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Tuberculosis in Canada 2012 – Pre-Release

2014-01-30

Introduction

Tuberculosis in Canada 2012 – Pre-release provides a brief, initial overview of the epidemiology of tuberculosis (TB) in Canada for the most recent reporting year (2012). The data presented in this abbreviated report are provisional and are subject to change prior to the release of the full, more comprehensive surveillance report entitled Tuberculosis in Canada 2012 which is anticipated to be released in the spring of 2014.

Highlights

In Canada, the reported number of new active and re-treatment TB cases in 2012 was 1,686, an increase of 4% from the number of cases reported in 2011 (1,617). The reported incidence rate increased from 4.7 to 4.8 cases per 100,000 population.  Compared with 2011, there were no significant changes in the distribution of cases by province or territory, or by age group (Tables 12 and 3). Foreign-born people continued to account for the majority of reported TB cases, and the reported incidence rate per 100,000 population remained highest among Canadian-born Aboriginal peoples (Table 4). Pulmonary TB was the most commonly reported site of disease in 2012 (Tables 5 and 6). Finally, outcome data for cases diagnosed in 2011 indicated that 86% of them had been cured or had completed treatment (Table 7).

The three most populous provinces (British Columbia, Ontario and Quebec), which collectively made up 75% of Canada’s population in 2012 accounted for 69% of the total number of reported cases. Alberta, British Columbia, Manitoba, Nunavut, Quebec and Saskatchewan reported higher case counts in 2012 than in 2011. Ontario, New Brunswick, Newfoundland and Labrador, Nova Scotia, Northwest Territories, Prince Edward Island and Yukon reported the same or lower case counts in 2012 compared with 2011. Nunavut reported 79 active TB cases for 2012, an increase from 74 cases reported in 2011; the reported incidence rate of 234.4 per 100,000 population continued to be the highest reported for any province or territory (Table 1).

In 2012, there was little change in the overall distribution of reported TB cases by age group. Individuals between the ages of 25 and 34 years made up the largest number of reported cases, accounting for 17% of the total. There were a total of 111 pediatric cases (those cases under the age of 15 years) reported in 2012, accounting for 7% of all reported TB cases and representing an incidence rate of 2.0 per 100,000 population aged less than 15 years. Individuals 75 years of age and over accounted for 13% of all reported cases but had the highest reported incidence rate of all age groups, at 9.1 per 100,000 population aged 75 years or more (Table 2).

For 2012, age distribution patterns across the provinces and territories generally followed the national trend, with most reported cases occurring within the 25 to 34 years age group (Table 3). There was some regional variation, however. In Nunavut, Quebec and Saskatchewan, over 12% of their reported cases were pediatric cases, compared with 7% for Canada. For British Columbia, and the Atlantic provinces (New Brunswick, Newfoundland and Labrador, Nova Scotia, Prince Edward Island), over 20% of the reported cases were 75 years of age or over, whereas for Canada only 13% were in this age group (Table 3).

Overall, in 2012, 64% of all reported TB cases were foreign-born individuals, 23% were Canadian-born Aboriginal peoples and 10% were Canadian-born non-Aboriginal people. For 3% of the reported cases, origin was unknown. Again, there was some regional variation. Alberta, British Columbia, Ontario and Quebec all reported that the majority of their cases were foreign-born individuals. However, as a result of an outbreak in northern Quebec, the number of TB cases reported who were Inuit people represented almost 30% of all the cases reported from Quebec, a noticeable increase from previous years. This also resulted in an increase in the overall incidence rate among Inuit people in Canada for 2012 relative to previous years.

In Manitoba, Saskatchewan and the territories (Northwest Territories, Nunavut and Yukon), the majority of cases reported were Canadian-born Aboriginal peoples. In the Atlantic provinces, the small number of reported cases was distributed between foreign-born and Canadian-born non-Aboriginal populations with one case being reported in a Canadian-born Aboriginal person (Table 4).

For 2012, pulmonary TB continued to be the major disease site, representing 67% of all reported cases. Between 2002 and 2012, there was little change in the distribution of cases by diagnostic site (Table 5).

In all provinces and territories, the majority of cases was diagnosed as having pulmonary disease. With regard to cases with a diagnosis of primary disease, however, the Atlantic provinces and Saskatchewan reported a greater percentage (13% or higher) than the other provinces or territories (0% to 8%, Table 6).

Of the 1,617 cases of active TB disease reported to the Agency in 2011, 1,304 (81%) had treatment outcome data available, 87 cases (5%) were still on treatment, and for 226 cases (14%) final treatment outcome data were unavailable. Of the 1,304 cases for which a treatment outcome data were available, 1,120 (86%) were reported to be cured or had completed treatment, 134 (10%) had died before or during treatment, and 27 (2%) had transferred out of Canada at some point during their treatment and final outcome was unknown.  Of the remaining 23 cases (2%) reporting an outcome, five absconded and were lost to follow-up, two experienced an adverse drug reaction and treatment was discontinued, and for 16 the treatment outcome was recorded as “other“ without clarification (Table 7).

Tables:

To obtain a copy of the report, send your request to:

Centre for Communicable Diseases and Infection Control
Public Health Agency of Canada
100 Eglantine Driveway
Tunney’s Pasture
Ottawa, ON K1A 0K9
E-mail: [email protected]

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