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Evaluation of TB elimination strategies in Canadian Inuit populations: Nunavut as a case study
Tuberculosis (TB) continues to disproportionately affect Inuit populations in Canada with some communities having over 300 times higher rate of active TB than Canadian-born, non-Indigenous people. Inuit Tuberculosis Elimination Framework has set the goal of reducing active TB incidence by at least 5...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
KeAi Publishing
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9583452/ https://www.ncbi.nlm.nih.gov/pubmed/36313153 http://dx.doi.org/10.1016/j.idm.2022.07.005 |
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author | Abdollahi, Elaheh Keynan, Yoav Foucault, Patrick Brophy, Jason Sheffield, Holden Moghadas, Seyed M. |
author_facet | Abdollahi, Elaheh Keynan, Yoav Foucault, Patrick Brophy, Jason Sheffield, Holden Moghadas, Seyed M. |
author_sort | Abdollahi, Elaheh |
collection | PubMed |
description | Tuberculosis (TB) continues to disproportionately affect Inuit populations in Canada with some communities having over 300 times higher rate of active TB than Canadian-born, non-Indigenous people. Inuit Tuberculosis Elimination Framework has set the goal of reducing active TB incidence by at least 50% by 2025, aiming to eliminate it by 2030. Whether these goals are achievable with available resources and treatment regimens currently in practice has not been evaluated. We developed an agent-based model of TB transmission to evaluate timelines and milestones attainable in Nunavut, Canada by including case findings, contact-tracing and testing, treatment of latent TB infection (LTBI), and the government investment on housing infrastructure to reduce the average household size. The model was calibrated to ten years of TB incidence data, and simulated for 20 years to project program outcomes. We found that, under a range of plausible scenarios with tracing and testing of 25%–100% of frequent contacts of detected active cases, the goal of 50% reduction in annual incidence by 2025 is not achievable. If active TB cases are identified rapidly within one week of becoming symptomatic, then the annual incidence would reduce below 100 per 100,000 population, with 50% reduction being met between 2025 and 2030. Eliminating TB from Inuit populations would require high rates of contact-tracing and would extend beyond 2030. The findings indicate that time-to-identification of active TB is a critical factor determining program effectiveness, suggesting that investment in resources for rapid case detection is fundamental to controlling TB. |
format | Online Article Text |
id | pubmed-9583452 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | KeAi Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-95834522022-10-27 Evaluation of TB elimination strategies in Canadian Inuit populations: Nunavut as a case study Abdollahi, Elaheh Keynan, Yoav Foucault, Patrick Brophy, Jason Sheffield, Holden Moghadas, Seyed M. Infect Dis Model Article Tuberculosis (TB) continues to disproportionately affect Inuit populations in Canada with some communities having over 300 times higher rate of active TB than Canadian-born, non-Indigenous people. Inuit Tuberculosis Elimination Framework has set the goal of reducing active TB incidence by at least 50% by 2025, aiming to eliminate it by 2030. Whether these goals are achievable with available resources and treatment regimens currently in practice has not been evaluated. We developed an agent-based model of TB transmission to evaluate timelines and milestones attainable in Nunavut, Canada by including case findings, contact-tracing and testing, treatment of latent TB infection (LTBI), and the government investment on housing infrastructure to reduce the average household size. The model was calibrated to ten years of TB incidence data, and simulated for 20 years to project program outcomes. We found that, under a range of plausible scenarios with tracing and testing of 25%–100% of frequent contacts of detected active cases, the goal of 50% reduction in annual incidence by 2025 is not achievable. If active TB cases are identified rapidly within one week of becoming symptomatic, then the annual incidence would reduce below 100 per 100,000 population, with 50% reduction being met between 2025 and 2030. Eliminating TB from Inuit populations would require high rates of contact-tracing and would extend beyond 2030. The findings indicate that time-to-identification of active TB is a critical factor determining program effectiveness, suggesting that investment in resources for rapid case detection is fundamental to controlling TB. KeAi Publishing 2022-09-05 /pmc/articles/PMC9583452/ /pubmed/36313153 http://dx.doi.org/10.1016/j.idm.2022.07.005 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Abdollahi, Elaheh Keynan, Yoav Foucault, Patrick Brophy, Jason Sheffield, Holden Moghadas, Seyed M. Evaluation of TB elimination strategies in Canadian Inuit populations: Nunavut as a case study |
title | Evaluation of TB elimination strategies in Canadian Inuit populations: Nunavut as a case study |
title_full | Evaluation of TB elimination strategies in Canadian Inuit populations: Nunavut as a case study |
title_fullStr | Evaluation of TB elimination strategies in Canadian Inuit populations: Nunavut as a case study |
title_full_unstemmed | Evaluation of TB elimination strategies in Canadian Inuit populations: Nunavut as a case study |
title_short | Evaluation of TB elimination strategies in Canadian Inuit populations: Nunavut as a case study |
title_sort | evaluation of tb elimination strategies in canadian inuit populations: nunavut as a case study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9583452/ https://www.ncbi.nlm.nih.gov/pubmed/36313153 http://dx.doi.org/10.1016/j.idm.2022.07.005 |
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