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First Nations and Inuit Health

Tuberculosis (TB)

Tuberculosis (TB) is an infectious disease caused by bacteria that are spread from person to person through the air. A person with active, infectious TB disease can propel the bacteria in the air by different means such as coughing, sneezing, singing, playing a wind instrument or to a lesser degree, talking.

TB can stay in the air for hours. If you breathe in the bacteria that cause TB, one of three things can happen: 1. Your immune system kills the bacteria you inhaled; 2. The bacteria remain alive but your immune system keeps them inactive in your body; 3. You can develop active TB disease.

When TB becomes active (i.e., the bacteria grow and multiply in your body), this is called active TB disease. If you have active TB disease, you will feel sick and you may spread the disease to other people.

Inactive TB is called latent TB infection (LTBI). You cannot spread TB to others when you have latent TB infection and you won't feel sick. Having latent TB infection means that you can develop active TB in the future if the inactive bacteria stored in your body become active. This can happen if your immune system is weakened by other diseases or medical conditions.

You can find more information on the diagnosis, treatment and prevention of TB at the Public Health Agency of Canada: "Next link will take you to another Web site Tuberculosis Prevention and Control FAQs (Frequently Asked Questions) about TB".

TB in Canadian Aboriginal Populations

The rate of TB in Canada is among the lowest in the world, with a steady decrease being seen over the past 30 years. Despite this low incidence for its overall population, certain populations in Canada, including Aboriginal populations, are disproportionately affected by TB. While a significant reduction in Aboriginal TB rates has been seen over the past 30 years, the rates remain much higher than those of the non-Aboriginal Canadian-born populations.

In particular, First Nation and Inuit populations in Canada face many health inequities that can place them at greater risk of being infected with TB, developing active TB disease and spreading it to others. For example, diabetes and HIV/AIDS are two health conditions that disproportionately affect First Nations and Inuit in Canada and are also known to weaken the immune system. If a person with a weakened immune system has inactive TB bacteria in their body, they are at increased risk of developing active TB disease. Other factors that can increase a person's risk of being infected with and developing active TB disease include living in overcrowded housing and having limited access to health care, such as often occurs in remote areas.

For additional information, please see Epidemiology of Tuberculosis in First Nations Living On-Reserve in Canada, 2000 - 2008.

The Government of Canada's Role in addressing TB in Aboriginal Populations

The Government of Canada is committed to supporting and working with communities, provincial and territorial health care systems, scientific experts and all TB partners to assist in the reduction of TB by developing scientific, evidence-based advice regarding TB prevention and control for Canada's Aboriginal populations. The Government of Canada also supports World TB Day, held each year on March 24th to mark the discovery of the cause of the disease. Tuberculosis is one of the world's deadliest diseases. In 2010, approximately 1.4 million deaths related to TB were reported worldwide.

As a key federal partner, the Public Health Agency of Canada (PHAC), in collaboration with experts from federal, provincial and territorial governments and organizations, coordinates and supports surveillance, guideline development and capacity building related to prevention and control of TB in Canada.

In Canada, provinces and territories have the legislated authority for TB prevention and control for their residents. Territories are solely responsible for TB prevention and control for their entire population. Health Canada, in partnership with the provinces, is responsible for assuring TB prevention and control services are either provided or accessible to First Nations living on reserve. In Nunatsiavut, Health Canada also provides funding to the Nunatsiavut Government to complement the provincial services provided to Nunatsiavut's citizens.

Health Canada's Strategy Against Tuberculosis for First Nations On-Reserve

To address the continuing high rates of TB in some First Nations communities, Health Canada has renewed its national Tuberculosis Strategy. The process of renewal began with a review of current evidence in TB prevention and control, best and promising practices and lessons learned. Through strong collaboration with partners and stakeholders, Health Canada's Strategy Against Tuberculosis for First Nations On-Reserve is meant to guide and support Health Canada regions and communities in enhancing their efforts to combat TB. It was developed to be used in conjunction with the Canadian TB Standards and aligns with the guidance document for TB prevention and control programs in Canada (a process currently being led by PHAC) as well as the World Health Organization's (WHO) Global Plan to Stop TB.

The Strategy's goal is to improve program delivery and performance measurement, as well as assure that standardized, culturally appropriate TB prevention and control services are available to First Nations on-reserve.

For additional information, please see Health Canada's Strategy Against Tuberculosis for First Nations On-Reserve.

Additional Resources