Ontario Public Health Standards

Tuberculosis Prevention and Control

Goal

  • To prevent or reduce the burden of tuberculosis (TB).

Societal Outcomes

  • There is reduced transmission of TB.
  • There is reduced progression of latent TB infection (LTBI) to active TB.
  • There is reduced incidence of drug-resistant TB.
  • Community partners and health care providers have improved capacity to effectively manage TB.
  • There is improved public access to the diagnosis and treatment of TB.
  • The public is aware of TB and its prevention.

Board of Health Outcomes

  • The board of health achieves timely and effective detection and identification of TB trends, emerging risks, and associated risk factors.
  • The board of health is aware of and uses epidemiology to influence the development of healthy public policy and its programs and services to prevent and reduce the burden of TB.
  • The board of health has effective partnerships with committees, advisory bodies, networks, and community organizations to address the prevention and control of TB.
  • Public health risks associated with active TB are mitigated.
  • Individuals with infectious TB are isolated.
  • Individuals with active TB (cases) receive the appropriate medication.
  • Individuals with active TB or LTBI are identified.
  • Individuals with LTBI are offered appropriate treatment.

Assessment and Surveillance

Requirements

  1. The board of health shall report TB data elements in accordance with the Health Protection and Promotion Act and the Tuberculosis Prevention and Control Protocol, 2008 (or as current). [PDF]
  2. The board of health shall conduct surveillance of active tuberculosis as well as individuals with LTBI in accordance with the Population Health Assessment and Surveillance Protocol, 2008 (or as current) [PDF] and the Tuberculosis Prevention and Control Protocol, 2008 (or as current). [PDF]
  3. The board of health shall conduct epidemiological analysis of surveillance data, including monitoring of trends over time, emerging trends, and priority populations,31 in accordance with the Population Health Assessment and Surveillance Protocol, 2008 (or as current). [PDF]

Health Promotion and Policy Development

Requirement

  1. The board of health shall engage in health promotion and policy development activities with community partners, policy-makers, and health care providers that have clients/contacts from priority populations based on local epidemiology.

Disease Prevention/Health Protection

Requirements

  1. The board of health shall facilitate timely identification of active cases of TB and referrals of persons with inactive TB through immigration medical surveillance32 in accordance with the Tuberculosis Prevention and Control Protocol, 2008 (or as current). [PDF]
  2. The board of health shall provide management of cases to minimize the public health risk in accordance with the Tuberculosis Prevention and Control Protocol, 2008 (or as current). [PDF]
  3. The board of health shall provide or ensure access to TB medication at no cost to clients or providers.
  4. The board of health shall provide or ensure the provision of the identification, assessment, and public health management of contacts of active cases in accordance with the Tuberculosis Prevention and Control Protocol, 2008 (or as current). [PDF]
  5. The board of health shall provide or ensure the provision of the identification and effective public health management of individuals with LTBI in accordance with the Tuberculosis Prevention and Control Protocol, 2008 (or as current), [PDF] with a particular focus on people at highest risk of progression to active TB.33
  6. The board of health shall respond to local, provincial/territorial, federal, and international changes in disease epidemiology by adapting programs and services.

Resources

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31 For the purpose of this standard, priority populations may include but are not limited to those incarcerated in correctional facilities, Aboriginal peoples and First Nation communities, refugees, recent arrivals to Canada, homeless persons, and those who work closely with these groups.
32 Referrals through Citizenship and Immigration Canada include individuals referred to boards of health, post-landing, for medical follow-up to rule out active TB and to determine the need for treatment of LTBI.
33 People at highest risk of progression to active TB may include recent contacts, the immunocompromised, and recent arrivals to Canada.

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