The World Health Organization (WHO) has declared March 24, 2016 as World Tuberculosis (TB) Day . Over the month of March, the Global Health Office will be publishing a series of blog posts about TB in hopes of raising awareness of its worldwide impact. WHO’s “End TB Strategy” has a goal of ending the TB epidemic by 2030, by targeting poverty, improving testing and treatment, ending stigma and discrimination, and driving research and innovation. Put simply, TB is not yet a disease of the past, but if we unite and focus our efforts, we can make TB history.
We have finally reached our final post in the March TB blog series: TB in Canada. Let’s start with a little history lesson.
The modern global TB epidemic began in Western Europe in the 17th century. European settlers brought their TB infection with them to Canada (called “Consumption” back in the good old days), thus beginning the Canadian TB epidemic of the last several centuries. In 1897, the first Canadian sanatorium, the Muskoka Cottage Sanatorium, was opened to treat TB patients. These facilities isolated infected patients, while providing rest, nutritious food, fresh air, education and rehabilitation. Other initiatives to treat and control TB in Canada in the pre-antibiotic era included free treatment hospitals, home visits from TB health nurses, and TB dispensaries providing food, clothing, free medicines and sputum boxes to those affected. By 1953, Canada had 101 sanatoria, which along with TB units in general hospitals, totalled 19,000 beds nationwide. Antibiotic treatment became widely available in 1948 with the introduction of streptomycin, and improved in effectiveness in 1952 with the introduction of isoniazid. These treatment advances greatly reduced the burden of TB in Canada, allowing most sanatoria to close by the end of the 1970s . However, TB is still present in Canada today, disproportionately affecting certain populations.
Nowadays, there are about 1600 new cases of active TB reported in Canada annually, a number that has remained relatively stable since the 1980s. This translates to one of the lowest rates of active TB worldwide. Cases of active TB must (legally) be reported to provincial or territorial departments of health. Provinces and territories may then voluntarily submit their surveillance data to the federal government for national surveillance reports. Approximately 90% of cases reported in Canada affect 2 main populations: foreign-born individuals (70%) and Canadian-born Indigenous Peoples (20%) . Compared to the Canadian-born non-Aboriginal population, the incidence rate of active TB disease for Inuit was almost 400 times higher in 2012. Higher rates of TB in these populations are linked to the social determinants of health. Certain Indigenous populations are subject to overcrowding and poorly ventilated housing conditions, as well as higher rates of co-morbidities such as HIV infection and diabetes, which increase the risk of TB infection. Poverty, recent travel to or residence in high-risk foreign countries, and the stresses associated with integration into Canadian society are all factors that may increase the risk of latent TB infection or profession to active TB disease in foreign-born populations .
The federal government participates in several initiatives to prevent, control and provide education around TB. One is the TAIMA TB project, funded by the Public Health Agency of Canada. This project was designed to increase awareness about TB in Iqaluit, while providing door-to-door latent TB testing in high-risk areas . Canada has also been active in both the STOP TB and the END TB strategies developed by the World Health Organization .
We hope you have learned more about TB through our series of blog posts! If you have any suggestions for feature topics on the GHO blog, please let us know by sending an e-mail to firstname.lastname@example.org.