Despite being both preventable and curable, tuberculosis (TB) remains one of the top 10 causes of death worldwide and is the leading cause of death from a single infectious agent. In 2017, an estimated 10 million people developed TB disease globally, resulting in an estimated 1.6 million deaths, with 300 000 of those deaths occurring in people living with HIV.
TB is not just an international public health issue. Cases are diagnosed every day in Canada. In BC, there were 241 cases of active TB in 2016. In 2015, 745 clients were started on latent tuberculosis infection (LTBI) therapy to prevent dormant TB from progressing to the active, infectious state. Although active TB incidence has generally declined over the last 10 years, BC’s active TB incidence remains slightly higher than the national rate (5.1/100 000 population compared to 4.8/100 000). TB also disproportionately affects persons with comorbid medical conditions (e.g., chronic kidney disease, transplant) and other marginalized groups.
In an effort to reduce the incidence, morbidity, and mortality of TB in BC, the BC Strategic Plan for Tuberculosis Prevention, Treatment and Control was released in 2012. The 10-year plan was developed in partnership with a broad range of stakeholders including the BC Ministry of Health, health authorities, and community organizations. The plan contains five strategic goals, each supported by corresponding objectives and actions. Implementation of the Strategic Plan continues to be a collaborative effort supported by the BC TB Strategic Committee (TBSC) with broad representation from all regional health authorities, the First Nations Health Authority, PHSA, and the ministry.
In late 2017, midway through the current plan, members of the TBSC came together over 2 days to reprioritize and streamline the objectives noted in the 2012 plan. This face-to-face meeting helped to identify successes and challenges to date, highlight key areas of focus, identify gaps in the plan, and clarify responsibility and ownership for the refreshed priorities. Refreshed provincial TB priorities and key deliverables are summarized in the Table.
The refreshed TB Strategic Plan guides the provincial response to TB and signifies a solid commitment from involved stakeholders to ensure British Columbians are protected from TB and receive quality care should infection or disease occur. This plan also helps solidify the importance of TB prevention and treatment as a provincial health priority. On an international level, the refreshed plan is aligned with the World Health Organization’s goal of eliminating TB in low-incidence countries like Canada. The British Columbia Tuberculosis Strategic Plan 5-Year Refresh (2017–2021) can be found at www.bccdc.ca/resource-gallery/Documents/Statistics%20and%20Research/Publications/TB/BC%20TB%20Strat%20Plan%20Refresh%202017.pdf.
—Shaila Jiwa, RN, MScPPH
Senior Practice Leader, Clinical Prevention Services, BCCDC
—Victoria Cook, MD, FRCPC
Medical Head, Provincial TB Services, BCCDC
This article is the opinion of the BC Centre for Disease Control and has not been peer reviewed by the BCMJ Editorial Board.
1. World Health Organization. Global tuberculosis report, 2018. Accessed 13 February 2019. https://apps.who.int/iris/bitstream/handle/10665/274453/9789241565646-eng.pdf?ua=1.
2. BC Centre for Disease Control. Annual TB report, 2016. Accessed 13 February 2019. www.bccdc.ca/resource-gallery/Documents/Statistics%20and%20Research/Statistics%20and%20Reports/TB/TB_Annual_Report_2016.pdf.
3. BC Communicable Disease Policy Advisory Committee. BC strategic plan for tuberculosis prevention, treatment and control. Accessed 26 February 2019. www.bccdc.ca/resource-gallery/Documents/Statistics%20and%20Research/Publications/TB/BC_Strategic_Plan_Tuberculosis.pdf.
4. World Health Organization. Towards TB elimination: An action framework for low-incidence countries, 2014. Accessed 19 February 2019. https://apps.who.int/iris/bitstream/handle/10665/132231/9789241507707_eng.pdf;jsessionid=1575EF1019F0C5EE82EAC6AD26D86C0C?sequence=1.
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