TUBERCULOSIS: The BCG World Atlas: a world first in the fight against tuberculosis

March 27, 2011
McGill, RI MUHC researchers launch free online atlas of TB vaccination policies from around the world
Tuberculosis (TB) continues to pose a major global health threat. Someone in the world is newly infected with TB bacteria every second. Every year, more than 9 million people develop active TB and it claims about 2 million lives. In Canada, the overall incidence of TB has declined, but rates remain high among immigrants from endemic countries and among Aboriginal populations. Currently, Nunavut is facing the largest TB outbreak in the territory’s 10- year history.
In the days leading up to World TB Day 2011 on March 24, a team of researchers from McGill University and the Research Institute of the McGill University Health Centre (RI MUHC) is officially launching the BCG World Atlas: a first-of-its-kind, easy-to-use, searchable website that provides free detailed information on current and past TB vaccination policies and practices for more than 180 countries.
“The Atlas is designed to be a useful resource for clinicians, policymakers and researchers alike,” said co-author Dr. Madhukar Pai, who is an assistant professor at McGill’s Dept. of Epidemiology, Biostatistics & Occupational Health and a researcher in the Respiratory Epidemiology and Clinical Research Unit at the Montreal Chest Institute and the RI MUHC. “It has important implications on diagnosing and treating TB and on the research that’s being done on developing a new TB vaccine.”
Pai is a senior author on a paper about the BCG World Atlas that will be published in the March edition of the journal PLoS Medicine.
The Bacille Calmette-Guérin (BCG) vaccine was introduced in 1921 and continues to be the only vaccine used to prevent TB. Despite nearly a century of use, the vaccine remains controversial, with known variations in efficacy, strains, policies and practices across the world. Clinicians need to be aware of the various BCG policies in different parts of the world, as well as changes to those policies over time, especially when dealing with foreign-born adults who were vaccinated as children and who are unlikely to have retained their childhood vaccination records.
Ms. Alice Zwerling, BCG Atlas project leader and PhD candidate in epidemiology at McGill, explained that BCG vaccination can cause false positives in the skin test that’s routinely used to screen for latent TB. “As a clinician, if you’re trying to interpret the skin test in a foreign-born person, you’re going to want to know when the BCG vaccination was given back home and how many times it has been given. The Atlas provides this information and can help doctors decide on when to use the newly available blood tests for TB that are not affected by BCG vaccination,” she added.
“I am pleased that the Public Health Agency of Canada (PHAC) could play a part in such an important project,” said Dr. David Butler-Jones, Canada’s Chief Public Health Officer and the head of PHAC, which provided funding for this project. “The BCG World Atlas will be a vital resource for practitioners across Canada, one that will help us prevent and control the spread of TB here at home.”
The Atlas project began in 2007 with the compilation of detailed information on past and present BCG vaccination policies on as many countries as possible. The data were assembled through respondent-completed questionnaires, published papers, reports, government policy documents and data available from the World Health Organization Vaccine Preventable Diseases Monitoring System. The beta version of the site went live in 2008 and over the past year more than 6,000 visits have been recorded with a steady increase in traffic over time. The Atlas is constantly being updated and its authors welcome input from countries that are currently not covered.
http://www.mednewsafrica.com/2011/03/27/the-bcg-world-atlas-a-world-first-in-the-fight-against-tuberculosis/

 Davell Wilkins 01/14/2011

`A knock at the door' could mean that there is someone to help raising awareness about the risks and symptoms of tuberculosis for its early detection as under a program named as Taima TB funded by the feds with an amount worth $800,000 to combat TB, volunteers will reach to people's homes to diagnose and treat the disease.
Taima TB connotes Stop TB in Inuktitut and the project has been launched specifically for neigbourhoods that are more prone to the disease. The approaches like social media and Inuktitut speakers would be used to spread the word about TB and its consequences.
TB is widely prevalent in some Northern communities and the reasons could be homes with poor ventilation, poor nutritional diet and high smoking rates.
Dr. Isaac Sobol, Nunavut's Chief Public Health Officer called for the efforts of more public health staff to conduct TB testing and providing treatment. He added that the new initiative may not eliminate TB from the community, but would prove beneficial in educating people about the disease and the significance of its testing.
"By providing financial support to the Taima TB project, we are partnering with the people of Nunavut to combat this deadly but curable disease", said Health Minister Leona Aglukkaq.
http://topnews.us/content/232480-taima-tb-feds-funded-project-fight-tuberculosis

TUBERCULOSIS: Canada: First Nations: Feds' plan to tackle First Nations TB cases 'disappointing'

Jen Skerritt
October 18, 2010
A federal health committee previously urged Health Canada to move quickly to step up its fight against TB and be more accountable about how it tracks, treats and monitors TB cases.
Health Canada's plan to reduce disproportionately high rates of tuberculosis among First Nations falls short, according to critics who called the government response "superficial" and "disappointing."
Last week, Health Canada quietly released their response to a slew of recommendations to revamp Canada's TB strategy to eliminate a disease critics have called a "national embarrassment." Rates of TB infection among Canadian aboriginals are roughly 31 times higher than among non-aboriginals.
A federal health committee previously urged Health Canada to move quickly to step up its fight against TB and be more accountable about how it tracks, treats and monitors TB cases. In April, a panel of experts — including former Manitoba TB control director Dr. Earl Hershfield and University of Manitoba professor Dr. Pamela Orr — testified at a House of Commons committee that there are no national standards on monitoring and controlling TB and there are insufficient resources and medical staff to fight the disease on reserves.
While First Nations leaders and medical experts were optimistic the recommendations would lead to a concrete plan to tackle the scourge on reserves, they said the federal government response lacked substance and was short on specifics.
Health Canada's response, posted online last week, reiterated previous health, housing, and economic funding announcements and said the government will take the recommendations into consideration as it renews its national TB strategy. Health Canada said it is collaborating with TB experts, provinces, territories, and First Nation and Inuit partners on its renewed strategy, which "is expected to begin in 2011 using a phased-in approach."
Hershfield called the response "disappointing," and said there was no indication the federal government plans to address the root causes of TB.
"They are regurgitating old plans and I don't think there's anything in here that would encourage me that they're going to do anything," Hershfield said. "It's a superficial government report making sure that every T is crossed and I is dotted and using the right words without any substance."
Manitoba is a national hot spot of TB that experts say is a byproduct of overcrowded homes, malnutrition and poor health. The airborne disease is rampant in many northern Manitoba communities where cramped living quarters help it spread.
Manitoba Keewatinowi Okimakanak Grand Chief David Harper said he found it "disturbing" that Health Canada mentioned TB's connection with overcrowded, poor homes toward the end of their response, and did not make a solid commitment to solve the current housing crisis. Harper said infectious diseases such as TB and MRSA will continue to spread until the federal government improves the current situation.
"Bottom line is this is spreading rapidly and is still spreading today from one community to another," he said of TB.
http://www.vancouversun.com/health/Feds+plan+tackle+First+Nations+cases+disappointing+Critics/3687829/story.html#ixzz13Tagoscmhttp://www.vancouversun.com/health/Feds+plan+tackle+First+Nations+cases+disappointing+Critics/3687829/story.html