As detailed in this chapter, there are pronounced disparities in Canada regarding TB. Certain populations and geographic regions continue to be disproportionately affected. In addition to foreign-born and Indigenous populations in Canada, those who are incarcerated or experience homelessness also show higher incidence rates of active TB disease, as will be outlined in subsequent chapters of these Standards. There are numerous determinants of health that relate to TB, including education, employment, physical environment, social support, access to health services, personal health practices and culture. Addressing health inequities and the underlying determinants of health is universally recognized by TB experts as being an integral component of TB prevention and response, both in Canada8 and globally.9,10
Additionally, ongoing collaboration with community partners, key stakeholders and governments, enhancement of TB surveillance data and evaluation of TB programs are needed to effectively address and reduce TB-related inequities and burden in Canada. Enhancing TB surveillance data would require a comprehensive integration of the different components of the current surveillance program (eg, clinical, laboratory, treatment), an expansion to include subclinical TB, as well as the use of new tools such as whole genome sequencing, which could greatly support outbreak investigation and control.
A collaborative, multi-faceted approach is needed to meet these aims and, ultimately, eliminate TB in Canada, as noted in the 2018 Chief Public Health Officer (CPHO) report on eliminating TB in Canada.8 Specifically, continued engagement with communities by all levels of government and effective coordination of TB surveillance and programmatic areas can help ensure interventions are appropriately tailored for specific groups and are evidence-informed. This is essential to help reduce disparities and improve TB diagnosis, monitoring, treatment outcomes and, ultimately, TB prevention.
The Canadian Tuberculosis Laboratory Surveillance System Contributing Provincial/Territorial Partners
Province/Territory | Name | Organization |
---|---|---|
Newfoundland & Labrador |
|
Dept. of Health & Community Services |
Prince Edward Island |
|
Public Health Office |
Nova Scotia |
|
Dept. of Health & Wellness (Provincial Public Health Laboratory network) |
New Brunswick |
|
Public Health New Brunswick (Saint John Regional Hospital) |
Québec |
|
Québec National Institute of Public Health (Québec Public Health Laboratory) |
Ontario |
|
Public Health Ontario (Public Health Ontario Laboratory) |
Manitoba |
|
Manitoba Health, Seniors & Active Living (Diagnostic Services, Shared Health) |
Saskatchewan |
|
Saskatchewan Health Authority (Saskatchewan Disease Control Laboratory) |
Alberta |
|
Alberta Health Services |
British Columbia |
|
BC Centre for Disease Control |
Yukon Territories |
|
Yukon Communicable Disease Control |
Northwest Territories |
|
Department of Health & Social Services (Stanton Territorial Hospital) |
Nunavut |
|
Department of Health (Qikiqtani General Hospital) |
The Canadian Tuberculosis Reporting System Contributing Provincial/Territorial Partners
Province/Territory | Name | Organization | |
---|---|---|---|
Newfoundland & Labrador |
|
Dept. of Health & Community Services | |
Prince Edward Island |
|
|
Public Health Office |
Nova Scotia |
|
Dept. of Health & Wellness | |
New Brunswick |
|
Public Health New Brunswick | |
Québec |
|
Québec National Institute of Public Health | |
Ontario |
|
|
Public Health Ontario |
Manitoba |
|
|
Manitoba Health, Seniors & Active Living |
Saskatchewan |
|
Saskatchewan Health Authority | |
Alberta |
|
|
Alberta Health Services |
British Columbia |
|
|
BC Centre for Disease Control |
Yukon Territories |
|
|
Yukon Communicable Disease Control |
Northwest Territories |
|
|
Department of Health & Social Services |
Nunavut |
|
Department of Health |
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