A combined strategy is needed to combat tuberculosis in Nunavut where the rate is 66 times higher than in the general Canadian population, states a commentary in CMAJ (Canadian Medical Association Journal).
Nunavut, Canada's eastern territory in the north, has seen a dramatic increase in the disease since 1997. Previous efforts to eradicate the disease focused on early identification and treatment of people as well as treatment of latent cases. This intense approach helped decrease the number of cases, but was not continued.
"Intensive control activities should be expanded throughout Nunavut, learning and adapting along the way," writes Dr. Pamela Orr, Department of Medical Microbiology and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba. She argues for a community approach combined with clear performance targets.
Door-to-door visits by local Inuit health care workers and education campaigns combine elements of successful public health care programs.
"Nunavut needs to reactivate the community health committees that became dormant and tap into the emerging health activism at the community and organizational levels," she writes.
"Tuberculosis is amenable to control through the application of science, as well as social and political will."