Major TB screening clinic to launch next month in Nunavut community
Approved use of new treatment drug will "change the picture dramatically," says doctor
Territorial and federal agencies plan to launch a major tuberculosis screening clinic in Qikiqtarjuaq next month, in the hope of tackling the infectious disease in the Baffin community of about 600 people.
The clinic comes after the territory suffered one of its worst years for active or latent cases of TB since 1999: 100 cases in 2017, the same number reported in 2010.
The majority of those cases last year were found in Qikiqtarjuaq, where health officials estimate about 10 per cent of the population is currently infected with TB.
It was that, and the tragic death of a Qikiqtarjuaq teen, Ileen Kooneeliusie, who died of a rare form of TB last January, that prompted the government response.
“When you’re managing TB, the key is to find the contact,” said Dr. Kim Barker, Nunavut’s chief medical officer, “and at this point, there are so many contacts that it’s possible that just about everyone in the community is exposed.
“So rather than do the contact tracing, we’ve decided to go the route of doing community-wide screening.”
The mobile screening clinic is drawing most of its support from the federal government, which, in partnership with Inuit leadership, launched a task force last fall to address TB in Inuit Nunangat.
And just last week, Indigenous Services Minister Jane Philpott made a pledge on behalf of the federal government to “eliminate” TB from Inuit communities, though Ottawa has yet to announced a target date.
“I would say it’s a long-term endeavour, which is probably 10 years required to eliminate [TB],” Baker said. “So it’s very ambitious.”
In the meantime, the federal government and health agencies are sending radio technicians, respiratory therapists, a pediatric TB specialist, a TB public health nurse plus top-line screening equipment to Qikiqtarjuaq, where the group will set up a clinic in the community hall.
Starting Feb. 5, the TB clinic will start seeing residents until every community member has been screened—something the local health centre wouldn’t have the means to accomplish.
“More than anything, it’s volume,” Baker said. “We’re going to be able to see a lot more people.”
“The one difference is that we’re hoping to be able to mobilize rapid testing equipment… that would allow us to diagnose—if someone has active TB—almost instantaneously, rather than having to send out [samples] to Iqaluit or Ottawa.”
The Public Health Agency of Canada is also donating new and updated equipment, like X-ray machines, which Nunavut’s Health Department can keep after the Qikiqtarjuaq clinic has wrapped up.
The clinic could run as long as 10 weeks, Barker said, depending on how long it takes to screen all the community’s residents.
As for why Qikiqtarjuaq has been so hard hit by TB, Barker can’t say for sure.
“Tuberculosis is a complicated disease—there’s never one answer,” she said, noting the social factors like crowded housing make Nunavummiut particularly susceptible.
“But I’m also hoping that [the high number of cases] is because we’re doing a better job of diagnosing it, and people are more aware and more likely to seek treatment.”
Through a territorial project, the Taima TB initiative was piloting a new drug to treat TB called rifapentine, which is not yet approved for use in Canada.
But just last year, Health Canada added rifapentine to its list of drugs that can be used to meet urgent public health needs.
Now the drug has been approved for use in the territory, Baker said, with Qikiqtarjuaq serving as its first major roll-out.
“We’re really had a lot of success,” Baker said of rifapentine. “It changes the picture dramatically, because rather than taking the medication on a daily basis for nine months, now you take it once a week for 12 weeks.”
Qikiqtarjuaq residents will receive information about the upcoming clinic by mail and through the local community radio station.