Tuberculosis rates remain sky-high among Canadian Inuit

Dr. Gonzalo Alvarez, the Ottawa researcher behind the Taima TB campaign, and Franco Buscemi of Nunasi Corp., call out the names of door prize winners after a community feast in 2012 where Alvarez presented the project’s results. Alvarez plans to present more results of ongoing TB-fighting project and the Qikiqtani General Hospital’s TB-tester at 7:00 p.m. at the Nunavut Research Institute in Iqaluit. (FILE PHOTO)

If you live in the Inuit regions of Canada, chances are that you or someone you know has tested positive for tuberculosis, a deadly infectious disease that usually affects the lungs.

In 2006 and again in 2014, Canada’s minister of health announced the adoption of a national TB reduction target of 3.6 cases per 100,000 by 2015.

But TB rates among Inuit continue to be high — overall, at least 30 times higher than that target rate, or, in Nunavut, 49 times higher.

A 2014 Health Canada document states that compared to the Canadian-born non-Aboriginal population, the incidence rate of active TB disease for Inuit is almost 400 times higher — although those rates don’t tell all the whole story because the actual numbers of Inuit TB suffers remain relatively small.

Still, TB, because it’s so contagious and lethal, remains a huge problem, on which Nunavut plans to spend $1.5 million in 2014-15, Health Minister Paul Okalik said during the recent legislative session.

The health department plans to introduce a TB awareness campaign, hire a TB educator to visit communities, hire indeterminate nurses in Clyde River, Pangnirtung, Qikiqtarjuaq, and Pond Inlet, hire a term nurse in Pond Inlet “to address the several new active cases,” hire a term mobile nurse in the Kivalliq region, hire a laboratory technician and supplies to expand the use of the GeneXpert tester in Iqaluit, and hire a term epidemiology program officer to track TB diagnoses.

TB cases have increased in Nunavut, Okalik said — with 83 confirmed active TB cases in 2014, and one to date in 2015.

“We are doing what we can to turn the tide. We need to stop it and we are doing our best right now to identify and track where the cases are and we have workers that track where they have been,” Okalik said.

The GN is urging everyone to get tested for TB — and especially anyone with the symptoms of TB, which include a major cough that lasts for more than three weeks, fatigue, loss of appetite, night sweats and weight loss.

Most people infected with TB don’t become ill or even know they are infected, because the TB bacteria can lie dormant in a person’s lungs for many years.

Lowering the high TB rates among Inuit will take a long-term commitment and money, ITK’s 2013 TB strategy said.

That strategy talked about how overcrowded and poorly-ventilated housing, limited access to nutritious food, and variable access to health care services contribute to the development of TB.

Expansion of programs, such as in-community x-ray clinics — like the community-wide x-ray testing offered in Kangiqsualujjuaq, Nunavik during a 2012 outbreak — the recent Taima TB project in Iqaluit, and new tools for TB detection, treatment, and prevention, all play a part in lowering the level of TB among Inuit, ITK said.

And, with more than 70 per cent of Inuit in Nunavut and Nunavik still smoking, the strategy also recommended making sure more Inuit are aware of the links between smoking and TB.

Overall, the strategy called for more community education, “Inuit-appropriate prevention control and care programs,” more research and good evaluation and reporting of TB cases.

The Taima TB project, which operated in Iqaluit from 2011 to 2013, found the best ways to tackle Nunavut’s TB rate is to visit people at home, hire Inuit to communicate with Inuit and get the community working together on the common goal of fighting TB.

Taima TB’s lessons appear to have inspired the new GN TB-plan, said Dr. Gonzalo Alvarez, a respirologist at the Ottawa Hospital.

Alvarez, who spearheaded the Taima TB project, recently wrote that “more can be done to bring down the Canadian incidence” of TB in in a public health publication, called “TB in Canada — The battle is not over.”

You can find out more about the ongoing activities Taima TB March 24 in Iqaluit, when Alvarez will present results of Taima TB’s three-year research project on Iqaluit’s GeneXpert TB-tester at the Nunavut Research Institute at 7:00 p.m.