Descriptive review of tuberculosis surveillance systems across the circumpolar regions.
BACKGROUND
Tuberculosis is highly prevalent in many Arctic areas. Members of the International Circumpolar Surveillance Tuberculosis (ICS-TB) Working Group collaborate to increase knowledge about tuberculosis in Arctic regions.


OBJECTIVE
To establish baseline knowledge of tuberculosis surveillance systems used by ICS-TB member jurisdictions.


METHODS
Three questionnaires were developed to reflect the different surveillance levels (local, regional and national); all 3 were forwarded to the official representative of each of the 15 ICS-TB member jurisdictions in 2013. Respondents self-identified the level of surveillance conducted in their region and completed the applicable questionnaire. Information collected included surveillance system objectives, case definitions, data collection methodology, storage and dissemination.


RESULTS
Thirteen ICS-TB jurisdictions [Canada (Labrador, Northwest Territories, Nunavik, Nunavut, Yukon), Finland, Greenland, Norway, Sweden, Russian Federation (Arkhangelsk, Khanty-Mansiysk Autonomous Okrug, Yakutia (Sakha Republic), United States (Alaska)] voluntarily completed the survey - representing 2 local, 7 regional and 4 national levels. Tuberculosis reporting is mandatory in all jurisdictions, and case definitions are comparable across regions. The common objectives across systems are to detect outbreaks, and inform the evaluation/planning of public health programmes and policies. All jurisdictions collect data on confirmed active tuberculosis cases and treatment outcomes; 11 collect contact tracing results. Faxing of standardized case reporting forms is the most common reporting method. Similar core data elements are collected; 8 regions report genotyping results. Data are stored using customized programmes (n=7) and commercial software (n=6). Nine jurisdictions provide monthly, bi-annual or annual reports to principally government and/or scientific/medical audiences.


CONCLUSIONS
This review successfully establishes baseline knowledge on similarities and differences among circumpolar tuberculosis surveillance systems. The similarity in case definitions will allow for description of the epidemiology of TB based on surveillance data in circumpolar regions, further study of tuberculosis trends across regions, and recommendation of best practices to improve surveillance activities.
Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON, Canada.
Annie-Claude
AC
Bourgeois
Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA; tsc3@cdc.gov.
Tammy
T
Zulz
Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Bolette
B
Soborg
Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Anders
A
Koch
D001110:Arctic Regions / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D011159:Population Surveillance; D015995:Prevalence; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology*
International Surveillance Circumpolar – Tuberculosis Working Group; circumpolar; surveillance; tuberculosis