Grant: Operating Grant

Tuberculosis (TB) remains a severe global public health threat, with over 9.4 million cases each year. TB is an important public health problem in Canada among immigrants and Aboriginal populations. Currently, Nunavut is facing the largest TB outbreak in the territory's 10 year history. One of the biggest challenges for TB control is early diagnosis. Many TB cases are detected late and this results in the spread of the infection in the community. Currently used TB tests are either inaccurate or not rapid enough. Better diagnostic options are urgently required, so that the spread of TB can be contained. Recently, the World Health Organization announced its endorsement of a novel molecular test for TB - the Xpert MTB/RIF test, a cartridge-based, completely automated test, which can accurately detect TB and drug resistance in less than 2 hours, and can be performed at the point-of-care (clinic) setting without laboratory expertise. We are proposing the first evaluation of Xpert MTB/RIF in Canada and one of the first studies to evaluate its impact at the point-of-care, to assess reduction in diagnostic and treatment delays, and cost-effectiveness. Our study will be conducted in Montreal, Quebec, and Iqaluit, Nunavut, and will generate data that will enable agencies such as the PHAC, Health Canada, and the Canadian TB Committee to develop evidence-based Canadian guidelines on this novel TB test.