Abstract
BackgroundThe Children's Hospital of Eastern Ontario (CHEO) provides services to children in Baffin Island, through the Baffin Island Pediatric Health Initiative. Tuberculosis (TB) remains a major public health problem in that region. The objective of our study was to describe the origin and clinical characteristics of patients with TB disease at CHEO, since the inception of the Baffin Island Pediatric Health Initiative.MethodsAll charts with a discharge diagnosis of TB disease during the first 10 years of the Baffin Island program were reviewed. Patients meeting a pre-determined case definition were included in analyses. A standard medical record abstraction form was used for patient data collection.ResultsTwenty patients met our case definition. Seven (35%) were Canadian-born children from Baffin Island. Seven resided in Ontario, 4 in Quebec, and 2 were visiting from other countries. All 7 children residing in Ontario were born in African countries. Endothoracic disease occurred in 16 patients (80%), including 9 with primary pulmonary TB, and 3 with sputum smear positive "adult-type" disease. Extrathoracic disease was present in 6 children (30%), including 3 with CNS disease. Three children had disease in 2 separate sites.ConclusionsWhile Baffin Island makes up 1% of the hospital catchment population, they contributed 35% of TB patients, and the only TB death. While TB in foreign-born children is due in part to epidemics abroad, the problem in Baffin Island is a reflection of disease burden and transmission within Canada.
Highlights
The Children’s Hospital of Eastern Ontario (CHEO) provides services to children in Baffin Island, through the Baffin Island Pediatric Health Initiative
The Children’s Hospital of Eastern Ontario (CHEO) provides services to children living in parts of eastern Ontario, western Quebec, and Baffin Island
The proportion of TB patients from Baffin Island rose from 10% during the first five-year period of the study to 60% during the second five-year period
Summary
The Children’s Hospital of Eastern Ontario (CHEO) provides services to children in Baffin Island, through the Baffin Island Pediatric Health Initiative. The objective of our study was to describe the origin and clinical characteristics of patients with TB disease at CHEO, since the inception of the Baffin Island Pediatric Health Initiative. The Children’s Hospital of Eastern Ontario (CHEO) provides services to children living in parts of eastern Ontario, western Quebec, and Baffin Island. The latter jurisdiction lies within Nunavut, a territory of northern Canada since 1999. The role of CHEO is one of clinical support, through the Baffin Island Pediatric Health Initiative. This program has been in place since April, 1998. Ongoing education is provided by staff at CHEO to health care workers throughout Baffin Island via teleheath services
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