High TB rates worry health officials, IAA

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Edmonton

The tuberculosis rate among Alberta's Treaty Indians is "very unacceptable," says an IAA official.

"I think it can be brought down considerably," said Gregg Smith, Treaty 7 vice-president with the Indian Association of Alberta.

"It's going to require work from not only health providers but from our own people in wanting it brought down," he said.

A total of 176 TB cases were reported in Alberta last year. Forty-five of the cases, almost half were Treaty Indians while another 13 cases were Metis.

Between 10 to 20 people die every year of the disease in Alberta. One-third of those who die are Treaty Indians.

The tuberculosis rate among Alberta's 50,000 Indians is 10 to 20 times higher than the provincial average, said Dr. Anne Fanning, medical director of TB Services Alberta.

Across the province last year the provincial average was 7.4 cases per 100,000 people while in Indians the rate was 91 per 100,000. The rates for Treaty Indians show that for

other years the ratios are similar including 1987 with 152 per 100,000 compared to 8.7 for the provincial average. Likewise in 1986 with 97 per 100,000 and 1985 with 82 per

100,000. Provincial averages in those years were 8.8 and 7.6 per 100,000 respectively.

Back in 1978, the provincial average was 12.5 while it was 153 for Treaty Indians, said Fanning.

"I've known for a long time it was quite a bit higher," said Smith.

"In a lot of cases when there's an outbreak, it's because of people's non-use of a medication or follow-up to that medication.

"As well immunization rates from all our Native communities are really low. I think it's a lack of understanding of immunization, which results in some of these things," Smith said.

Fanning called the high TB rates "awful. It's unacceptable and I'm committed to changing it."

"I'm the bottom line. I have to be held responsible" for lowering the rate, she said. "Of course, it's difficult. But I'm committed to making a change.

"What's going to be required is a very aggressive information program so those at highest risk recognize the need to be checked and treated," said Fanning.

The number of deaths occurring from such a preventable disease is shocking, said Fanning.

In one-half of the cases, the disease isn't detected until after death, she said.

"There's a general tendency towards lower rates" of tuberculosis, although they do vary sometimes quite considerably from year to year, she said.

Rates are a little higher in northern communities, she said, probably because they're isolated

Untreated, one-third of those who get TB, are likely to die within two to three years.