In Canada, local public health authorities are required to report on all individuals diagnosed with active TB disease to their respective provincial/territorial TB program. Provincial and territorial TB programs then voluntarily submit reports that meet the surveillance definition of active incident (new and retreatment) TB disease to the Canadian TB Reporting System (CTBRS), at the Public Health Agency of Canada (PHAC). Although participation in the CTBRS is voluntary, all provinces and territories are active participants.
The CTBRS definition of active TB disease is based on either clinical or laboratory criteria. The clinical definition refers to one or a combination of:
signs and symptoms or diagnostic imaging findings compatible with active TB disease;
pathologic or postmortem evidence of active TB disease; and
a favorable response to a therapeutic trial of anti-TB drugs.
A positive laboratory diagnosis requires a positive culture to Mycobacterium TB (M. tuberculosis) complex (not including Mycobacterium bovis BCG strain) or a combination of clinical findings consistent with active TB disease and a positive nucleic acid amplification test.
Individuals with active TB disease are diagnosed by health care professionals and documented for local, provincial/territorial and national reporting. Reports are collated at the CTBRS, which maintains a database of non-identifying information on each person diagnosed with active TB disease, including demographic (age, sex, indigenous identity and ethnicity), clinical, co-morbid (HIV/AIDS, diabetes), treatment and outcome details.
Incidence rates for a specific population (Indigenous, Canadian-born non-Indigenous, foreign-born) in a given location (province/territory) are calculated as the number of individuals with active TB disease in that population divided by the total population born in that location. For foreign-born incidence rates, these denominators were Statistics Canada estimates of individuals residing in Canada who were born abroad.
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