International Union for Circumpolar Health Ministry of Public Health and Social Development of RF Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Sciences Medical Polar Fund “Science” The Northern Forum

Abstracts

Seminar Infection Diseases in Arctic

Objectives:

In 1992, the First Nations and Inuit Health Branch (FNIHB) established elimination (< 1 case/1,000,000 by the year 2010) as the goal of its Tuberculosis (TB) Strategy. An interim target was set at a case rate < 20/100,000 by the year 2000. However, many experts believe that elimination is not achievable in the foreseeable future and setting an unattainable goal is unhelpful for programme planning.

The objective of this project was to determine whether TB elimination should continue to be the goal for FNIHB, or if a new, evidence based goal could be developed.

Study Design:

Study design included literature review, analysis of surveillance and modeling data, and modified Delphi technique.

Methods:

Three types of information were systematically analyzed: 1. International/national reports and medical journals articles; 2. Epidemiologic data, novel disease modeling and forecasting data from federal government sources; 3. Expert opinion from national TB advisory committee, provincial/territorial TB directors and the federal TB programme.

Proposed goals and targets were developed and presented to FNIHB TB Programme decision makers for consensus opinion.

Results:

TB trend analysis demonstrated that the interim goal of < 20 cases/100,000 was achieved for Status Indians in some FNIHB regions. Among Non-Status Indians and Métis, rates have remained virtually unchanged since 1992. Among the Inuit, TB rates declined from 1992-1997 but have steadily increased to over 60 cases/100,000 annually and interim targets were not met.

Three programme options were proposed, including maintenance of elimination as a goal, adoption of an international goal, and adoption of the proposed Canadian national goal.

Conclusions:

Published literature, epidemiologic analyses, mathematical modeling and expert opinion are useful for developing health programme goals, especially when there is concurrence between different sources. The proposed evidence based FNIHB national goal is to reduce TB incidence to 3.6/100,000 by 2015 among on-reserve First Nations and Inuit. This would align the FNIHB programme with both international and proposed national TB targets. Intensified efforts in the First Nations and Inuit populations by FNIHB and the Nunavut Department of Health and Social Services will be especially important to meeting this goal.

Note. Abstracts are published in author's edition

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Last update: 06-Jul-2012 (11:52:05)