The Determinants of TB Transmission in the Canadian-born Population of the Prairie Provinces

Sylvia Abonyi  - Co-Investigator

Background Facts about Tuberculosis

• Tuberculosis (TB), caused by Mycobacterium tuberculosis, persists as an international public health crisis with eight million new cases, and 1.9 million deaths occurring each year, despite a known cure and proven control strategies. 
• In Canada, TB disproportionately affects First Nations/Inuit and the foreign-born.  On the prairies, rates are 30 times higher in First Nations than the rest of the Canadian-born population and repeated outbreaks in reserve communities have put elimination efforts back decades.  HIV is increasing in Aboriginals and its synergy with TB will inevitable worsen the situation. 

This Project

The shortfall lies not in our knowledge of the disease or in the availability of the tools to fight it, but in our failure to grasp how deeply rooted social-cultural factors, economic disparity, political apathy, and artificial borders can compromise elimination strategies rolled out within local jurisdictions. This project proposes a detailed study of the determinants of TB transmission in the Canadian-born population of the Prairie Provinces with two main objectives:

• to investigate the stability of the host-pathogen relationship within global migrations patterns on the prairies; and
• to add depth to the retrospective data by conducting semi-structured interviews with all consenting Canadian-born adult TB cases diagnosed on the prairies over two years. 

These two objectives comprise a framework to address the complexity of TB transmission by going beyond individual-level risk factors to examining epidemiologic, socio-cultural, socio-economic, and environmental determinants at geographic and temporal scales.