Determinants of tuberculosis trends in six Indigenous populations of the USA, Canada, and Greenland from 1960 to 2014: a population-based study

Dehghani, Kianoush; Lan, Zhiyi; Li, Peizhi; Michelsen, Sascha Wilk; Waites, Sean; Benedetti, Andrea; Lejeune, Pierre; Torrie, Jill; Robinson, Elizabeth; Vejvoda, Berenica; Mullah, Muhammad Abu Shadeque; Redwood, Diana; Cooper, Michael J.; Fanning, Anne; Yacoub, Wadieh; Alvarez, Gonzalo G.; Søborg, Bolette; Long, Richard; Menzies, Dick

doi:10.1016/s2468-2667(18)30002-1

Cited by 29 publications

(22 citation statements)

References 18 publications

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“…Other side effects that are less severe but affect completion include nausea, fatigue and headaches. Despite these limitations, the community‐wide implementation of diagnosis and treatment of LTBI using INH was recently reported to be associated with a 10% annual decline in TB morbidity in high‐risk indigenous populations in North America …”

Section: Treatment Of Ltbimentioning

confidence: 99%

“…Despite these limitations, the community-wide implementation of diagnosis and treatment of LTBI using INH was recently reported to be associated with a 10% annual decline in TB morbidity in high-risk indigenous populations in North America. 58 Shorter regimens using rifamycins are increasingly preferred because of better tolerability and higher treatment completion. Rifampicin-based regimens were first shown to be efficacious in persons with silicosis and HIV infection.…”

Section: Treatment Of Ltbimentioning

confidence: 99%

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Latent tuberculosis infection: Opportunities and challenges

et al. 2018

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Diagnosing and treating latent tuberculosis (TB) infection (LTBI) is recognized by the World Health Organization as an important strategy to accelerate the decline in global TB and achieve TB elimination. Even among low-TB burden countries that have achieved high rates of detection and successful treatment for active TB, a number of barriers have prevented implementing or expanding LTBI treatment programmes. Of those infected with TB, relatively few will develop active disease and the current diagnostic tests have a low predictive value. LTBI treatment using isoniazid (INH) has low completion rates due to the long duration of therapy and poor tolerability. Both patients and physicians often perceive the risk of toxicity to be greater than the risk of reactivation TB. As a result, LTBI treatment has had a limited or negligible role outside of countries with high resources and low burden of disease. New tools have emerged including the interferon-gamma release assays that more accurately diagnose LTBI, particularly in people vaccinated with Bacillus Calmette-Guerin (BCG). Shorter, better tolerated treatment using rifamycins are proving safe and effective alternatives to INH. While still imperfect, TB prevention using these new diagnostic and treatment tools appear cost effective in modelling studies in the United States and have the potential to improve TB prevention efforts globally. Continued research to understand the host-organism interactions within the spectrum of LTBI is needed to develop better tools. Until then, overcoming the barriers and optimizing our current tools is essential for progressing toward TB elimination.

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Section: Treatment Of Ltbimentioning

confidence: 99%

Section: Treatment Of Ltbimentioning

confidence: 99%

Latent tuberculosis infection: Opportunities and challenges

et al. 2018

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“…There are important variations in the distribution of these social determinants of health across southern and northern FN communities (31). Crowded houses, poverty, malnutrition, lack of access to responsive PHC services, stigma and lack of culturally appropriate practices are all important factors contributing to the higher rates of hospitalizations (35). Equitable and culturally appropriate healthcare services in all FN communities is only one, albeit important action, to reduce health disparities.…”

Section: Discussionmentioning

confidence: 99%

Is geographical isolation associated with poorer outcomes for Northern Manitoba First Nation communities?

Lavoie¹,

Philips-Beck²,

Kinew³

et al. 2019

Preprint

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Background: For First Nations, geographical isolation is often simultaneously presented as protective (less direct exposure racism, colonial encroachment on land, dispossession, and colonial imposition) and as a risk factor (lack of opportunities to participate in the formal economy, poorer access to services including healthcare). Our study sought to test the assumption that geographical isolation is associated with poorer population health outcomes among First Nations in Manitoba. Methods: We conducted a population-based retrospective time-trend analysis using administrative data housed at the Manitoba Centre for Health Policy. The study included all Manitoba residents eligible under the Manitoba Health Services Plan (1984-2014). We measured premature mortality rates (PMR), and trends in hospitalization rates and length of stay (LOS) for Ambulatory Care Sensitive Conditions (ACSC) in northern and southern First Nations (FN) communities in Manitoba.Results: The PMR was significantly higher in northern FN compared to southern FN. Hospitalization rates for mental health-related conditions were significantly higher in the northern First Nation communities compared to all Manitoba, and rising (southern, change=1.52%, P=0.015; northern, change=5.49%, P<0.0001), and significantly higher in northern compared to southern FN communities. The LOS for all ACSC increased significantly for all Manitoba (change=0.63%, P=0.0011) but not for FN communities. The LOS for mental health-related conditions increased only for the southern FN communities (% change=1.67, P=0.0032). Conclusions: Our results show higher PMR in northern communities, declining slower than for any other Manitoba communities. Our results also show lower hospitalization rate for ACSC in the north, suggesting barriers to prevention and early diagnosis. There remains a large gap in ACSC hospitalization rates between FN and all Manitobans. Further research is warranted to understand the relationship between the changes in the rates of ACSC and the difference in the rates between northern and southern communities.

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“…The social determinants of health are the circumstances in which people are born, grow, live, work and grow old, as well as inequities in power and resources, and these are central to health inequities for Indigenous peoples 4. Social processes are underpinned by history, culture and government policy,5 all of which have a profound influence on TB incidence 6–11. Indigenous-specific social inequities contribute to TB and impede the human rights of Indigenous peoples to be free from TB 12.…”

Section: Introductionmentioning

confidence: 99%

The missing voices of Indigenous Australians in the social, cultural and historical experiences of tuberculosis: a systematic and integrative review

et al. 2019

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IntroductionDisparities in tuberculosis (TB) rates exist between Indigenous and non-Indigenous populations in many countries, including Australia. The social determinants of health are central to health inequities including disparities in TB rates. There are limitations in the dominant biomedical and epidemiological approaches to representing, understanding and addressing the unequal burden of TB for Indigenous peoples represented in the literature. This paper applies a social determinants of health approach and examines the structural, programmatic and historical causes of inequities for TB in Indigenous Australia.MethodsAboriginal Australians’ families in northern New South Wales who are affected by TB initiated this investigation. A systematic search of published literature was conducted using PubMed, PsycINFO, Scopus and Informit ATSIhealth databases, the Australian Indigenous Health, InfoNet and Google. Ninety-five records published between 1885 and 2019 were categorised and graphed over time, inductively coded and thematically analysed.ResultsIndigenous Australians’ voices are scarce in the TB literature and absent in the development of TB policies and programmes. Epidemiological reports are descriptive and technical and avoid analysis of social processes involved in the perpetuation of TB. For Indigenous Australians, TB is more than a biomedical diagnosis and treatment; it is a consequence of European invasion and a contributor to dispossession and the ongoing fight for justice. The introduction and spread of TB has resulted in the stealing of lives, family, community and cultures for Indigenous Australians. Racist policies and practices predominate in the experiences of individuals and families as consequences of, and resulting in, ongoing structural and systematic exclusion.ConclusionDevelopment of TB policies and programmes requires reconfiguration. Space must be given for Indigenous Australians to lead, be partners and to have ownership of decisions about how to eliminate TB. Shared knowledge between Indigenous Australians, policy makers and service managers of the social practices and structures that generate TB disparity for Indigenous Australians is essential.A social determinant of health approach will shift the focus to the social structures that cause TB. Collaboration with Indigenous partners in research is critical, and use of methods that amplify Indigenous peoples' voices and reconfigure power relations in favour of Indigenous Australians in the process is required.

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Determinants of tuberculosis trends in six Indigenous populations of the USA, Canada, and Greenland from 1960 to 2014: a population-based study

Abstract: Public Health Department of the Cree Board of Health and Social Services of James Bay.

Cited by 29 publications

References 18 publications

Latent tuberculosis infection: Opportunities and challenges

Latent tuberculosis infection: Opportunities and challenges

Is geographical isolation associated with poorer outcomes for Northern Manitoba First Nation communities?

The missing voices of Indigenous Australians in the social, cultural and historical experiences of tuberculosis: a systematic and integrative review

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