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Patterns and characteristics of TB among key risk groups in Canada, 1993–2018

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BACKGROUND: Canada has a low incidence of TB, although certain groups are disproportionately affected.

OBJECTIVE: To describe and compare the epidemiology, trends and characteristics of TB in Quebec, Canada, among all patients reported during 1993–2018.

METHODS: Demographics and risk factors were compared for the three groups accounting for most TB diagnoses reported in Quebec (foreign-born, Canadian-born non-Indigenous and Inuit). Average annual incidence and incidence rate ratios (IRRs) were estimated and compared using Poisson regression.

RESULTS: Of 6,941 persons with a first episode of TB, 4,077 (59%) were foreign-born, 2,314 (33%) were Canadian-born non-Indigenous and 389 (6%) were Inuit. The average annual incidence for foreign-born, Canadian-born non-Indigenous and Inuit was respectively 17.0, 1.4 and 137.1 per 100,000 population. Compared to Canadian-born non-Indigenous, the IRR for foreign-born and Inuit was respectively 12.3 (95% CI 11.6–12.9) and 98.7 (95% CI 88.6–109.9). There was evidence of community transmission among the Inuit, with more than 80% of patients having a TB contact (2012–2018 data) and 65% (251/389) of diagnoses in those aged <25 years.

CONCLUSION: Although TB rates among the Canadian-born non-Indigenous are extremely low, there are persistent and distinct TB epidemics among the foreign-born and Inuit. Tailored approaches to TB prevention and care are needed to address TB among high-risk populations in low TB incidence settings.

Keywords: Inuit; epidemiology; foreign-born

Document Type: Research Article

Affiliations: 1: Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada, Department of Medicine, McGill University, Montreal, QC, Canada 2: Département de médecine sociale et préventive, École de santé publique de l´Université de Montréal, Montréal, QC, Canada, Direction régionale de santé publique, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l´Île-de-Montréal, Montréal, QC, Canada 3: Department of Medicine, McGill University, Montreal, QC, Canada, Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, QC, Canada 4: Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada 5: Department of Medicine, McGill University, Montreal, QC, Canada, Respiratory Division, Sir Mortimer B Davis (SMBD)- Jewish General Hospital, Montreal, QC, Canada 6: Respiratory Division, Department of Medicine, McGill University, Montreal, QC, Canada, McGill International TB Centre, Montreal, QC, Canada, Montreal Chest Institute, Montreal, QC, Canada, Research Institute of the McGill University Health Centre, Montreal, QC, Canada 7: Respiratory Division, Department of Medicine, McGill University, Montreal, QC, Canada, McGill International TB Centre, Montreal, QC, Canada, Montreal Chest Institute, Montreal, QC, Canada, Research Institute of the McGill University Health Centre, Montreal, QC, Canada 8: Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada, Department of Medicine, McGill University, Montreal, QC, Canada, McGill International TB Centre, Montreal, QC, Canada, Division of Infectious Diseases, SMBD Jewish General Hospital, Montreal, QC, Canada

Publication date: November 1, 2022

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