Tuberculosis in First Nations Communities, 1999
Michael Clark, Research Analyst,
First Nations and Inuit Health Branch
Dr. Peter Riben, Community Medicine Specialist,
First Nations and Inuit Health Branch
Published by authority of the Minister of Health, 1999
ISBN: 0-662-30044-0
Cat. No.: H35-4/7-1999E
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Table of Contents
1. Executive Summary
2. Tuberculosis Elimination Strategy
3. Epidemiology of Tuberculosis (TB) among First Nations
persons living on-reserve
4. Regional TB Control Programs
5. TB outbreaks
References
Appendix A. Screening: a framework for discussion
Appendix B. Demographics of the First Nations on-reserve
population
Tables
Table 3.1 National age-standardized
TB notification rate (per 100,000) in First Nations communities (1990-1999)
and Canada (1990-1997), with standardized morbidity ratios
Table 3.2 First Nations, on-reserve
TB cases (new and relapsed) by First Nations and Inuit Health Branch
(FNIHB) Region (1990-1999)
Table 3.3 Three-year moving, age-standardized,
Regional TB notification rates, per 100,000 (1991-1998)
Table 3.4 Standardized morbidity ratios
(%) of Regional First Nations TB notification rates to corresponding
provincial rates (1991-1997)
Table 3.5 Age-specific TB notification
rates among the Inuit of northern Quebec (1995-1999)
Table 3.6 Bacteriologically confirmed,
pulmonary TB notifications, by Region (1997-1999)
Table 3.7 Tuberculin skin test (TST)
positivity among children by Region (1997), and associated annual risk
of infection (1991)
Table 3.8 Results of tuberculin surveys
and contact investigations in 3 Regions (1995-1999)
Table 3.9 Mortality from active TB
in First Nations communities, by Region (1991-1999)
Table 3.10 Reported HIV infection
in active TB cases, by Region (1991-1999)
Table 3.11 Reported drug resistance
in the First Nations, on-reserve population (1991-1999)
Table 4.1 Treatment completion, Pacific
Region (1991-1999)
Table 4.2 Contacts, treatment of LTBI,
and BCG coverage, Pacific Region (1996-1999)
Table 4.3 Treatment completion, Alberta
Region (1991-1999)
Table 4.4 Contacts, treatment of
LTBI, and BCG coverage, Alberta Region (1996-1999)
Table 4.5 Treatment completion, Saskatchewan
Region (1991-1999)
Table 4.6 Contacts, treatment of
LTBI, and BCG coverage, Saskatchewan Region (1996-1999)
Table 4.7 Treatment completion and
contacts, Manitoba Region (1991-1999)
Table 4.8 Treatment completion, Ontario
Region (1991-1999)
Table 4.9 Contacts, treatment of
LTBI, and BCG coverage, Ontario Region (1996-1999)
Table 4.10 Current Regional screening
activities for schoolchildren and high-risk groups
Table 4.11 Results of contact investigations,
by Region (1996)
Table 4.12 Adverse reactions to
the BCG vaccine, by type of reaction, in Pacific,
Alberta, Saskatchewan, and Ontario (1996-1999)
Table 5.1 Active TB notification rates
by degree of isolation (1997-1999)
Table 5.2 TB notification rates by
community housing density categories (1997)
Table 5.3 TB notification rates by
community housing density categories (1997-1999)
Table A.1 Interpretation of a tuberculin
skin test
Table A.2 Positive predictive value
of a tuberculin skin test
Table A.3 Results of published school-based
screening evaluations in Canada, and this report
Table B.1 On-reserve population,
by age group and Region (1990)
Table B.2 On-reserve population,
by age group and Region (1991)
Table B.3 On-reserve population,
by age group and Region (1992)
Table B.4 On-reserve population,
by age group and Region (1993)
Table B.5 On-reserve population,
by age group and Region (1994)
Table B.6 On-reserve population,
by age group and Region (1995)
Table B.7 On-reserve population,
by age group and Region (1996)
Table B.8 On-reserve population,
by age group and Region (1997)
Table B.9 On-reserve population,
by age group and Region (1998)
Table B.10 On-reserve population,
by age group and Region (1999)
Figures
Figure 3.1 Age-specific TB notification
rates (per 100,000) in First Nations communities (1991-1998)
Figure 3.2 Three-year moving pediatric
TB notification rate (0-14 years), by Region (1990-1999)
Figure 3.3 TB cases by diagnostic
site (1990-1998)
Figure 3.4 Distribution of TB cases
by diagnostic site, by Region (1990-1998), compared to entire Canadian
population (1990-1996)
Figure 3.5 Age distribution of pulmonary,
bacteriologically confirmed cases (1997-1999)
Figure 3.6 Trend in the annual risk
of infection in Pacific Region (1982-1995)
Figure 3.7 Trend in the annual risk
of infection in Saskatchewan Region (1979-1993)
Figure 3.8 TST positivity by age
group in Pacific Region (1991-1999)
Figure 3.9 TST positivity by age
group in Saskatchewan Region (1991-1998)
Figure 4.1 Method of detection of
TB cases (1990-1998)
Figure 5.1 Nursing shortages in remote
communities, expressed as percentages (January -- May, 2000)
Figure 5.2 Total population and TB
notification rate by community housing density (1997-1999)
Figure B.1 Comparison of Indian and
Northern Affairs Canada (INAC) and Community Workload Increase System
(CWIS) total populations for six Regions
Figure B.2 Difference between CWIS
and INAC age-specific population estimates, by total age-specific populations
Figure B.3 Difference between CWIS
and INAC age-specific population estimates, by percentage of total population
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