Abstract
Although Canada has a low incidence of tuberculosis (TB), certain populations, including the foreign-born and Canadian-born Indigenous peoples, continue to be disproportionately represented among reported cases. The overall incidence rates of active TB in Canada have not significantly changed in the past decade and work still needs to be done to reach TB elimination goals set by the World Health Organization (WHO). In trying to achieve TB elimination in Canada, primary care clinicians, with the support of public health professionals and TB experts, can help by focusing on 1) targeted screening and treatment of latent TB infection (LTBI) and 2) timely diagnosis and referral of active TB disease. The following article focuses on some key primary care considerations to keep in mind in day-to-day patient care. To help conduct targeted screening and treatment for LTBI, several key populations, including immigrants from high TB burden countries, Indigenous peoples and several other at-risk groups, are outlined. Reactivation of LTBI plays a significant role in TB burden and is likely an area of major potential impact in achieving TB elimination. Advancement in LTBI treatment, including short course therapy, is also described. In addition, to help make a timely diagnosis of active TB, several key risk factors, including several co-morbidities which increase the risk of developing TB disease, can be considered. Being front-line in patient care, keeping in mind some of these key pearls may aid primary care providers to have potential impact on eliminating TB in Canada.
Highlights
In May 2014, the World Health Assembly approved the World Health Organization’s (WHO’s) post-2015 global strategy to end tuberculosis (TB) by 2035
Based on The Global Plan to Stop TB 2006–2015 (WHO) [2], Canada’s goal was to reach a target incidence of 3.6 per 100,000 population per year by 2015, a target that was reiterated in the 2014 Tuberculosis Prevention and Control in Canada: A Federal Framework for Action [3]
It summarizes seven select groups from various at-risk populations that primary care physicians may commonly encounter in their practice and who they should consider for targeted latent TB infection (LTBI) screening
Summary
In May 2014, the World Health Assembly approved the World Health Organization’s (WHO’s) post-2015 global strategy to end tuberculosis (TB) by 2035. One of the eight outlined priority action areas for these countries include undertaking screening for latent TB infection (LTBI) and active TB among contacts and selected high-risk groups, and providing appropriate treatment [1]. With the support of public health professionals and TB experts, have two key roles in Canada’s elimination efforts: conducting targeted screening and treatment of LTBI, which prevents reactivation and helps accelerate the decline in TB incidence, and making timely diagnosis of active TB disease, which prevents further transmission and helps maintain the decline in TB incidence. It summarizes seven select groups from various at-risk populations that primary care physicians may commonly encounter in their practice and who they should consider for targeted LTBI screening.
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