Summary of Epidemiology of Tuberculosis in First Nations Living On-Reserve in Canada, 2000-2008

Epidemiology of Tuberculosis in First Nations Living On-Reserve in Canada, 2000-2008

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The reported incidence rate of tuberculosis in Canada is among the lowest in the world. According to the Public Health Agency of Canada (PHAC), the reported incidence of TB has steadily declined in the general Canadian population over the past 30 years. Certain populations in Canada continue to be disproportionately affected, including foreign-born Canadians, persons who abuse substances, the homeless and Aboriginal peoples. For example, while the 2006 Census reports that Aboriginal peoples account for just under 4% of the Canadian population, 21% of all TB cases occurred in this population in 2008.

The objectives of the current report are to:

  • summarize and present epidemiological data on tuberculosis in First Nation communities from 2000 to 2008
  • communicate and highlight key findings associated with tuberculosis in First Nation communities
  • present baseline data that can be used to help evaluate progress made as a result of a revised TB strategy and new initiatives

Highlights

  • This report presents epidemiological data on new and re-treatment cases of tuberculosis (TB) in First Nation communities from 2000 to 2008 for the seven regions of Health Canada's First Nations and Inuit Health Branch. Tuberculosis data were obtained from regional data sources and the Canadian Tuberculosis Reporting System of the Public Health Agency of Canada.
  • Over the past two decades, the reported incidence rate of active TB cases (new and re-treatment) among First Nations living on-reserve decreased by 60%.
  • The active TB reported incidence rate for First Nations living on-reserve in the seven regions of Health Canada's First Nations and Inuit Health Branch was 26.6 per 100,000 in 2008, which was 29.6 times higher than the Canadian-born non-Aboriginal population.
  • From 2000 to 2008, regional TB reported incidence rates for First Nations living on-reserve across Canada varied considerably, ranging from 4.2 to 79.4 cases per 100,000 population.
  • From 2000 to 2008, the age-standardized active TB reported incidence rates for First Nations living on-reserve were between 32 and 59 times higher than the Canadian-born non-Aboriginal population, and between 2 and 3 times higher than the foreign-born Canadian population.
  • Over the reporting period, TB incidence rates reported for First Nations on-reserve were stable in almost all age groups, with the exception of those 65 years of age and older. In this age group, the reported incidence of TB decreased from 83.7 per 100,000 population in 2000 to 36.7 per 100,000 in 2008. Even with this decrease, the reported TB incidence remains highest in this age group in all regions, with the exception of Saskatchewan and Québec.
  • Among the regions for which data are available, pulmonary TB was the leading diagnosis of active tuberculosis for all regions, with the exception of Saskatchewan region (where the leading diagnosis was primary TB).

This report represents the most current data on tuberculosis for First Nations living on-reserve across Canada. Since 2000, the TB rates for this population have stabilized; however, they remain considerably higher than the rates observed in the Canadian-born non-Aboriginal population.

This report highlights that there are important differences in TB activity across the country that are influenced by the geographic region in which First Nations live. It is therefore important that the interpretation of data on a national level keep these variations in mind. These regional differences will be particularly important for planning health promotion activities and educational programs in those regions with a higher reported incidence of TB. This report also provides a breakdown of the classification of TB cases by diagnostic site, which will allow for targeted approaches to TB prevention activities.

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