Tuberculosis on rise despite tests, treatment

JACKIE WALLACE

The incidence of tuberculosis is climbing once again in Nunavut, with 28 reported cases so far this year despite diligent testing and increased access to treatment.

That means 2006 could be one of the worst years for tuberculosis cases since the creation of the territory.

Elaine Randall, a communicable disease consultant for the GN, says conditions in Nunavut create an environment where TB blooms and “a reservoir of infected” continue to transmit it.

Nunavut has the highest rates of TB in Canada, peaking at 48 cases in 2000 and with 2005 not far behind with 45 cases.

“Unlike down south, up here people are very aware that TB is still around,” said Randall.

Often considered a Third World disease, TB is one of the most common infectious diseases worldwide.

One-third of the world’s population is infected with the disease, but healthy people may carry the infection with no effects. People with poor health and compromised immune systems — those who don’t get enough food to eat, or enough healthy food — may come down with the disease.

People with symptoms will develop a persistent cough lasting more three weeks, and may also experience night sweats, weight loss and chest pains.

Randall says that overcrowded living conditions in Nunavut make it easy for the disease to spread. Health officials follow up and test everyone in prolonged contact with people who have the disease.

In Nunavut, that can often mean testing 40 to 50 people who have been in close contact with a patient — people who have shared the same airspace for a long period of time.

The disease can be cured, but that means about six months of taking three or more types of medicine, and otherwise staying healthy.

People suspected of having the illness are tested before they are put on medication. They may be treated in hospital for a short time, but some patients are never hospitalized, and almost all patients return to their homes, where they continue to take their medication.

Randall says screenings are done in schools as early as kindergarten and also at targeted places that are ripe for the disease, such as homeless shelters.

She says that one problem is that there is reluctance among people to be screened and treated on their own.

This can be due to a stigma attached with the disease, and the history of TB in the territory. People remember or have heard stories of people spending years in TB sanitariums for treatment. Other people do not want the long-term treatment to change their lifestyle.

Randall said that for many dealing with poverty, homelessness, abuse or addiction, “sometimes TB is the last thing on people’s minds.”

She said that the conditions currently making Nunavummiut susceptible to TB are not going to change anytime soon and that working at the root causes, such as poor living conditions and poor nutrition, will ultimately be what eradicates the disease from the territory.

“It definitely requires a combined effort,” said Randall. “It will be a long process.”