TB: Rising to the Challenges

Transcription

1 TB: Rising to the Challenges The Ontario Lung Association is pleased to welcome you to the 204 Tuberculosis Conference. November 7-9, 204 Eaton Chelsea Toronto Hotel Toronto, Ontario Final Conference Program

2 Tribute to Dr. Jae Yang Dr. Jae Won Yang Dr. Jae Won Yang was a renowned Respirologist who dedicated his career towards tuberculosis care. Dr. Yang graduated from the University of Toronto s medical school in 99, and completed his Respirology training in 996 in Toronto. As the Medical Director of St. Michael s Hospital s TB Program since its inception in 999, Dr. Yang provided the clinical, political, and administrative support which helped shape current TB practices and management in Toronto and its surrounding area. He demonstrated outstanding dedication towards caring for marginalized populations. He was recognized for his compassion in 200 by receiving the American College of Chest Physicians Governor s Community Service Award. Throughout his career, he was a strong advocate of Public Health and the Ontario Lung Association as he believed in the collective commitment towards TB control. Dr. Yang was a gifted clinician and teacher. He was the recipient of numerous teaching awards. He became St. Michael s Respirology s Training Site Director in 999, and then the Education Director for the University of Toronto s Respirology Program in He enthusiastically piloted initiatives aimed at developing Respirology trainees including thoracic imaging rounds, bronchoscopy courses, and a TB elective rotation. The Jae Yang Memorial Award for Excellence in Teaching was established in 203 by the University of Toronto s Division of Respirology in recognition of his mentorship abilities. Dr. Yang is greatly missed. He is remembered as a distinguished physician by his patients, and colleagues alike. Our condolences remain with Dr. Yang s family: his wife, Dr. Margaret Srebrnjak; their children, Matthew, Adam, and Hanna; his parents, Ms. Hae Sook and the late Mr. U Taek Yang. 204 Tuberculosis Conference

3 Welcome to TB: Rising to the Challenges There are many challenges when dealing with TB. The stigma of the diagnosis is still present for many persons in Ontario who have been diagnosed with TB. Some delay seeking medical attention despite symptoms becoming worse. Often TB is misdiagnosed as pneumonia or cancer, further delaying the start of effective treatment. Despite publicly-funded medications and comprehensive case management by health care providers and public health, challenges still exist. This year s conference focuses on Rising to the Challenges : TB continues to challenge us all and we hope this conference highlights some of the initiatives that can help us all meet these challenges. The purpose of this conference is to bring together health care providers to discuss and exchange current information and ideas on tuberculosis. By providing a diverse range of educational sessions of interest to health care professionals from many disciplines and health care settings, our goal is to increase knowledge of global issues, current trends, best practices and new recommendations for the prevention, diagnosis, management and control of tuberculosis. Through our conference, we wish to provide opportunities to learn, discuss and share information in both professional and social atmospheres. Our hope is that together we can affirm the approaches that are effective and successful, as well as generate new methods to meet the ongoing challenges of tuberculosis prevention and treatment. Joy Marshall, MN and Shelley Walkerley, NP-PHC PhD Co-Chairs, Ontario Lung Association TB Committee 204 Tuberculosis Conference 2

4 Conference Goal To provide advanced information to health care providers on the complexity of tuberculosis management. Conference Objectives To identify current TB management strategies in the context of emerging issues and co-morbidities; To heighten awareness of the challenges of preventing and managing TB; To highlight innovations in TB diagnosis and care. Conference Planning Committee TB: Rising to the Challenges is an initiative of the Ontario Lung Association Tuberculosis Committee. Co-chairs: Ms. Joy Marshall, York Region Health Services Ms. Shelley Walkerley, York University & Stonegate Community Health Centre Members: Mr. Obed Adore, Centre for Addiction and Mental Health Ms. Tiffany Bateman, Public Health Ontario Ms. Clare Burnell, Toronto Public Health Ms. Sondra Davis, Peel Public Health Ms. Darlene Fawcett, Ontario Shores Centre for Mental Health Sciences Mr. Ray Lam, The Hospital for Sick Children Ms. Leslie LeGresley, West Park Healthcare Centre Ms. Mabel Lim, Regional Infection Control Network Dr. Meb Rashid, University of Toronto Ms. Tara Raine, St. Michael s Hospital Dr. Elizabeth Rea, Toronto Public Health Ms. Helen Twigg, Simcoe Muskoka District Health Unit Staff: Ms. Sheila Gordon-Dillane, Ontario Respiratory Care Society, Ontario Lung Association Conference Management: Ms. Janet Victor, Ms. Gale Gingrich, Ms. Michelle Wilson, Eventives Conference & Event Management Accreditation This program has been accredited by the College of Family Physicians of Canada and the Ontario Chapter for up to.5 Mainpro-M credits Tuberculosis Conference

5 Conference Program Please note: All conference plenary sessions are in the Churchill Ballroom Monday, November 7, 204 Optional Pre-Conference Concurrent Sessions 2:00-4:00 I TB 0 - Joy Marshall and Martina Cuillerier, York Region Health Services or II The Good, The Lab and The Ugly Optimizing the Laboratory Diagnosis of Tuberculosis - Dr. Fran Jamieson and Kevin May, Public Health Ontario Tuesday, November 8, 204 Wednesday, November 9, 204 7:45 Continental Breakfast/Exhibits Churchill Court 8:45 Welcome/Opening Remarks Churchill Ballroom Mr. George Habib, Ontario Lung Association 9:00 The Legacy of TB in Canada s Residential Schools The Importance of Looking Back Dr. Paul Hackett, University of Saskatchewan 9:45 TB in a Colorado High School Carolyn Bargman, Boulder County Public Health 0:45 Break/Exhibits/Posters Churchill Court :0 Peel Public Health Conducts its Largest Tuberculosis School Contact Investigation Ha Nguyen, Peel Public Health :45 Panel Discussion 2:00 Presentation of the Ontario Lung Association Meritorious Service Award to Joy Marshall Mr. George Habib, Ontario Lung Association 2:05 Lunch/Exhibits/Posters Churchill Court/Ballroom *please ensure you are in your concurrent session room before :5 pm :5 Concurrent Sessions CS I: Building Relationships with First Nations People in Ontario: The Effect on Tuberculosis Control in Ontario Kim Daly and Dr. Caroline Kennedy, Health Canada CS II: Using Genotyping Fingerprinting in TB Contact Investigations Dr. Elizabeth Rea, Toronto Public Health Carlyle Room Churchill Ballroom 8:00 Continental Breakfast/Posters Churchill Court 8:45 Welcome to Day 2 Churchill Ballroom 9:00 Fluoroquinolones as a First Line Drug in TB Treatment: New Hope or New Problems?: A Debate Dr. Jane Batt, St. Michael s Hospital Pro position Dr. Kamran Khan, St. Michael s Hospital Con position 9:45 Tuberculosis The Forgotten (Re-emerging?) Zoonosis Dr. Catherine Filejski, Ontario Ministry of Health and Long-Term Care 0:30 Break/Posters Churchill Court 0:50 Management of Non-adherent Cases Dr. Elizabeth Rea, Toronto Public Health Leslie LeGresley, West Park Healthcare Centre Tina Proctor, Toronto Public Health 2:30 Lunch/Posters Churchill Court/Ballroom :20 Over-consumption: TB and Diabetes Dr. Richard Brostrom, CDR United States Public Health Service 2:0 Adolescent Patients: The Challenges of TB Diagnosis and Treatment Dr. Ian Kitai and Ray Lam, The Hospital for Sick Children 3:00 Break/Posters Churchill Court 3:20 The Dr. Jae Yang Lecture Interpreting the Black & White: A Review of the Radiographic Findings of TB Dr. Ambrose Lau, University Health Network and St. Michael s Hospital 4:0 Closing Remarks CS III:Ventilation: More than Open Windows! Adrian Sebastian, Toronto Public Health CS IV: Protecting Corporate Reputation and Combating Negativity Brady Wood, Niagara Health System Scott Room Seymour Room 2:5 Break/Exhibits/Posters Churchill Court 2:40 Latent Tuberculosis: Perspectives from Churchill Ballroom the Bench and Beyond Dr. Howard Song, West Park Healthcare Centre and University of Toronto 3:30 Meeting the Challenge: Managing the Practical Aspects of TB Infection in an Acute Care Hospital Dr. Matthew Muller, St. Michael s Hospital 4:5 Wrap-Up of Day 204 Tuberculosis Conference 4

6 Speaker Biographies Jane Batt Dr. Jane Batt is a Clinician Scientist, and the Medical Director of the TB Program at St. Michael s Hospital. She graduated from McMaster University medical school in 99, and Internal Medicine and Respirology at the University of Toronto in 997. She completed her PhD at the Institute of Medical Sciences at the University of Toronto in 2002, and is also cross-appointed as an Assistant Professor to the Faculty of Medicine. Her current research focuses on skeletal muscle atrophy and dysfunction in end-stage respiratory disease and critical illness. Carolyn Bargman Carolyn Bargman has had a joint position working for the Denver Metro TB Clinic and Boulder County Public Health as a TB nurse case-manager, consultant and educator for community providers for the past 5 years. Carolyn earned her BSN from the University of Texas in San Antonio and she has an MA in Health Communication from the University of Maryland. Prior to working for the TB program, she worked for many years in community and public health in Boulder, CO and Seattle, WA. She spent four years in Ecuador as a volunteer, a trainer and as a staff nurse with the Peace Corps and was also a Fulbright scholar. Richard Brostrom Dr. Brostrom is a US CDC TB Medical Officer for the Pacific Region, currently placed as Chief of the Hawaii TB Program. Additional duties include clinical supervision for TB Control in the 6 US Pacific Jurisdictions. Prior to this post, he worked as a Family Practitioner caring for many thousands of Pacific Islanders with diabetes. He served for 0 years as the Medical Director of Public Health for the Commonwealth of the Northern Marianas Islands, where he restructured the Diabetes program and led improvements to care for the Department of Health. He also assumed duties as the primary clinician for the many tuberculosis and leprosy patients for the islands, which led to Regional opportunities for the Western Pacific. He was the Team Lead for a WHO evaluation of the Fiji TB Program in 2008, and led a CDC-WHO team evaluating the Marshall Islands TB Control Program in Also in 2009, he led a US Department of State evaluation of TB Screening for Bhutanese Refugees in Nepal. He received a National Service Award for work with drug-resistant TB cases in Micronesia in 200. He is the primary author of novel TB-DM standards for the Pacific and has worked to integrate TB and DM programs since The work is challenging and unpredictable. This past summer, he led a US Navy team providing integrated NCD screening for hypertension, diabetes, tuberculosis, and leprosy in Marshall Islands communities. More recently, he worked with CDC to install and train staff for 7 new GeneXpert machines across the Pacific, and led a response to an outbreak of TB at a small college in Micronesia. And yes, Dr. Brostrom does understand and appreciate how fortunate he is to be working to reduce suffering from tuberculosis in a region with amazing natural beauty, and very, very high needs! Kim Daly Kim Daly has been working for the First Nations and Inuit Health Branch since During her time with FNIHB she has been able to assist with the development of Health Canada s Strategy against Tuberculosis for First Nations On-Reserve. She has most recently been active with the evaluation of the use of BCG in Northern Ontario. She obtained her BN from the University of New Brunswick and her Masters from Athabasca University. Kim is a proud military wife and curling mom. You can always bend her ear about curling as all three of her children are avid curlers and she spends most of her free time knitting nervously while watching the games. Catherine Filejski Dr. Filejski s professional and academic background includes expertise in international relations, public policy, public health and veterinary medicine. With graduate degrees from the College of Europe in Bruges, Belgium, as well as the University of Toronto, she specialized in European Union enlargement negotiation issues prior to obtaining her veterinary medical training and Doctor of Veterinary Medicine degree from the Ontario Veterinary College at the University of Guelph. Dr. Filejski joined the Public Health Division of the Ministry in 2008, where she provides veterinary public health advice and expertise on zoonotic disease issues to the Chief Medical Officer of Health, as well as local public health units across the province. Paul Hackett Paul Hackett is an assistant professor in the Department of Geography and Planning at the University of Saskatchewan, and is a faculty researcher with the Saskatchewan Population Health and Evaluation Research Unit ( His work examines the interplay between geography, culture and history in the emergence of Aboriginal disease in Canada. As a graduate student he studied the diffusion of epidemics in eastern Manitoba and northwestern Ontario during the fur trade era. His current primary research projects examine the emergence of tuberculosis and type 2 diabetes among the First Nations of western Canada, and he is part of a team examining the Determinants of Tuberculosis Transmission in the west Tuberculosis Conference

7 Christine Kennedy Christine Kennedy is currently the Regional Community Medicine Specialist for Ontario Region FNIHB. She practices both Public Health Medicine and Family Medicine and has a research background in Health Economics. She came to Ontario Region from Alberta Region FNIHB in May 204. Kamran Khan Dr. Khan is a clinician-scientist with the Division of Infectious Diseases at St. Michael s Hospital and an Associate Professor of Medicine at the University of Toronto. His research focuses on the relationship between human migration and travel and the globalization of infectious diseases. Dr. Khan has a particular interest in the screening of new immigrants and refugees for tuberculosis at the time of immigration. Ian Kitai Dr. Ian Kitai trained in medicine in South Africa, and in Paediatrics and Infectious Diseases in the UK and Toronto. He worked in rural Zimbabwe for 3 years for the aid organization Oxfam and later at the medical school there. Since 999 he has been the Tuberculosis specialist at Sickkids, has worked in infection control at Rouge Valley Health System, and has a consulting practice in pediatrics and infectious diseases in Ajax, Ontario. He is the principal author of the pediatric chapter of the Canadian TB Standards and of several publications related to paediatric TB in Canada. He is an Associate Professor in the Department of Pediatrics at the University of Toronto. Ray Lam Ray Lam is an Adjunct Lecturer, Facilitator & Faculty Advisor for the Universities of Toronto, Ryerson & McMaster schools in Ontario, Canada and is a certified Primary Health Care Family Practitioner with a specialty in Pediatric TB. He is also the Lead for the Family Travel Medicine Clinic at SickKids Hospital. He completed his Honours BSc in Pre-Optometry/Pre-Med from the University of Waterloo, Honours BScN from Lakehead University, and his PHC-NP & Masters in Nursing Certificates from Athabasca University, Calgary Alberta. He has been nursing for almost 2-3 years to date. Ambrose Lau Dr. Ambrose Lau completed medical school at the University of Western Ontario in He completed his Internal Medicine training through the University of British Columbia in 2008, and a Respirology Fellowship at the University of Toronto in 200. He recently completed a Master of Education degree through the University of Toronto: Ontario Institute for Studies in Education. He is a staff physician at St. Michael s Hospital, Toronto Western Hospital and also practices General Respirology in the community in the north end of the city. Dr. Lau was a pioneer in the development of a dedicated TB Elective for Respirology Fellows at the University of Toronto. His interests strongly focus on teaching, occupational lung disease, tuberculosis, and interstitial lung disease. Leslie LeGresley Leslie is a native Torontonian, who after obtaining a Bachelor of Arts from the University of Toronto went on to train as a Respiratory Therapist and later obtained a Master of Business Admin from the Schulich School of Business. Currently Leslie is the manager of the Tuberculosis and Functional Enhancement Services where she has held a variety of positions over her 23 plus years at West Park Healthcare Centre. Matthew Muller Matthew P. Muller completed his medical degree, residency in internal medicine and specialization in infectious diseases at the University of Toronto. He then completed a PhD in clinical epidemiology studying the epidemiology and clinical features of SARS. Currently, he is the Medical Director of Infection Prevention and Control at St. Michael s Hospital and an Assistant Professor of Medicine in the Division of Infectious Diseases, Department of Medicine, University of Toronto. He is a member of the Public Health Agency of Canada Expert Working Group on infection control and chairs the Provincial Infectious Diseases Advisory Committee (PIDAC) Infection Control Committee. His research is focused on preventing the transmission of infections, including TB, within the healthcare setting. Ha Nguyen Ha Nguyen is a registered nurse who completed her Master s degree in nursing at the University of Toronto, Bloomberg Faculty of Nursing. While studying, she also worked there as a clinical instructor and a research assistant. She is currently the supervisor of the TB Case Management Team at the Region of Peel. She has held previous roles there as a front line Public Health Nurse in the TB program and as a Research & Policy Analyst for the Communicable Disease Case Management Section. 204 Tuberculosis Conference 6

8 Speaker Biographies Tina Proctor Tina Proctor is a Registered Nurse working for Toronto Public Health in the TB program for over 7 years. She enjoys working with a diverse population in the capacity of a DOT nurse. Tina s passion and enthusiasm for her work and people has helped many patients complete their TB treatment. Tina s willingness to work with challenging patients makes her a valuable member of the team. Elizabeth Rea Dr. Elizabeth Rea is an Associate Medical Officer of Health at Toronto Public Health, where she has worked primarily with the Tuberculosis program since She is originally from Manitoba, where she did her medical degree. She worked in general practice before completing her residency in Public Health and Preventive Medicine and an MSc in Epidemiology at the University of Toronto. She is a Fellow of the Royal College in Public Health and Preventive Medicine, and an associate professor at the University of Toronto, where she teaches communicable disease epidemiology at the Dalla Lana School of Public Health as well as undergraduate and post-grad teaching in the Faculty of Medicine. She has worked in public health for 7 years, mainly in communicable disease control and epidemiology, and in public health ethics. She has been involved in TB policy at the national level for several years; her research interests include TB epidemiology and operational research in TB control. Adrian Sebastian Adrian, RN, BScN, is a Manager for Toronto Public Health s TB Prevention and Control program. He has been with Toronto Public Health since Adrian has a Bachelors of Science in Nursing from Ryerson University (200) and course certificates for emergency nursing (George Brown College) and Infection Control (Centennial College). Howard Song Dr. Howard Song received his combined MD and PhD from the University of Toronto in He subsequently obtained his Fellowship from the Royal College of Physicians and Surgeons in Infectious Diseases in 20. He currently remains a trainee in the Clinician Investigator Program at the University of Toronto. He has been a member of the TB Service and has served as an Infectious Disease consultant at West Park Healthcare Centre since 20. His main research interests include the development and use of animal models of mycobacterial infections in understanding the pathogenesis of tuberculosis. Brady Wood Brady Wood is a trusted communications leader, known for assisting organizations through difficult reputation challenges. As Chief Communications Officer at Niagara Health System for the past 3 years, Brady continues to spearhead the organization s ongoing reputation recovery. A member of the organization s Executive Team, Brady is the lead for both the Communications and Patient Relations teams. Previously Brady held leadership roles at St. Joseph s Health System, St. Joseph s Healthcare Hamilton, and with the St. Joseph s International Outreach Program in Haiti and Uganda. Brady has also been a member of Ministerial review teams in Ontario, examining and aiding challenged hospitals across Ontario for consecutive Ministers of Health. Brady also teaches the Reputation Management Module for the Healthcare Leadership program offered by the DeGroote School of Business at McMaster University in partnership with St. Joseph s Healthcare Hamilton. This year Brady also joined the Board of the Canadian Arab Institute, a non-partisan think tank addressing issues affecting Arabs in Canada. He recently became the Chair of the Board Tuberculosis Conference

9 Poster Descriptions. A Collaborative Initiative to Prevent and Control Tuberculosis in Correctional Facilities in Toronto G. Carlos, J. Fuller, L. Grant, M. Kraguljak, E. Rea, B. Yaffe, M. Dwyer 2, C. Miller 2, L. Ogilvie 2 Toronto Public Health, 2 Ministry of Community Safety and Correctional Services The Toronto Public Health (TPH)/ Ministry of Community Safety and Correctional Services (MCSCS) TB Initiative was established to prevent and control TB in the four Toronto correctional facilities. The TB initiative has greatly strengthened TB prevention and control in the city s detention centres and critical to its success include effective communication, reciprocal knowledge and collaboration. 2. Homology of TB fingerprint results on the Canadian Prairies - Implications for Programming Courtney Heffernan, Betsy Varughese, Richard Long University of Alberta Tuberculosis is a highly focal disease, though the arbitrary delineation of programming efforts by province or alternate jurisdictions may not capture transmission that occurs in areas confounded by mobile populations. Programming efforts that have heretofore been operating independently will need to look for mechanisms for information and data sharing to better manage this disease without borders. 3. Years ago - Evoking the Past in First Nations Narratives of Tuberculosis on the Canadian Prairies Sara V. Komarnisky, Paul Hackett 2, Sylvia Abonyi 2, Courtney Heffernan, Maria Mayan 3, Richard Long University of Alberta, 2 University of Saskatchewan, 3 Community- University Partnership for the Study of Children, Youth, and Families Indigenous TB patients talked about the historical context of TB in interviews. These historical statements connect colonialism, historical mistreatment of TB, and ongoing health inequalities to contemporary experiences of TB. Efforts to prevent and manage TB among Indigenous communities in Canada need to reconcile with this historical legacy to succeed. 4. A descriptive analysis of TB in Ontario, 2008 to 203 S. Raju, M. Whelan, T. Bateman, F. Jamieson Public Health Ontario We describe the epidemiology of TB in Ontario using routinely collected public health surveillance data. Ontario has a low incidence rate of TB, with foreign-born cases representing the largest proportion of TB cases. Ontario s reported incidence of TB has remained stable, but continued education of high risk populations on different aspects of TB, as well as identification and appropriate treatment for those with TB remains a public health priority. 5. A TB Contact Investigation in a Neonatal ICU R. Kadri, B. Fox, J. Lechner, K. Chong, R. Stuart, E. Rea, I. Kitai 2, K. Schwartz 2, R. Lovinsky 3, P. Azzopardi 3 Toronto Public Health, 2 SickKids Hospital, 3 The Scarborough Hospital A proactive, co-ordinated approach involving specialist clinicians, public health, and the hospital is essential for timely, high-quality follow-up for infant NICU TB exposures. Secondary TB cases are rare and INH window prophylaxis is likely a safe option. 6. Amplification of drug resistance under public health practices: The need for early use of public health legislation Dr. Will Caryl, Wilson Kwong 2, Dr. Elizabeth Rea 3, Dr. Monica Avendano 4, Dr. Wendy Wobeser 2 University of Toronto, 2 Queen s University, 3 Toronto Public Health, 4 West Park Healthcare Centre Documentation of the most drug-resistant case of tuberculosis in Canada and the need for public health legislation in preventing future cases. 7. Click Into the Future: VDOT Pilot at the Simcoe Muskoka District Health Unit and Niagara Health Unit Helen Twigg, Erin McFarland, Cathy Martin 2 Simcoe Muskoka District Health Unit, 2 Niagara Region Health Unit Two health units have successfully delivered video directly observed therapy (VDOT) through a PHIPA-compliant videoconferencing service for clients requiring DOT visits while on active TB treatment. The use of this technology provides the client with the ability to return to work, travel and the flexibility to carry out daily activities rather than be restricted to waiting at home for a DOT visit to occur, while preserving the privacy and security of an in-person DOT visit. 8. Cost Analysis and Benefits of e-directly Observed Therapy for TB Treatment Sophie Gouveia, Janice Walters 2, Andrew Papadopoulos University of Guelph, 2 Wellington Dufferin Guelph Public Health e-directly Observed Therapy (DOT) using a tablet and internet access for face-to-face meetings combined with in-person visits would allow to provide DOT seven days per week at considerably lower cost than the current five days per week practice while improving service delivery for both providers and clients. 9. Could neonatal immunologic screening increase the safety of a BCG vaccination program? Alice Zhabokritsky, Dr. Wendy L. Wobeser Queen s University BCG vaccination continues to be offered to some infants from indigenous communities, which can be fatal in children with undiagnosed SCID. We explore the potential of incorporating screening tools for SCID into BCG vaccination policy. 204 Tuberculosis Conference 8

10 Poster Descriptions 0. Partnering to Improve TB Care and Outcomes Stacey Ramey, Emma Cumming Labrador Grenfell Health Authority The implementation of a TB Clinic for the Northern Communities of Labrador resulted in a streamlined, efficient standard of care for all peoples of the region. It highlights how collaboration worked in developing a process with hopes of reducing the incidence rate of TB for the region.. Potential role for IGRA in TB screening in a remote First Nations community - operational challenges and rewards Paddy Dasno, Anne Cleland, Janet Gordon, Wilson Kwong 2, Dr. Wendy Wobeser 2 Sioux Lookout First Nations Health Authority, 2 Queen s University We present a case where children in a small remote First Nations community who were vaccinated with the BCG vaccine as neonates demonstrated false positive TB skin tests, despite current guidelines not considering the vaccine to be a false positive contributor. 2. Predicting successful contact investigations for Canadian-Born Aboriginal and non-aboriginal TB cases in Alberta L. Eisenbeis, G. Verma, Z. Gao, W. Yacoub, R. Long University of Alberta Predictors of success for contact investigations in Alberta are largely unknown or documented. Presented is a 0 year retrospective analysis of investigations for Canadian-Born adult pulmonary cases, including Aboriginal Peoples living on and off-reserve. 3. Taima (Stop) TB: A Tuberculosis Education Initiative with Inuit Youth Deborah Van Dyk, Sandra Finn 2, Dr. Gonzalo Alvarez Ottawa Hospital Research Institute, 2 Government of Nunavut 4. TB Contact Follow Up in a Long Term Care Home Alanna McGeough, Erin Boyle Ottawa Public Health According to the updated Canadian Tuberculosis Standards (7th edition), tuberculin skin tests (TST) are no longer recommended for contact follow-up of residents who are over age 65 and in long term care homes (LTCH). We present our experience with applying the new guidelines to a TB contact investigation in a LTCH. 5. Addressing TB in the Northwest Territories Lydia Cheng, Caroline Newberry, Heather Hannah Government of Northwest Territories TB remains a significant public health issue in the Northwest Territories (NWT), where incidence rates of active TB are on average seven times higher than the national rate. This poster highlights the epidemiology of active and latent TB infection, along with ongoing initiatives aimed to reduce TB in the NWT. 6. Working with the Tibetan Community D. Blencoe, N. Nangsetsang, T. Samarita, A. Sebastian, E. Rea, A. Stuart Toronto Public Health Toronto has the largest Tibetan community in Canada, with very high rates of TB and MDR-TB. Learn about strategies that TPH used to help overcome the challenges in serving the Tibetan community. 7. Rapid identification of mycobacterium tuberculosis from clinical samples by PCR-RFLP analysis (IPRA) method Mahnaz Saifi, Esmail Jabbarzadeh, Majid Hakimi 2 Pasteur Institute of Iran, 2 Ahar Azad University The rapid and accurate diagnosis of mycobacterial infections is case sensitive for control and prevention programs of TB infections. This poster presentation outlines the successes and challenges of engaging with communities to develop, implement, and evaluate education activities that can be tailored to fit the unique context of each community while maintaining a common educational foundation that is consistent and reproducible Tuberculosis Conference

11 Notes 204 Tuberculosis Conference 0

12 Leaders in Lung Health designed by bigshoe.net The Ontario Lung Association assists, educates and empowers people living with or caring for others with lung disease. We provide programs and services to patients and health-care providers, invest in lung research and campaign for improved policies on lung health. Our Lung Health Information Line LUNG (5864) is staffed by Certified Respiratory Educators. Through our professional societies the Ontario Respiratory Care Society and the Ontario Thoracic Society the Association provides professional education programs, research funding and resources to carry forward our mission of improving lung health for all Ontarians. Asthma Chronic Obstructive Pulmonary Disease (COPD) Healthy Air Tobacco Control Tuberculosis Research When you can t breathe, nothing else matters LUNG (5864) JOIN US FOR THE 205 BETTER BREATHING CONFERENCE Global Threats, Local Responses January 29-3, 205, Toronto Marriott Downtown Eaton Centre Hotel Please register online at: Early Bird Deadline: December 3, 204. Provincial Office Address: 8 Wynford Drive, Suite 40, Toronto, ON M3C 0K