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Pediatric Tuberculosis in Alberta

Epidemiology and Case Characteristics (1990–2004)

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Abstract

Background

Pediatric tuberculosis (TB) is important medically and indicative of a public health problem. An understanding of the epidemiology and case characteristics of pediatric TB, in a province that accepts large numbers of immigrants, can inform TB elimination strategy.

Methods

All cases of pediatric TB notified in Alberta between 1990 and 2004 were identified in the TB Registry. Individual diagnostic criteria were reviewed and case patients were related to a population grid derived from Statistics Canada censuses and population estimates of Status Indians from the Department of Indian and Northern Affairs, Canada. Incidence rates were determined by ethnic group and gender. Clinical/mycobacteriologic case characteristics were compared by ethnic group and birth country.

Results

Among 124 notified cases, 95 (96 episodes) met strict diagnostic criteria: 45 Status Indians, 30 Canadian-born ‘other’ and 21 foreign-born. Incidence rates were much higher in Status Indians and the foreign-born compared to the Canadian-born ‘other’; 10.7, 5.4, and 0.4 per 100,000 person-years, respectively. Among Canadian-born ‘other’ cases, 12 were Métis and 11 were Canadian-born children of foreign-born parents. Compared to foreign-born cases, Canadian-born cases were more likely to have a source case in Alberta, to be detected through contact tracing, to have primary pulmonary TB, and to have a rural address.

Conclusion

Pediatric TB in Alberta is mainly the result of ongoing transmission in Aboriginal peoples and immigration to Canada of persons with latent TB infection. The elimination of pediatric TB will require interruption of transmission in Aboriginal peoples and prevention of disease in immigrants.

Résumé

Contexte

Outre son importance sur le plan médical, la tuberculose infantile est l’indicateur d’un problème de santé publique. La connaissance de l’épidémiologie et des caractéristiques des cas de tuberculose infantile en Alberta, une province qui accueille des immigrants en grand nombre, pourrait étayer la stratégie d’élimination de la tuberculose.

Méthode

Nous avons relevé dans le registre de la tuberculose tous les cas de tuberculose infantile déclarés en Alberta entre 1990 et 2004. Les critères de diagnostic de chaque cas ont été examinés, et les cas déclarés ont été reportés sur une grille démographique dérivée des recensements de Statistique Canada et des estimations de la population des Indiens de plein droit du ministère fédéral des Affaires indiennes et du Nord. Des taux de fréquence ont été calculés par groupe ethnique et par sexe. Les aspects cliniques et mycobactériologiques de chaque cas ont été comparés selon le groupe ethnique et le pays d’origine.

Résultats

Sur les 124 cas déclarés, 95 cas (soit 96 accès de tuberculose) répondaient strictement aux critères de diagnostic: 45 Indiens de plein droit, 30 « autres » sujets nés au Canada et 21 sujets nés à l’étranger. Les taux de fréquence étaient beaucoup plus élevés chez les Indiens de plein droit et les sujets nés à l’étranger que chez les « autres » sujets nés au Canada (soit 10,7, 5,4 et 0,4 pour 100 000 personnes-année, respectivement). Chez les « autres » sujets nés au Canada, 12 étaient des Métis et 11 étaient des enfants nés au Canada de parents étrangers. Par rapport aux cas de tuberculose infantile chez les sujets nés à l’étranger, les cas répertoriés chez les sujets nés au Canada étaient plus susceptibles d’avoir un cas source situé en Alberta, d’avoir été détectés par recherche de contacts, de présenter une tuberculose pulmonaire primaire et d’avoir une adresse rurale.

Conclusion

La tuberculose infantile en Alberta résulte principalement de la transmission continue du virus dans la population autochtone et de l’immigration au Canada de personnes atteintes de tuberculose latente. L’élimination de la tuberculose infantile nécessite donc à la fois l’interruption de la transmission du virus chez les Autochtones et la prévention de l’évolution de la maladie chez les immigrants.

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Author information

Authors and Affiliations

  1. Department of Medicine and Radiology, University of Alberta, Edmonton, AB, Canada

    David Yip MD, MPH, Ravi Bhargava MD, Karen Sutherland MA &  Richard Long MD

  2. Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, Canada

    David Yip MD, MPH, Ravi Bhargava MD & Yin Yao PhD

  3. Disease Control and Prevention Branch, Alberta Health and Wellness, Canada

    Karen Sutherland MA &  Richard Long MD

  4. Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada

    Jure Manfreda MD, MSc

Authors
  1. David Yip MD, MPH
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  2. Ravi Bhargava MD
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  3. Yin Yao PhD
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  4. Karen Sutherland MA
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  5. Jure Manfreda MD, MSc
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  6. Richard Long MD
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Corresponding author

Correspondence to Richard Long MD.

Additional information

This work was prepared in partial fulfillment of a Masters degree in Public Health by Dr. David Yip. It was presented in poster format to the Canadian College of Family Physicians in Vancouver, December 8–10, 2005

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Yip, D., Bhargava, R., Yao, Y. et al. Pediatric Tuberculosis in Alberta. Can J Public Health 98, 276–280 (2007). https://doi.org/10.1007/BF03405402

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