Grant: Project Grant

Tuberculosis (TB) is the world's leading infectious disease killer. This disease affects over 10 million people each year and causes 1.8 million deaths. The World Health Organization has made TB elimination a priority and is calling for new programs that prevent and treat TB. Unfortunately, progress towards TB elimination in Canada has stalled in recent years and our national TB elimination efforts are far from complete. This is in part due to persistently high rates of TB in Canada's growing foreign-born population. To accelerate TB elimination efforts in Canada, new strategies for TB prevention in migrant populations are needed. The most promising approach to TB prevention is to detect latent (asymptomatic) TB and treat it before the disease develops and spreads. This approach is potentially effective but is extremely resource intensive, so broad latent TB screening and treatment of the 6.8 million foreign-born residents of Canada is impractical. Instead, we need to create a screening strategy that balances the public health benefits of TB prevention with the system resources required for such a program. Using health databases from BC, Ontario, and Quebec--the three largest migrant-receiving provinces, we aim to develop evidence that will help guide TB screening and preventative therapy in the foreign-born population of Canada. First, we plan to develop a TB risk calculator that quantifies an individual's risk of active TB. We then plan to examine the impact of screening in different populations, including understanding the most cost-effective screening approaches. This research directly addresses the three key themes highlighted by the federal government's plan to enhance Canadian TB elimination. Our findings will generate valuable to inform public health policies and screening programs aimed at tackling TB.