Publication related to RSI or an RSI staff member
Taima (stop) TB: the impact of a multifaceted TB awareness and door-to-door campaign in residential areas of high risk for TB in Iqaluit, Nunavut.
BACKGROUND: The incidence rate of active tuberculosis (TB) disease in the Canadian Territory of Nunavut has shown a rising trend over the past 10 years. In 2010 it was 60 times greater than the national incidence rate. The objective of the Taima (translates to “stop” in Inuktitut) TB study was to implement and evaluate a public health campaign to enhance existing TB prevention efforts in Nunavut. METHODS: A TB awareness campaign followed by a door-to-door screening campaign was carried out in Iqaluit, Nunavut. The aim of the campaign was to raise awareness about TB, and to provide in-home screening and treatment for people living in residential areas at high risk for TB. Screening was based on geographic location rather than on individual risk factors. RESULTS: During the general awareness campaign an increase in the number of people who requested TB testing at the local public health clinic was observed. However, this increase was not sustained following cessation of the awareness campaign. Targeted TB screening in high risk residential areas in Iqaluit resulted in 224 individuals having TSTs read, and detection of 42 previously unidentified cases of latent TB, (overall yield of 18.8% or number needed to screen = 5.3). These cases of latent TB infection (LTBI) were extra cases that had not been picked up by traditional screening practices (34% relative increase within the community). This resulted in a 33% relative increase in the completion of LTBI treatment within the community. The program directly and indirectly identified 5/17 new cases of active TB disease in Iqaluit during the study period (29.5% of all incident cases). CONCLUSIONS: While contact tracing investigations remain a cornerstone of TB prevention, additional awareness, screening, and treatment programs like Taima TB may contribute to the successful control of TB in Aboriginal communities.
Authors
- Alvarez, Gonzalo G, Alvarez GG, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada; University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada; The Ottawa Hospital, Department of Medicine, Divisions of Respirology and Infectious Diseases, Ottawa, Ontario, Canada.
- VanDyk, Deborah D, VanDyk DD, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada.
- Aaron, Shawn D, Aaron SD, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada; University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada; The Ottawa Hospital, Department of Medicine, Divisions of Respirology and Infectious Diseases, Ottawa, Ontario, Canada.
- Cameron, D William, Cameron DW, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada; University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada; The Ottawa Hospital, Department of Medicine, Divisions of Respirology and Infectious Diseases, Ottawa, Ontario, Canada.
- Davies, Naomi, Davies N, Government of Nunavut, Department of Health, Iqaluit, Nunavut, Canada.
- Stephen, Natasha, Stephen N, Government of Nunavut, Department of Health, Iqaluit, Nunavut, Canada.
- Mallick, Ranjeeta, Mallick R, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada; University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada.
- Momoli, Franco, Momoli F, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada; University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario, Children's Hospital of Eastern Ontario Research Institute, Center for Practice Changing Research, Ottawa, Ontario, Canada.
- Moreau, Katherine, Moreau K, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario, Children's Hospital of Eastern Ontario Research Institute, Center for Practice Changing Research, Ottawa, Ontario, Canada.
- Obed, Natan, Obed N, Nunavut Tunngavik Inc., Department of Social and Cultural Development, Iqaluit, Nunavut, Canada.
- Baikie, Maureen, Baikie M, Government of Nunavut, Department of Health, Iqaluit, Nunavut, Canada.
- Osborne, Geraldine, Osborne G, Government of Nunavut, Department of Health, Iqaluit, Nunavut, Canada.
BACKGROUND: The incidence rate of active tuberculosis (TB) disease in the Canadian Territory of Nunavut has shown a rising trend over the past 10 years. In 2010 it was 60 times greater than the national incidence rate. The objective of the Taima (translates to "stop" in Inuktitut) TB study was to implement and evaluate a public health campaign to enhance existing TB prevention efforts in Nunavut. METHODS: A TB awareness campaign followed by a door-to-door screening campaign was carried out in Iqaluit, Nunavut. The aim of the campaign was to raise awareness about TB, and to provide in-home screening and treatment for people living in residential areas at high risk for TB. Screening was based on geographic location rather than on individual risk factors. RESULTS: During the general awareness campaign an increase in the number of people who requested TB testing at the local public health clinic was observed. However, this increase was not sustained following cessation of the awareness campaign. Targeted TB screening in high risk residential areas in Iqaluit resulted in 224 individuals having TSTs read, and detection of 42 previously unidentified cases of latent TB, (overall yield of 18.8% or number needed to screen = 5.3). These cases of latent TB infection (LTBI) were extra cases that had not been picked up by traditional screening practices (34% relative increase within the community). This resulted in a 33% relative increase in the completion of LTBI treatment within the community. The program directly and indirectly identified 5/17 new cases of active TB disease in Iqaluit during the study period (29.5% of all incident cases). CONCLUSIONS: While contact tracing investigations remain a cornerstone of TB prevention, additional awareness, screening, and treatment programs like Taima TB may contribute to the successful control of TB in Aboriginal communities.
