TB rate 'unacceptable'

Minister promises swift action on 26 recommendations

Jorge Barrera
Northern News Services

Yellowknife (Feb 26/01) - An Alberta specialist says tuberculosis rates in the territory are unacceptably high.

The statement was included in a report released Friday by Health Minister Jane Groenewegn. It's part of a larger study she ordered last September after Fort McPherson teacher Effie Blake died of TB last summer.

Report Highlights All patients, with a cough of more than three weeks, or suspected of having TB ... must have sputum collected for TB culture ... for interpretation within 48 hours. All contact/follow-up of infectious pulmonary tuberculosis be undertaken within seven days of the diagnosis of the source case. That adequate funding is available... Provide adequate staff, with up-to-date training and supervision, to substantially reduce the burden of tuberculosis in high-incidence communities. Ensure that all new staff and existing staff are trained in TB program execution. A permanent nurse health educator to support training and supervision of health care workers in TB control "is essential." Since the TB manual is a standard and a guideline, boards are expected to implement: "it is not an option."

Blake's family believes she died because of a misdiagnosis. She spent five weeks in Inuvik hospital before being diagnosed with TB at Stanton Regional Hospital in Yellowknife. Blake died in hospital in Edmonton.

The report by University of Alberta TB expert Dr. Anne Fanning and Dr. Mike Mulherin, regional medical health officer for the Inuvik Health and Social Services Board, focused on how TB diagnosis and treatment is delivered rather than the Blake case itself.

"It is unacceptable for rates of TB in parts of the NWT to be 10 times the rates in the rest of Canada," said the report.

Only their 26 recommendations were released by the minister. The rest of the report is confidential, although Blake's family is to be briefed on the contents of the entire document.

Fanning said the territory's TB program is fine on paper, but difficult to carry out. "The capacity to carry out all measures ... is impeded by limitations of staff time, training, community support and level of awareness," said the report.

Complicating the matter is high staff turnover. "I don't know how anybody could get up to speed in that short of time," said Fanning.

The recommendations are wide-ranging. They include calling for all patients with a cough lasting more than three weeks to be tested for TB, making sure the NWT's policy is followed, maintaining the TB registry and improving community education about the disease.

Groenewegen promised swift action. "We'll be responding to the report in the next two weeks," she said. The minister has also ordered NWT Chief Coroner Percy Kinney to investigate Blake's death.