Tuberculosis in Canada 2001

TUBERCULOSIS IN CANADA 2001
465 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: PAEDIATRIC TUBERCULOSIS IN CANADA
EXECUTIVE SUMMARY
INTRODUCTION
RESULTS
SECTION I – 2001 CASE REPORTING
	National trends
	Geographic distribution
	Sex and age group distribution
	Birthplace distribution
	Diagnostic details
	Resistance patterns
SECTION II – 2000 TREATMENT OUTCOMES
	National trends
CONCLUSION
APPENDICES
Appendix I	Technical notes
Appendix II	Data tables: 2001
Appendix III	Population estimates: 2001
Appendix IV	Estimated incidence of TB, 22 high-burden countries: 2001
Appendix V	WHO regions and member countries
Appendix VI	Reporting forms
Appendix VII	The Canadian Tuberculosis Committee
FIGURES
Figure SR-1	Paediatric tuberculosis cases and incidence in Canada, 1970–2001
Figure SR-2	Paediatric tuberculosis by diagnostic site and age, 1970–2001
Figure SR-3	Paediatric tuberculosis by origin, 1970–2001
Figure 1	Tuberculosis incidence and mortality rates – Canada: 1924-2001
Figure 2	Tuberculosis cases and incidence – Canada: 1981-2001
Figure 3	Tuberculosis incidence by province/territory as compared with national rate (5.5 per 100,000): 2001
Figure 4	Tuberculosis incidence by sex – Canada: 1981-2001
Figure 5	Tuberculosis incidence by age group – Canada: 2001
Figure 6	Tuberculosis incidence by age group and sex – Canada: 2001
Figure 7	Proportion of tuberculosis cases by origin – Canada: 1981-2001
Figure 8	Tuberculosis incidence by origin – Canada: 1981-2001
Figure 9	Tuberculosis cases by age group and origin – Canada: 2001
Figure 10	Distribution of tuberculosis cases by origin and incidence – provinces/territories: 2001
Figure 11	Number of foreign-born tuberculosis cases by WHO region – Canada: 1991-2001
Figure 12	Comparison of tuberculosis incidence in WHO regions and among individuals from regions in Canada: 2001
Figure 13	Tuberculosis cases by main diagnostic site and origin – Canada: 2001
Figure 14	Pulmonary sputum smear positive tuberculosis cases – Canada: 1991-2001
Figure 15	Proportion of tuberculosis cases for which HIV status is known – Canada: 1997-2001
Figure 16	Treatment outcome status of tuberculosis cases by provinces/territories – Canada: 2000
Figure 17	Treatment outcome status of tuberculosis cases by major mode of treatment – Canada: 2000
TABLES
Table SR-A	Distribution and incidence (2001) of paediatric tuberculosis cases by origin in Canada: 1970-2001
Table A	Incidence of tuberculosis in Canada, 3-year moving average: 1990-2001
Table B	Ranked tuberculosis incidence in Canada – provinces/territories: 2001
Table C	Proportion (%) of tuberculosis cases in Canada by origin – provinces/territories: 2001
Table D	Comparison of reported WHO region rates (per 100,000) in Canada and notification rates in WHO region
Table E	Tuberculosis cases by main diagnostic site in Canada: 2001

 

EXECUTIVE SUMMARY

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In 2001, a total of 1,704 cases (5.5 per 100,000) of new active and relapsed tuberculosis (TB) were reported to the Canadian Tuberculosis Reporting System (CTBRS). The highest rate, of 138.4 per 100,000, was in Nunavut. TB incidence was lowest in the Atlantic region (New Brunswick, Newfoundland and Labrador, Nova Scotia and Prince Edward Island, at 1.7 per 100,000). The three most populous provinces (British Columbia, Ontario and Quebec), 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 19% of the total. However, the corresponding case rate of 7.2 per 100,000 for this age group was surpassed by the age-specific rates of 9.9 and 14.1 per 100,000 for those in the older age groups of 65 to 74 years and greater than 74 years respectively. 

Accurate information on the country of origin of TB cases in Canada has been available since 1970. In 2001, TB among foreign-born individuals accounted for 62% of all reported cases in Canada. Furthermore, 2001 marked the first time that the proportion of Canadian-born Aboriginal cases surpassed the proportion of cases reported among Canadian-born non-Aboriginal individuals (18% and 16% respectively). Birthplace was unknown for 3% of cases. 

Respiratory TB was the most frequently reported main diagnostic site, representing 66% of reported cases in 2001, although diagnostic site varied by birthplace. TB of the peripheral lymph nodes was the second most commonly reported diagnostic site (13%), and 35% of these cases occurred in foreign-born individuals who originated in the World Health Organization (WHO) Western Pacific Region. Primary TB accounted for 7% of reported cases and was more common among Canadian-born Aboriginals.  

The number of laboratory confirmed cases was 1,563 (92% of all cases). Of these cases, 1,345 (86%) were culture positive. Of these, 93% had no resistance to the drugs used to treat TB, 5% were resistant to one drug, and the remaining 3% showed patterns of resistance to two or more drugs prescribed. The most common type of mono-resistance was to isoniazid (INH), accounting for 36% of all reported resistance. Multi-drug resistant TB (defined as resistance to at least INH and rifampin) accounted for less than 1% of the positive cultures reported (Appendix II, Table 15). 

Of the 1,695 cases diagnosed in 2000, 705 cases had a treatment outcome report. Where treatment outcome status was known, 567 cases (80%) were reported as being culture negative (cure) or having completed treatment. The vast majority of individuals given TB drug therapy in Canada received treatment as per the Canadian Tuberculosis Standards;¹ 94% of these cases received three or more anti-tuberculosis drugs. 

The 2001 Tuberculosis in Canada annual report is a publication of Tuberculosis Prevention and Control (TBPC), Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada, Health Canada. Reports of new active and relapsed tuberculosis cases come to TBPC through the Canadian Tuberculosis Reporting System (CTBRS) from the 10 provinces and three territories. 

TBPC stores and maintains surveillance reports on tuberculosis in Canada dating from the early 1920s. Health Canada assumed responsibility from Statistics Canada for the CTBRS in 1994. 

The report contains information on the overall TB case counts and case rates for selected demographic and clinical characteristics. It 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 

Appendices to the report provide technical notes on the methodology of the report, including the definition of terms (Appendix I), data tables (Appendix II), population estimates for 2001 (Appendix III), the estimated incidence of TB from 22 high burden countries as designated by the WHO (Appendix IV). Further appendices include the World Health Organization (WHO) regions and their member countries (Appendix V), the tuberculosis case reporting form and the treatment outcome reporting form (Appendix VI), and the members of the Canadian Tuberculosis Committee (Appendix VII). 

The annual reports on TB have undergone and will continue to undergo 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: 

        Tuberculosis Prevention and Control
        Centre for Infectious Disease Prevention and Control
        Public Health Agency of Canada
        Health Canada
        Room 0108B, Brooke Claxton Building
        Tunney's Pasture, Ottawa, Ontario K1A 0K9 

        Internal Postal Address: 0900B-1 

        Telephone:     (613) 941-0238
        Facsimile:     (613) 946-3902 

This report can also be accessed on the internet at: 

       http://www.phac-aspc.gc.ca/

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

Edward Ellis, MD, MPH, FRCPC
Chief
Tuberculosis Prevention and Control 

Melissa Phypers, MSc
Senior Epidemiologist
Tuberculosis Prevention and Control 

Adam Medaglia, BSM
Surveillance Officer
Tuberculosis Prevention and Control 

Chris Sheardown, BA
Tuberculosis Database Manager
Tuberculosis Prevention and Control

 

 

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 2003 

Cat. H49-108/2001
ISBN 0-662-67105-8 

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