Health Organization targets and the long-term goal of TB elimination. The population under study was served by two urban clinics in the first decennial and two urban and one provincial clinic in the second.

METHODS: TB rates among Status Indians, Canadian-born ‘others’ and the foreign-born were estimated using provincial and national databases. Program performance was measured in on-reserve Status Indians in each decennial.

RESULTS: In each decennial, the incidence rate in Status Indians and the foreign-born was greater than that in the Canadian-born ‘others’; respectively 27.7 and 33.0 times in Status Indians, and 8.0 and 20.9 times in the foreign-born. Between decennials, the rate fell by 56% in Status Indians, 58% in Canadian-born ‘others’, and 18% in the foreign-born. On-reserve Status Indians had higher rates than off-reserve Status Indians, and the three-clinic model out-performed the two-clinic model among those on-reserve. Rates in the foreign-born varied by World Bank region, and were highest among those from Africa and Asia.

CONCLUSION: Status Indians and the foreign-born are at increased risk of TB in Canada. Significant progress towards TB elimination has been made in Status Indians but not in the foreign-born.

Keywords: tuberculosis elimination; tuberculosis epidemiology

Document Type: Research Article

DOI: http://dx.doi.org/10.5588/ijtld.11.0374

Affiliations: 1: Tuberculosis Program Evaluation and Research Unit, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada 2: Tuberculosis Program Evaluation and Research Unit, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; and Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada 3: Tuberculosis Program Evaluation and Research Unit, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada; and Provincial Program Development and Disease Control Branch, Alberta Health and Wellness, Edmonton, Alberta, Canada

Publication date: January 1, 2012

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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