| dc.description.abstract | In 2003, British Columbia (BC) opted to discontinue routine Bacille Calmette-Guerin (BCG)
vaccination for First Nation children and replace this with enhanced tuberculosis (TB) control
activities as recommended by First Nations and Inuit Health, Health Canada (Public Health
Agency of Canada, National Advisory Committee Statement on BCG, 2004). BCG is the most
widely administered vaccine in the world and is used to prevent serious forms of TB in children,
most notably TB meningitis and miliary TB (Fine, P., Carneiro, T, Milstien, J. & Clements, C.J.,
1999). Evaluation of reports detailing serious adverse events caused by the BCG vaccine in some
First Nation children raised concerns that the routine neonatal BCG immunization program may
well be associated with unforeseeable and unacceptable health risks (Public Health Agency of
Canada, 2004a). The decision to shift from mass vaccination of infants to selective vaccination
of high risk groups is guided by criteria established by the International Union against
Tuberculosis and Lung Disease (lUATLD) (World Health Organization, 2004). Of significant
importance to meeting these criteria, there must be an efficient notification system in place to
monitor, case find and treat active TB cases.
BC Center for Disease Control (BCCDC) is the centralized health authority for maintaining
communicable disease registry and services for the province of British Columbia. All core TB
services are delivered by BCCDC in partnership with First Nation & Inuit Health, Pacific
Region. To monitor and improve TB control efforts with First Nation reserves, an enhanced
surveillance and screening program was developed and implemented in June 2004.
Effective evaluation of the enhanced surveillance program will help facilitate future direction for
TB control initiatives and priorities with First Nation communities and provide additional
research for public health policy. | |
