Grant: Project Grant

The incidence rate of TB among Canadian Inuit is 400x that of non-Indigenous Canadians. The federal government has set a goal of eliminating TB across the Inuit homeland by 2030. Historically, community wide screening to prevent TB has significantly reduced TB incidence among Canadian Inuit however it is labour intensive and could take decades to complete. The aim of the study is to identify residential zones consisting of one or more households that are at high-risk of developing active TB disease in order to concentrate efforts in community wide screening and treatment using an Inuit specific prediction score that goes beyond traditional biological risk factors that often do not apply to Inuit living in this remote region of Canada in a reproducible, evidence based approach that can be applied by local health care practitioners. The proposed study will derive and validate the TAIMA (means stop in Inuktut) TB risk score which aims to predict the risk of developing active TB disease among Inuit households in Nunavut. The variables used in the score will include detailed variables on social determinants of health (SDH) and geospatial information specific to Inuit households in Nunavut. The score will be developed using classical statistical methods and artificial intelligence (computer learning). The goal of the TAIMA TB household risk score will be to provide health care teams the ability to prioritize households most at risk of developing TB prior to doing a community wide screen which will transform the approach to a community wide focused screen. As a result, the number of households that require screening could be significantly reduced thus allowing for the program to concentrate efforts on the most vulnerable households. The approach would allow for screening many communities in a much shorter amount of time moving us closer to the goal of TB elimination among Inuit.