Vachon J, Gallant V, Siu W
Centre for Communicable Disease and Infection Control, Public Health Agency of Canada, Ottawa, ON.
Can Commun Dis Rep. 2018 Mar 1;44(3-4):75-81. doi: 10.14745/ccdr.v44i34a01.
Tuberculosis (TB) is a major global health problem that affected an estimated 10.4 million people worldwide in 2016. The Public Health Agency of Canada (PHAC) monitors active TB disease through a national surveillance system, which is a collaborative effort withthe provinces and territories.
This article presents an epidemiological summary of the active TB disease cases reported from 2006 to 2016, with a focus on 2016. Treatment outcomes for cases diagnosed in 2015 are also presented.
The Canadian Tuberculosis Reporting System (CTBRS) is a case-based surveillance system that maintains non-nominal data on people diagnosed with active TB disease in Canada. Data are collected annually from the provinces and territories, analyzed by PHAC and validated by each province and territory.
The number of active TB disease cases increased from 1,642 in 2015 to 1,737 in 2016, corresponding to an increase in incidence rate from 4.6 to 4.8 per 100,000 population. Foreign born individuals continued to make up the majority of cases reported (70%) and the incidence rate remained highest among Canadian born Indigenous people (23.5 per 100,000 population) and was particularly high within the Inuit population (170.1 per 100,000 population). Over the past decade, there was a slight decrease in the number of cases among children and the proportion of re-treatment cases declined from 8.3% of cases in 2006 to 5.4% of cases in 2016.
Although tuberculosis incidence rates in Canada are low in the global context and have been relatively stable over the last decade, there has been a slight increase in rates over the last three years, especially in the foreign born population which accounts for the majority of cases. The decrease in cases among children suggests less active transmission and the low proportion of re-treatment cases suggests effective treatment and adherence.
结核病是一个重大的全球健康问题,2016年全球估计有1040万人受到影响。加拿大公共卫生局(PHAC)通过一个国家监测系统监测活动性结核病,该系统是与各省和地区合作开展的。
本文介绍了2006年至2016年报告的活动性结核病病例的流行病学总结,重点是2016年。还介绍了2015年诊断病例的治疗结果。
加拿大结核病报告系统(CTBRS)是一个基于病例的监测系统,保存有关加拿大诊断为活动性结核病患者的非名义数据。每年从各省和地区收集数据,由PHAC进行分析,并由每个省和地区进行验证。
活动性结核病病例数从2015年的1642例增加到2016年的1737例,发病率从每10万人4.6例增加到4.8例。出生在国外的人继续占报告病例的大多数(70%),加拿大出生的原住民发病率仍然最高(每10万人23.5例),在因纽特人群中尤其高(每10万人170.1例)。在过去十年中,儿童病例数略有下降,复治病例比例从2006年的8.3%下降到2016年的5.4%。
尽管在全球范围内加拿大的结核病发病率较低,且在过去十年中相对稳定,但在过去三年中发病率略有上升,尤其是在占大多数病例的出生在国外的人群中。儿童病例数的减少表明传播活动减少,而复治病例比例低表明治疗有效且依从性好。