Tuberculosis in Canada 2000

TUBERCULOSIS IN CANADA 2000
512 KB in PDF Format Only

Cat. H49-108/2000
ISBN 0-662-67074-4

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TABLE OF CONTENTS

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SPECIAL REPORT: TUBERCULOSIS AMONG THE FOREIGN-BORN IN CANADA
EXECUTIVE SUMMARY
INTRODUCTION
RESULTS
SECTION I – 2000 CASE REPORTING
	National trends
	Geographic distribution
	Sex and age group distribution
	Birthplace distribution
	Diagnostic details
	Resistance patterns
SECTION II – 1999 TREATMENT OUTCOMES
	National trends
CONCLUSION
APPENDICES
Appendix I	Technical notes
Appendix II	Data tables: 2000
Appendix III	Estimated incidence of TB, 23 high-burden countries: 1999
Appendix IV	Population estimates: 2000
Appendix V	Reporting forms
Appendix VI	WHO region by country
Appendix VII	The Canadian Tuberculosis Committee
FIGURES
Figure 1	Proportion of TB cases in Canada by origin, 1970–2000
Figure 2	TB incidence in Canada, 1980–2000
Figure 3	TB cases in Canada, 1970–2000
Figure 4	Incidence of TB among the foreign-born in Canada, 1st and 2nd year after arrival
Figure 5	Foreign-born TB cases by year of arrival in Canada
Figure 6	Foreign-born TB cases by WHO region
Figure 7	Tuberculosis incidence and mortality rates – Canada: 1924-2000
Figure 8	Tuberculosis cases and incidence – Canada: 1980-2000
Figure 9	Tuberculosis incidence by province/territory as compared with national rate (5.5 per 100,000): 2000
Figure 10	Tuberculosis incidence (95% confidence interval) – Canada and provinces/territories: 2000
Figure 11	Tuberculosis incidence by sex – Canada: 1980-2000
Figure 12	Tuberculosis incidence by age group – Canada: 2000
Figure 13	Tuberculosis incidence by age group and sex – Canada: 2000
Figure 14	Proportion of tuberculosis cases by origin – Canada: 1980-2000
Figure 15	Tuberculosis cases by age group and origin – Canada: 2000
Figure 16	Distribution of tuberculosis cases by origin and incidence – provinces/territories: 2000
Figure 17	Proportion of foreign-born tuberculosis cases by WHO region – Canada: 1990-2000
Figure 18	Comparison of tuberculosis incidence in WHO regions and in individuals from regions in Canada: 2000
Figure 19	Tuberculosis cases by main diagnostic site and origin – Canada: 2000
Figure 20	Pulmonary smear positive tuberculosis cases – Canada: 1989-2000
Figure 21	Proportion of tuberculosis cases for which HIV status is known – Canada: 1997-2000
Figure 22	Treatment outcome status of tuberculosis cases by provinces/territories – Canada: 1999
Figure 23	Treatment outcome status of tuberculosis cases by major mode of treatment – Canada: 1999
TABLES
Table A	Incidence of tuberculosis in Canada, 3-year moving average: 1989-2000
Table B	Ranked tuberculosis incidence in Canada – provinces/territories: 2000
Table C	Proportion of tuberculosis cases in Canada by origin – provinces/territories: 2000
Table D	Comparison of WHO region rates (per 100,000) in Canada and in WHO region
Table E	Tuberculosis cases by main diagnostic site in Canada: 2000

 

EXECUTIVE SUMMARY

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In 2000, 1,694 cases (5.5 per 100,000) of new active and relapsed TB were reported to the CTBRS. The highest rate of 61.1 per 100,000 was reported in the northern region (Yukon Territory, Northwest Territories and Nunavut). TB incidence was lowest in the Atlantic region (Nova Scotia, New Brunswick, Prince Edward Island, Newfoundland and Labrador: 1 per 100,000). The three most populous provinces (Ontario, Quebec and British Columbia), which collectively make up 75% of Canada's population, accounted for 75% of the total reported cases. 

By age group, individuals between the ages of 25 and 34 years made up the largest number of reported cases, accounting for 18% of the total. However, the corresponding case rate of 7.0 per 100,000 for this age group was surpassed by the age-specific rates of 9.3 and 14.2 per 100,000 for those in the older age groups of 65 to 74 years and greater than 74 years, respectively. 

TB incidence continues to be highest among the foreign-born population. In 2000, the foreign-born represented 18% of the Canadian population but accounted for 65% of all reported TB cases in Canada. Canadian-born Aboriginal peoples constituted 4% of the overall population whereas reported cases of TB in this group accounted for 18% of the disease burden. Canadian-born non-Aboriginal cases accounted for15% of the reported cases and birthplace was unknown for 1% of cases. 

Respiratory TB was the most frequently reported main diagnostic site, representing 67% of reported cases in 2000. Diagnostic site varied by birthplace. TB of the peripheral lymph nodes was the second most commonly reported diagnostic site (15%), with 38% of these cases occurring in foreign-born individuals who originated in the WHO Western Pacific Region. Primary TB accounted for 6% of reported cases and was more common among Canadian-born Aboriginal Peoples. 

Of the 1,694 reported cases, 1,568 (93%) were laboratory confirmed. Of the 1,067 pulmonary cases, 52% were smear (microscopy) positive and 86% were culture positive. (Appendix II, Table 12; Figure 20). 

Of the 1,694 cases reported in 2000, 1,387 cases were culture positive. Of these, 89% had no resistance to TB drugs. 7.8% were resistant to one drug and the remaining 2.9% showed patterns of resistance to two or more drugs prescribed. The most common type of mono-resistance was resistance to isoniazid (INH) accounting for 41.6% of all reported resistance. Multi-drug resistant TB (defined as resistance to INH and rifampin) accounted for less than 1% of the positive cultures reported (Appendix II, Table 15). 

Of the 1,806 cases reported in 1999, treatment outcome data was reported for 777 cases. Of these, 651 cases (84%) were reported as being culture negative or having completed treatment. The majority of individuals placed on TB drug therapy in Canada (84%) were treated with three or more anti-tuberculosis drugs.

Surveillance reports on TB in Canada have been stored and maintained by Tuberculosis and Bacterial Respiratory Diseases (TB-BRD), Health Canada, from the early 1920s. Health Canada assumed responsibility for the Canadian Tuberculosis Reporting System (CTBRS) in 1994. 

The 2000 Tuberculosis in Canada annual report is a publication of TB-BRD, Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada, Health Canada. Reports of new active and relapsed TB cases are reported to TB-BRD through the CTBRS from the 10 provinces and three territories. 

The report contains information on the overall TB case counts and case rates for selected demographic and clinical characteristics. The report outlines case and treatment outcome data on the following: 

• province/territory 
• gender 
• age 
• birthplace 
• activity status 
• main diagnostic site 
• bacillary status 
• method of detection 
• immigration status 
• HIV status 
• patterns of drug resistance 
• treatment outcomes 
• treatment drug regimens. 

Appendices to the report include technical notes on the methodology of the report, including the definition of terms (Appendix I), data tables (Appendix II), estimated incidence of TB from 23 high burden countries (as designated by the WHO) (Appendix III), population estimates for 2000 (Appendix IV), the tuberculosis case reporting form and the treatment outcome reporting form. (Appendix V). 

The annual reports on tuberculosis morbidity have undergone and will continue to have revisions in format and content from year to year. It is our goal to continue to adapt and improve this publication in response to changes in the epidemiology and treatment of tuberculosis. We welcome any comments on the content or format of this document.

HOW TO REACH US

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For more information, copies of this report or other related reports, please contact: 

The following figures, tables and explanatory text were prepared by: 

 

ACKNOWLEDGEMENT

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The authors would like to acknowledge the Provincial/Territorial Tuberculosis Programs and their teams for their contribution to and participation in the Canadian Tuberculosis Reporting System (CTBRS). 

The authors would also like to thank the Scientific Publication and Multimedia Services Section, Public Health Agency of Canada, for its assistance in preparing this report. 

Published by authority of the Minister of Health 

© Minister of Public Works and Government Services Canada 2002 

Cat. H49-108/2000
ISBN 0-662-67074-4 

This publication can be made available in alternative formats upon request.