Tuberculosis in Canada, 2016

Abstract

Background: Tuberculosis (TB) is a major global health problem that affected an estimated 10.4 million people worldwide in 2016. The Public Health Agency of Canada (PHAC) monitors active TB disease through a national surveillance system, which is a collaborative effort withthe provinces and territories.

Objective: This article presents an epidemiological summary of the active TB disease cases reported from 2006 to 2016, with a focus on 2016. Treatment outcomes for cases diagnosed in 2015 are also presented.

Methods: The Canadian Tuberculosis Reporting System (CTBRS) is a case-based surveillance system that maintains non-nominal data on people diagnosed with active TB disease in Canada. Data are collected annually from the provinces and territories, analyzed by PHAC and validated by each province and territory.

Results: The number of active TB disease cases increased from 1,642 in 2015 to 1,737 in 2016, corresponding to an increase in incidence rate from 4.6 to 4.8 per 100,000 population. Foreign born individuals continued to make up the majority of cases reported (70%) and the incidence rate remained highest among Canadian born Indigenous people (23.5 per 100,000 population) and was particularly high within the Inuit population (170.1 per 100,000 population). Over the past decade, there was a slight decrease in the number of cases among children and the proportion of re-treatment cases declined from 8.3% of cases in 2006 to 5.4% of cases in 2016.

Conclusion: Although tuberculosis incidence rates in Canada are low in the global context and have been relatively stable over the last decade, there has been a slight increase in rates over the last three years, especially in the foreign born population which accounts for the majority of cases. The decrease in cases among children suggests less active transmission and the low proportion of re-treatment cases suggests effective treatment and adherence.

Figure 1. Number and incidence rate per 100,000 population of reported active tuberculosis cases (new and re-treatment), Canada, 2006 to 2016

Figure 2. Tuberculosis incidence rate per 100,000 population by province/territory, Canada, 2016

Figure 3. Tuberculosis incidence rates per 100,000 population and percentage by age group and sex, Canada, 2016

Figure 4. Number of reported active tuberculosis cases (new and re-treatment) and incidence rates per 100,000 population by sex, Canada, 2006 to 2016

Figure 5. Distribution of active tuberculosis cases (new and re-treatment) by origin, Canada, 2016

Figure 6. Tuberculosis incidence rate per 100,000 population by Indigenous population, Canada, 2016

Figure 7. Tuberculosis incidence rate per 100,000 population among foreign born cases by epidemiological region^a, Canada, 2016

Abbreviations: AFR-High, Africa high HIV prevalence; AFR-Low, Africa low HIV prevalence; AMR, American Region – Latin American countries; CEUR, Central Europe; EEUR, Eastern European Region; EME, Established Market Economies; EMR, Eastern Mediterranean Region; SEAR, South-East Asian Region; TB; tuberculosis; WPR, Western Pacific Region ^a Based on birth country, which are regrouped by epidemiologic regions as specified by the World Health Organization (11)