Tuberculosis in Indigenous communities
Learn about tuberculosis (TB) and the importance of taking steps to prevent the spread of the disease. TB is preventable and curable.
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What is TB and how does it spread
TB is an infectious disease caused by mycobacterium bacteria, spread through the air when someone with contagious TB coughs, sneezes, sings or talks. It mainly affects the lungs and airways but can also affect other parts of the body.
What happens if I breathe the TB germs into my lungs?
One of 3 things can happen:
- Your immune system kills the bacteria and you do not become infected.
- You become infected, but your immune system keeps the germs in an inactive or sleeping state within your body. This is called latent TB infection, or sleeping TB. Latent TB does not cause any symptoms and is not contagious.
- You become infected and then develop active TB or TB disease. This may happen soon after infection (weeks or months) or years later. Active TB will make you feel sick and it is contagious.
If I have TB, can it spread to my friends and family?
- Latent or sleeping TB infection cannot be spread to others.
- Active TB or TB disease can spread to others by coughing, sneezing, talking or even singing, when it is in the lungs or airways.
- You cannot spread TB to others by shaking hands or sharing dishes with them.
- Anyone can get TB, and people often don't know they have it until they are tested or they get very sick. People affected by TB are not at fault.
Symptoms
If you have active TB disease, you may feel sick with some of the following symptoms:
- cough lasting more than 2 weeks
- coughing up sputum (phlegm)
- coughing up blood
- chest pain
- no appetite
- unexpected or unexplained weight loss
- weakness or lack of energy
- chills or fever
- sweating at night
- other symptoms that are undiagnosed (that is, abdominal pain, back pain, bone pain)
If you are sick with any of the above symptoms and wonder if it could be TB, you should see your health care provider and ask them whether your symptoms could be related to TB.
Diagnosis
TB is diagnosed using information that can include:
- personal health history (especially whether you have been in contact with someone affected by TB recently or in the past)
- symptom check list
- tuberculin skin test (also called TST or Mantoux test)
- blood tests such as an interferon gamma release assay (IGRA)
- sputum (phlegm) testing
- chest X-ray
How is TB treated?
Both latent TB and active TB can be treated with antibiotics. Left untreated, latent TB can develop into active TB. Active TB can spread to others and can be fatal without medical treatment.
- If you have latent or sleeping TB infection, you may be offered antibiotics to prevent the TB from becoming active disease. Depending on the treatment you and your physician decide on, treatment can last 3 to 9 months.
- If you have active TB disease, you must be treated with antibiotics to kill all of the germs and cure the TB. Treatment usually takes between 6 and 9 months.
- TB medicine is often given by a trained TB worker who will support your treatment journey.
If you stop taking the medicine early or don't take all of the doses, TB may come back and become a stronger TB germ. When this happens, even the best TB antibiotics might not work on the germs anymore. This is called drug resistant TB. Drug resistant TB is more complicated and difficult to treat. It is very important to take all of the medication, even when you start to feel better.
How to help prevent the spread of TB
Be TB aware. Know the symptoms of the disease. Know whether there is, or has been, TB in your community.
Talk to your healthcare provider about your own risk for TB. If you have latent TB, ask what you can do to reduce your risk of progression to active disease.
If you have symptoms of disease, get checked as soon as possible. The sooner TB is found and treated, the less it can spread to your friends and family and the better chance you have for a complete cure.
Share information about TB with your family, in your school and around your community.
Support the people in your community that have been affected by TB. TB can affect anyone, anywhere. However, the proper medications and support can cure TB.
TB and Indigenous communities
For most people in Canada, the risk of acquiring TB is very low. However, the rates of active TB are disproportionately higher among Indigenous Peoples in Canada due to social inequities as a direct result of colonial policies and practices that include forced relocation, loss of lands, creation of the reserve system, banning of Indigenous language and cultural practices, Indian hospitals and TB sanitoria, and the creation of the residential school system. Learn more about the history of TB in First Nations, Inuit and Metis communities.
- In 2022, the rate of active TB disease among Inuit was over 455 times higher than that of the Canadian-born, non-Indigenous population, and over 26 times that of the overall Canadian population.
- In 2022, the rate of active TB disease among First Nations in Canada was over 71 times that of the Canadian-born, non-Indigenous population, and over 4 times that of the overall Canadian population.
Factors that increase the chance of developing active TB
If you have latent TB infection, there is a 5 to 10% chance over your lifetime that it will become active TB. The chance increases if you experience conditions that weaken the immune system (such as HIV, substance use, diabetes, severe kidney disease, organ transplant recipient, taking medications that weaken immune system), food insecurity and are of a young or advanced age. First Nations, Inuit and Metis in Canada are disproportionately impacted by factors that increase the chance of being exposed to TB or progressing to active TB in the context of inequities and the historical and ongoing impacts of colonization.
TB resources
These resources can help you raise awareness and understanding about TB and how to prevent the spread of TB.
TB is curable.
Share what you learn about TB with family and friends. Together let's stop TB!
Resources for Inuit
Resource for First Nations
Related links
- Raising awareness and fighting tuberculosis stigma
- Tuberculosis: symptoms and treatment
- Inuit Tapiriit Kanatami Elimination Framework
- Chapter 12: An introductory guide to tuberculosis care to improve cultural competence for health care workers and public health professionals serving Indigenous Peoples of Canada