The last 8 years have witnessed great strides in our under- standing of the pathogenesis, immunology and epidemiology of tuberculosis. In the past decade, after too many decades of inaction, new diagnostics and new treatment regimens for tuberculosis (TB) infection, and drug-resistant TB disease have been developed. This 8th edition of the Canadian Tuberculosis Standards (the Standards) has been extensively revised to incorporate much of this new information, build- ing upon the 7 previous versions of the Standards, which were published in 1972 (with a pediatric supplement in 1974), 1981, 1988, 1996, 2000, 2007 and 2013.
Specifically, in response to feedback from users of previous versions of the Standards, some sections have been expanded, while others have been reduced or eliminated.
For example, the chapter on Bacille Calmette-Guérin vaccination has been dropped and updated content is now within the chapter on Pediatric TB. The chapter on disease due to non-tuberculous mycobacteria has also been dropped; some parts are now found in the chapter on diagnosis of TB disease. A new chapter on monitoring TB program performance is a fitting new edition to the Standards (promoting standards for TB programs).
The objective of this document remains to provide practical management information to public health and clinical professionals on all aspects of the pathogenesis, epidemiology, and management of TB in Canada. The guidance pertains to all individuals at risk for or confirmed to have latent or active TB. Specific target users may include: decision-makers, public health professionals, specialists man- aging TB (eg, internists, respirologists, infectious diseases specialists) and primary care providers.
Of note, the document does not supersede any provincial/ territorial legislative, regulatory, policy and practice requirements, or professional guidelines that govern the practice of health professionals in their respective jurisdictions. The Standards also is not intended to replace consultations regarding management of individual patients or other circumstances, between providers and persons with relevant expertise in tuberculosis.
Reference is made to specific tests, procedures and therapies throughout the Standards. For the most part, generic terms are used rather than trade names or manufacturers’ names. However, in a few instances when only a single manufacturer or product is available, a trade name may be mentioned. This is done only to enhance readers’ understanding by providing a name with which they are more likely to be familiar. Use of trade names and commercial sources is for identification only and does not imply endorsement by the Canadian Thoracic Society (CTS).
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