Introducing the fifth edition of the Canadian Tuberculosis Standards.

Abstract

The fifth and latest edition of the Canadian Tuberculosis Standards is now available through the offices of the Canadian Lung Association (CLA), and the individual provincial and territorial lung associations. Since the publication of the last edition of the Canadian Tuberculosis Standards (1) of the CLA and Canadian Thoracic Society (CTS), there has been renewed interest in the global resurgence of tuberculosis. In Canada, the epidemiology of tuberculosis reflects the many important challenges for tuberculosis control: an increasing proportion, now 64%, of all patients with tuberculosis in Canada are born outside Canada; there has been limited success in reducing the incidence of tuberculosis among aboriginal peoples, particularly in western Canada and the Territories; and tuberculosis-human immunodeficiency virus coinfection and drug resistance are growing problems. As a result, there has been increasing collaboration between the various tuberculosis stakeholders in the country including the provincial and territorial tuberculosis control programs, Health Canada, Citizenship and Immigration Canada and the CLA/CTS. It is altogether fitting, therefore, that the fifth edition of the Canadian Tuberculosis Standards has been coproduced by the CLA/CTS and the Division of Tuberculosis Prevention and Control at the Centre for Infectious Disease Prevention and Control, Health Canada. Some may ask, why a fifth edition of the Standards in such close succession to the fourth, published in 1996? Perhaps the best answer is the need to prepare ourselves in the new millennium to better respond to two major tuberculosis elimination initiatives: a National Tuberculosis Elimination Strategy issued by Medical Services Branch, Health Canada in 1992, with the aim of eliminating tuberculosis in First Nations peoples by the year 2010; and a National Consensus Conference on Tuberculosis, such as the one held in 1997, sponsored by Health Canada, at which there was agreement by conference participants on an interim elimination goal of a 5% reduction in the number of tuberculosis cases in Canada each year. Historically, the Canadian medical and public health communities have had a genuine interest in tuberculosis, with many notable persons and organizations having made significant regional, national and international contributions in the field. The fifth edition of the Standards draws upon a cross-section of current Canadian epidemiological, medical microbiological, respirological, infectious disease and public health expertise in tuberculosis (see appended Table of