EPIDEMIOLOGY OF TUBERCULOSIS IN MONTREAL

Objective: To identify the epidemiologic caracteristics of tuberculosi s (TB) in Montreal and the patterns of resistance to antituberculous d rugs in order: to improve TB control in the region. Design: Descriptiv e analysis of surveillance data for TB cases reported in Montreal by p hysicians and laboratories between 1992 and 1995. Setting: Region of M ontreal, population 1 775 899. Participants: All cases of active TB am ong Montreal residents reported to the Department of Public Health bet ween Jan. 1, 1992, and Dec. 31, 1995. Outcome measures: Epidemiologic characteristics, proportion of cases resistant to antituberculous drug s and types of resistance. Results: A total of 798 cases of TB (mean a nnual incidence 11.2 per 100 000) were reported in Montreal during the study period. Of these patients, 617 (77.3%) were born outside Canada . The annual incidence of TB in the foreign-born population (37.5 per 100 000) was 10 times the rate in the Canadian-born population, and th e highest rate among foreign-born residents (62.8 per 100 000) occurre d in those 15-29 years of age. In general, annual incidence in Montrea l's foreign-born population reflected the reported incidence of TB in their regions of birth. In 8.7% of all cases, the disease was resistan t to isoniazid, and the proportion of cases resistant to this drug was greater than 4% in almost all age groups, among both foreign-born and Canadian-born patients. Conclusions: TB remains a major problem in Mo ntreal, as in other large cities. Surveillance data give opportunities to public health agencies to adapt their prevention and control strat egies to local situations and can also help clinicians in their clinic al decision-making.