In this presentation, we described concerns related to global and national multidrug-resistant tuberculosis (MDR-TB) epidemiology. We also reviewed key steps in prevention, diagnosis, and treatment. Important challenges faced by Canadian public health systems in responding to MDR-TB and solutions to support people who affected were also discussed.
Date
June 13, 2023
Synopsis
Multidrug-Resistant TB (MDR-TB) is a potentially fatal and difficult to treat infectious disease. Incidence in Canada is low but may increase in coming years. Managing MDR-TB presents several challenges for public health systems and places an enormous burden on those affected and their families.
Objectives
- Provide a deeper understanding of why MDR-TB is a serious threat to public health in Canada.
- Provide information on key challenges for the Canadian response to MDR-TB.
- Increase awareness of solutions to reduce MDR-TB incidence in Canada and to support people affected and their families.
This webinar was conducted in English and included a Q&A session.
Moderator
Nancy Bedingfield, Project Manager
Speaker
Dr. Brett Edwards is a clinician and researcher in the Division of Infectious Diseases at the University of Calgary. He completed his subspecialty medicine training in Infectious Diseases before obtaining a Clinical and Research Fellowship in Mycobacterial Disease at the University of Toronto and West Park Health Care Centre. He obtained further clinical training in TB, including drug-resistant TB, at the Groote Schuur Hospital in Cape Town, South Africa, which sees some of the highest rates of MDR-TB worldwide. He currently works with Calgary TB Services, which works directly with Public Health in Alberta, in addition to Clinical Infectious Diseases, and the Nontuberculous Mycobacterial Program at the University of Calgary.
Resources
- Brode S, Dwillow R, Kunimoto D, Menzies D, Khan, F. Chapter 8: Drug-resistant tuberculosis Canadian Journal of respiratory, Critical Care, and Sleep Medicine 2022, Vol. 6, no. s1, 109–128 https://www.tandfonline.com/doi/epdf/10.1080/24745332.2022.2039499?needAccess=true&role=button
- Johnston J, Cooper R, Menzies D. Chapter 5: Treatment of tuberculosis disease Canadian Journal of respiratory, Critical Care, and Sleep Medicine 2022, Vol. 6, no. s1, 66–76 https://www.tandfonline.com/doi/epdf/10.1080/24745332.2022.2036504?needAccess=true&role=button
- Dunn JL, Larocque M, Van Dyk D, Vides, Khan FA, Wong T, Long R, Alvarez GG, Chapter 12: An introductory guide to tuberculosis care to improve cultural competence for health care workers and public health professionals serving Indigenous Peoples of Canada. Canadian Journal of respiratory, Critical Care, and Sleep Medicine 2022, Vol. 6, no. s1, 184–193 https://www.tandfonline.com/doi/epdf/10.1080/24745332.2022.2041328?needAccess=true&role=button
- Multidrug Resistant Tuberculosis: Disease Debrief (2022), National Collaborating Centre for Infectious Diseases https://nccid.ca/debrief/multidrug-resistant-tuberculosis/
- LaFreniere M, Dam D, Canadian Tuberculosis Laboratory Technical Network, Strudwick S, McDermott S. Tuberculosis drug resistance in Canada 2018 (2020) Canada Communicable Disease Report, 46(1) https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2020-46/issue-1-january-2-2020/article-2-tuberculosis-trend-canada-2008-2018.html
- Public Health Agency of Canada (2023). Tuberculosis in Canada: Infographic. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/tuberculosis-canada-2021-infographic.html
- Connors C, Nishi C, Sekirov S, Cook V, Johnston J. Novel six-month all oral treatment of pre-extensively drug-resistant tuberculosis in Canada: New treatment options present new implementation challenges (2023) Canada Communicable Disease Report, 49(1) https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2023-49/issue-1-january-2023/novel-six-month-oral-treatment-pre-extensively-drug-resistant-tuberculosis.html
- Hirama T, Sabur N, Derkach P, McNamee J, Song H, Marras T, Brode S. Risk factors for drug-resistant tuberculosis at a referral centre in Toronto, Ontario, Canada: 2010–2016 (2020) Canada Communicable Disease Report 46(4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7145431/
- Campbell JR, Nsengiyumva P, Chiang LY, Jamieson F, Khadawardi H, Mah HK, Oxlade O, Rasberry H, Rea E, Romanowski K, Sabur NF. Costs of Tuberculosis at 3 Treatment Centers, Canada, 2010–2016. Emerging Infectious Diseases. 2022 Sep;28(9):1814-23. https://stacks.cdc.gov/view/cdc/121035
- Taylor HA, Dowdy DW, Searle AR, Stennett AL, Dukhanin V, Zwerling AA, Merritt MW. Disadvantage and the experience of treatment for multidrug-resistant tuberculosis (MDR-TB). SSM-Qualitative Research in Health. 2022 Dec 1;2:100042. https://www.sciencedirect.com/science/article/pii/S266732152200004X?via%3Dihub
- World Health Organization (2019) WHO consolidated guidelines on drug-resistant tuberculosis treatment https://www.who.int/publications/i/item/9789241550529
- World Health Organization (2022) HO consolidated guidelines on tuberculosis. Module 4: treatment – drug-resistant tuberculosis treatment, 2022 update. https://www.who.int/publications/i/item/9789240063129