World TB Day, March 24, commemorates the moment in 1882 when Dr. Robert Koch first identified Mycobacterium tuberculosis as TB’s culprit. Another game-changer came decades later with the rise of antibiotics: the bug could be vanquished. Despite being curable, tuberculosis is still a killer, wreaking havoc even in pockets of the developed world.
Tuberculosis, known as “consumption” in earlier centuries for its wasting effect on victims, now tops HIV and malaria as the world’s deadliest infectious disease. The good news is that the global rate of TB is declining, says Dr. Madhukar Pai, director of global health at Montreal’s McGill University. But the disease continues to claim 1.8 million lives a year worldwide, according to 2015 figures. TB is concentrated in poverty-stricken areas such as sub-Saharan Africa and Southeast Asia, where inadequate health care is a major factor. “There are no doctors, only nurses, and the microscopes are often broken,” says Pai.
At risk in Nunavut
Though most Canadians will never encounter TB, Inuit of Nunavut are infected at 40 times the national average, says Toronto Public Health’s Dr. Elizabeth Rea. Poor ventilation, crowded dwellings, high rates of smoking and burgeoning diabetes are to blame. Until recently, all sputum samples had to be flown south for lab testing, taking weeks to get a diagnosis. In 2012, Pai and other researchers introduced a new machine, the GeneXpert, to Nunavut. The low-tech device can detect the presence of TB bacterial DNA in just two hours. This means that the bacterium can be prevented from spreading further.
To prevent active TB, you need to screen people who have dormant (or “latent”) tuberculosis — that is, they’re infected but have no symptoms. However, many Inuit distrust the process. Up until the 1950s, TB patients were sent to sanatoriums in the South. Some never returned; their families were left to wonder what happened. In 2011, a campaign in Iqaluit, Nunavut’s capital, enlisted local residents to spread the message that tuberculosis is curable and treatable at home. The effort worked, and TB detection increased. “Tuberculosis is preventable, and Canada’s ongoing commitment to it is important,” says Rea.