TB: Making a difference The Lung Association’s Tuberculosis Committee is pleased to welcome you to the 2012 Tuberculosis Conference. November 19 & 20, 2012 • Delta Chelsea Hotel, Toronto

Final Conference Program

Conference Planning Committee TB: Making a difference is an initiative of the Ontario Lung Association Tuberculosis Committee Co-Chairs: Ms. Joy Marshall, Regional Municipality of York Ms. Shelley Walkerley, Stonegate CHC and York University Members: Mr. Obed Adore, Centre for Addiction and Mental Health Ms. Tiffany Bateman, Public Health Ontario Ms. Leslie Calhoun, Peel Public Health Ms. Darlene Fawcett, Ontario Shores Centre for Mental Health Services Ms. Rita Kadri, Toronto Public Health Mr. Ray Lam, The Hospital for Sick Children Ms. Leslie LeGresley, West Park Healthcare Centre Ms. Mabel Lim, Public Health Ontario Dr. Meb Rashid, University of Toronto Dr. Elizabeth Rea, Toronto Public Health Ms. Julie Seemangal, St. Michael’s Hospital Ms. Chris Seto, Toronto Public Health Ms. Helen Twigg, Simcoe Muskoka District Health Unit Staff: Ms. Sheila Gordon-Dillane, Ontario Respiratory Care Society, The Lung Association Conference Management: Ms. Janet Victor, Ms. Gale Gingrich, Ms. Michelle Wilson, Eventives Conference and Event Management

Accreditation This program has been accredited by The College of Family Physicians of Canada and the Ontario Chapter for up to 11 Mainpro-M1 credits.

This conference is supported by

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2012 Tuberculosis Conference

TB: Making a difference Welcome from the Planning Committee In Ontario, the diagnosis and treatment of TB is in good hands! Reliable laboratories, a secure system of publicly-funded TB medications, health care providers who recognize and treat TB, and public health units who identify contacts and support and follow TB cases, sometimes for years: they all make a difference! However, globally only one-half the number of TB cases that occur each year are actually detected and reported. Each year in India, almost 300,000 people still die of TB. This year’s conference focuses on ‘Making a difference’: how we, as individuals and agencies work together, using new resources and innovations, to influence how TB is diagnosed and treated. We ARE making a difference in managing TB in Ontario, despite the global challenges. The purpose of this conference is to bring together health care providers to discuss and exchange current information and ideas on tuberculosis. By providing a diverse range of educational sessions of interest to health care professionals from many disciplines and health care settings, our goal is to increase knowledge of global issues, current trends, best practices and new recommendations for the diagnosis, management and control of tuberculosis with a focus on the health care provider. Through our conference, we wish to provide opportunities to learn, discuss and share information in both professional and social atmospheres. Our hope is that together we can affirm the approaches that are effective and successful, as well as generate new methods to meet the ongoing challenges of tuberculosis. Joy Marshall, MN and Shelley Walkerley, NP-PHC MN Co-Chairs, The Lung Association TB Committee

Conference Goal To provide advanced information to health care providers on the complexity of tuberculosis management.

Conference Objectives • To identify current TB management strategies in the context of emerging issues and co-morbidities; • To heighten awareness of the challenges of preventing and managing TB; • To highlight innovations in TB diagnosis and care.

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Conference Schedule Sunday, November 18, 2012 2:00 - 5:30

Registration

Mountbatten Court

:00 - 5:00 Pre-Conference Concurrent Sessions 3 TB 101: Everything You’ve Always Wanted to Ask About TB – Here’s Your Chance! Rita Kadri, Toronto Public Health; Joy Marshall, MN, Regional Municipality of York; Julie Seemangal, St. Michael’s Hospital

Seymour Room

Ethical Issues Concerning Public Health Risks of TB Dr. Elizabeth Rea, Toronto Public Health

Stevenson Room

Monday, November 19, 2012 Please note: All conference plenary sessions are in the Churchill Ballroom. 7:30

Registration and Continental Breakfast

8:45

Welcome and Opening Remarks Andrea Stevens Lavigne, Vice-President, Provincial Programs, The Lung Association; Dr. Arlene King, Chief Medical Officer of Health, Ontario Ministry of Health and Long-Term Care

9:00

Public Health Practice and TB Dr. Tom Wong, Public Health Agency of Canada, Ottawa

9:30

Making the Best Drugs Work Better Dr. Jerry Stambaugh, Southeastern National TB Center, Florida

10:30

Refreshment Break and Posters

11:00

The Role of Surgery in Primary and Complicated Tuberculosis Dr. Michael Ko, St. Joseph’s Hospital, Toronto

11:45

Clara’s Rib – A True Story of a Young Girl Growing up in a Tuberculosis Hospital Anne Raina, author and sister of Clara Raina

12:15

Lunch and Posters

Churchill Court Churchill Ballroom

Churchill Court Churchill Court/Ballroom

1:15 Concurrent Sessions CS I. Delivering TB Care Through Clinic Models Dr. Sergio Borgia, William Osler Hospital, Brampton; Lisa Fernandes, Peel Public Health; Jill Seara and Jody Paget, Middlesex-London Health Unit

Scott Room

CS II. Here’s Looking at You! Video Technology – An Innovative Approach to Churchill Ballroom Providing Directly Observed Therapy to TB Cases Theresa Samarita and Adrian Sebastian, Toronto Public Health; Sheryll Gordon, Peel Public Health; Aaron Aitchison, Middlesex-London Health Unit CS III. Ask a TB Expert Dr. Fran Jamieson, Public Health Ontario, Toronto; Dr. Ian Kitai, The Hospital for Sick Children, Toronto; Dr. Elizabeth Rea, Toronto Public Health; Dr. Jane Batt, St. Michael’s Hospital, Toronto

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2:45

Refreshment Break and Posters

3:00

Advances in Latent TB Infection (LTBI) Management Dr. John Jereb, Centers for Disease Control, Atlanta; Lisa Eisenbeis, University of Alberta, Edmonton

4:00

TB: The Human Stories David Rochkind, Photographer, Port-au-Prince, Haiti

4:30

Reception and Photo Exhibit

6:00

End of Day One

2012 Tuberculosis Conference



Carlyle Room

Churchill Court

Mountbatten Ballroom

Tuesday, November 20, 2012 Please note: All conference plenary sessions are in the Churchill Ballroom. 7:30

Registration, Continental Breakfast and Exhibits

8:55

Welcome to Day Two

9:00

Early Diagnosis of TB and Leading New Treatment Recommendations in the 7th Edition of the Canadian TB Standards Dr. Richard Long, University of Alberta, Edmonton

10:00

Home Isolation and Use of Portable HEPA/UV Units Adrian Sebastian and Dr. Elizabeth Rea, Toronto Public Health

10:45

Refreshment Break, Posters and Exhibits including Photo Exhibit

11:15

IGRA Use in Ontario Dr. Wendy Wobeser, Queen’s University, Kingston; Dr. Ian Kitai, The Hospital for Sick Children, Toronto

12:15

Lunch, Posters and Exhibits including Photo Exhibit

1:30

Quantifying the Effectiveness and Efficiency of Medical Surveillance for TB Dr. Kamran Khan, St. Michael’s Hospital, Toronto

2:15

TB and the Elderly Dr. Monica Avendaño, West Park Healthcare Centre, Toronto; Dr. Nicola Mercer, Wellington- Dufferin-Guelph Public Health; Mr. Kash Ramchandani, Royal Terrace Long Term and Residential Care, Palmerston

3:45

Closing Remarks

Churchill Court/Mountbatten Churchill Ballroom

Churchill Court/Mountbatten

Churchill Court/Mountbatten

Ontario

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Speakers’ Biographies Aaron Aitchison Aaron Aitchison is a public health nurse at the Middlesex-London Health Unit with 10 years of experience in communicable disease and sexual health services. Aaron graduated from Western University in London, Ontario with a BScN and Hon. BSc in Microbiology & Immunology. He is a past executive member of CHICA-Southwestern Ontario chapter - education committee.

Monica Avendaño Dr. Monica Avendaño is well known within the field of Tuberculosis as an expert in the treatment of complex cases and especially of patients with multi-drug resistant disease. She frequently consults on cases from the local to the international. In addition, she shares medical leadership for two other in-patient units at West Park Healthcare Centre: Respiratory Rehabilitation Service and the Chronic Assisted Ventilatory Care Unit which was recently designated as a Centre of Excellence in chronic ventilation. Dr. Avendaño is an enthusiastic teacher and is an Associate Professor at the University of Toronto. She is the Physician in Charge of the only dedicated in-patient unit for the treatment of Tuberculosis in the province of Ontario. Over the last 25 years, Dr. Avendaño has created a Centre of Excellence for the treatment of the most difficult cases of Tuberculosis, amalgamating a multi-disciplinary team of dedicated health professionals although perhaps her proudest role is that as a grandmother of five.

Jane Batt Dr. Jane Batt is a Clinician Scientist, and the Interim Medical Director of the TB Program at St. Michael’s Hospital. She graduated from McMaster University medical school in 1991, and Internal Medicine and Respirology at the University of Toronto in 1997. She completed her PhD at the Institute of Medical Sciences at the University of Toronto in 2002, and is also cross-appointed as an Assistant Professor to the Faculty of Medicine. Her current research focuses on skeletal muscle atrophy and dysfunction in endstage respiratory disease and critical illness.

Sinai Hospital in Toronto. Dr. Borgia obtained his M.D. degree from Queen’s University, Kingston, Ontario. He completed his specialty training in Internal Medicine and Infectious Diseases at McMaster University prior to joining William Osler where he serves as Co-Chair of the P&T committee and as the Medical Director of the Hepatitis C and Tuberculosis clinics. He is an Assistant Clinical Professor in the Department of Medicine and Infectious Diseases at McMaster University and is an Investigating Coroner for the Region of Peel. He has published in a number of peer-reviewed Infectious Diseases and basic science journals and has served as a reviewer for JAMA and CMAJ. He most enjoys playing with his young children and traveling off the beaten path. He has a passion for driving fast cars, movies and scuba diving.

Lisa Eisenbeis Ms. Lisa Eisenbeis, RN, BScN, BSc is the Study Coordinator with the TB Program Evaluation and Research Unit at the University of Alberta. She is currently managing the Edmonton site for an international randomized control trial comparing 4 months of Rifampin to 9 months of INH for latent TB infection in both adults and children. The larger trial is under the direction and lead of Dr. Dick Menzies from McGill University. Further she is the adverse event administrator for the study which involves 9 other countries. Lisa is the former provincial nursing consultant for TB with Alberta Health and Wellness, where she also served as the acting manager of the provincial TB program. She holds undergraduate degrees in both Nursing and Science and is currently a graduate student in the Faculty of Medicine and Dentistry at the U of A where she is pursuing her master’s degree. She is most grateful to the committee for extending the invitation to speak at this conference.

Lisa Fernandes Lisa Fernandes, RN, BScN, earned her Baccalaureate Degree in Nursing from the University of Toronto and worked at the Hospital for Sick Children on the Infectious Disease unit. She later worked as a Public Health Nurse at Peel Public Health in both the Family and Communicable Disease divisions. Lisa is currently the supervisor of the TB Prevention and Health Promotion team in the Communicable Disease Control Program at Peel Public Health.

Sergio Borgia Dr. Sergio Borgia, M.Sc., M.D., FRCP(C) is an Infectious Diseases and Infection Prevention & Control consultant at William Osler Health Centre in Brampton and Etobicoke, Ontario. He earned his Bachelor of Science in Microbiology from the University of Toronto and became interested in microbial research working on Helicobacter pylori in the laboratory of Dr. Clifford Lingwood at Toronto’s Hospital for Sick Children. He completed his graduate work in Medical Genetics & Microbiology under Dr. Joyce de Azavedo and Dr. Donald Low in Streptococcal Genetics at Mount

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Sheryll Gordon Sheryll Gordon has been with Peel Public Health for 10 years. She joined the TB program in 2007 and is one of four Health Outreach Workers in the program. Sheryll holds a Baccalaureate degree from York University and a Social Service Worker Post-Graduate diploma from Sheridan College.

Fran Jamieson

Ian Kitai

Dr. Jamieson obtained her MD from the University of Toronto in 1984. She trained in anatomic pathology and medical microbiology at the University of Toronto, and received her Fellowship from the Royal College of Physicians and Surgeons in Medical Microbiology in 1991. Dr. Jamieson was a Federal Field Epidemiologist and Staff Medical Microbiologist at the Hospital for Sick Children prior to joining the Public Health Laboratories in 1996, then with the Ministry of Health and Long-Term Care, and since 2008 as part of Public Health Ontario. Dr. Jamieson is the Associate Medical Director for the Public Health Ontario Laboratories. She holds an appointment as Associate Professor, Dept. of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, and as assistant scientific staff, Dept. of Microbiology, Mount Sinai Hospital. Her primary areas of interest include tuberculosis and mycobacterial diseases, meningococcal disease, molecular surveillance of pathogens of public health importance, and public health policy.

Dr. Ian Kitai trained in medicine in South Africa, and in Paediatrics and Infectious Diseases in the UK and Toronto. He worked in rural Zimbabwe for 3 years for the aid organisation Oxfam and later at the medical school there. Since 1999 he has been the Tuberculosis specialist at Sickkids, has worked in infection control at Rouge Valley Health System, and has a consulting practice in pediatrics and infectious diseases in Ajax, Ontario. He is the principal author of the pediatric chapter of the Canadian TB Standards and of several publications related to paediatric TB in Canada. He is an Associate Professor in the Department of Pediatrics at the University of Toronto.

John Jereb Dr. Jereb is a graduate of Cornell University, where he obtained his B.A. and M.D. degrees. He trained in pediatrics at the University of Southern California-Los Angeles County Medical Center, and he is a Fellow, American Academy of Pediatrics. After completing residency, he served in the U.S. Indian Health Service as a primary care provider at the Rosebud Hospital, South Dakota, 1986--1990. From there, he entered the Epidemic Intelligence Service at the U.S. Centers for Disease Control and Prevention, and in 1992, he joined the CDC Division of Tuberculosis Elimination as a medical officer. In that Division, he has worked in surveillance, outbreak investigations, and clinical research. Currently, he focuses on public health program management, medical training and consultation, and epidemiology. He has participated in the development of 12 national guideline publications.

Kamran Khan Dr. Khan is a physician and scientist with the Division of Infectious Diseases at St. Michael’s Hospital and an Associate Professor of Medicine at the University of Toronto. His research focuses on the relationship between human migration and travel and the globalization of infectious diseases. Dr. Khan has a particular interest in tuberculosis - both as a clinician and a scientist - and has recently completed a decade long study evaluating the medical surveillance program for TB in Ontario.

Michael Ko Dr. Ko is currently Associate Professor of Surgery, Division of Thoracic Surgery at St. Joseph’s Hospital in Toronto. He completed his Bachelor of Science (Hon biochem) degree at McMaster University in 1996, Medical School at the University of Western Ontario in 2000, and General Surgery in 2002. He then took a hiatus from residency to complete the Clinician Investigator program at the University of Toronto, and he completed a PhD in cancer genetics and molecular biology under the supervision of Carol Swallow at Mt. Sinai Hospital in Toronto. He completed General Surgery in 2008 and Thoracic residency in 2010 at the University of Toronto. Dr. Ko has won numerous awards in the fields of surgery and teaching, and has published widely in multiple peer reviewed publications including those in Nature Genetics, PNAS, Oncogene and Annals of Thoracic Surgery. He has also presented many research papers in Canada and the US.

Richard Long Dr. Richard Long is a clinician-scientist at the University of Alberta. His research training was in models of acute lung injury at the University of Manitoba and University of Chicago. In 1984, while working at the Hôpital Albert Schweitzer in Haiti, he developed a special interest in tuberculosis (TB). In January 1998, he was recruited to the University of Alberta from the University of Manitoba, to be the Medical Officer of Health for TB in Alberta. He is now a Professor in the Department of Medicine at the University of Alberta and a TB Consultant to Alberta Health Services, Alberta; First Nations and Inuit Health Branch, Prairie Regional Officers and Headquarters. He directs the TB Program Evaluation and Research Unit at the University of Alberta (http://tbper.med.ualberta.ca/ ).

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Speakers’ Biographies Nicola Mercer

Kash Ramchandani

Dr. Nicola Mercer has been the Medical Officer of Health and CEO at Wellington-Dufferin-Guelph Public Health since July 2007.

Kash Ramchandani was educated in Singapore, India and England. He has been a Chartered Accountant in both England and Canada since 1969, but has not practiced as a CA since entering the health care field in 1973. Mr. Ramchandani has been in long-term care and the retirement home field since 1973, when he purchased a nursing home in rural Ontario in the small town of Palmerston. He has been the Owner/Administrator of Royal Terrace for thirty-nine years in Palmerston, and still is today.

She graduated from the University of Toronto in medicine in 1987 and became a Fellow of the Royal College of Physicians and Surgeons in 1992. In 1999, she completed a Master of Business Administration degree from Wilfrid Laurier University. In 2010, she graduated from the University of Waterloo with a Masters of Public Health. Prior to her employment at Wellington-Dufferin-Guelph Public Health, Dr. Mercer had hospital privileges at 5 hospitals including the Guelph General Hospital for 15 years, practicing Intensive Care Medicine and Anesthesiology. She has been the Chief of the Department of Anesthesiology, an Examiner for the Royal College of Physicians and Surgeons of Canada and involved in the Ontario Medical Association. She is currently the president of the Wellington County Medical Association.

Jody Paget Jody Paget, BA, BScN, RN, is a Public Health Nurse on the Infectious Disease Control Team at the Middlesex-London Health Unit. Currently, she is responsible for the Latent TB program including the coordination of the health unit based TB clinics. Jody graduated from the University of Western Ontario with a Bachelor of Science in Nursing and a Bachelor of Arts in Psychology. She has worked in public health for thirteen years with experience in vaccine preventable diseases, infection control, outbreak management, and communicable disease follow-up.

Anne Raina Anne Raina is the youngest of ten children, seven of whom contracted tuberculosis.  Anne’s father and her eldest and youngest brothers died of the disease. Anne worked for many years in the public and not-for-profit sectors. She was a senior executive with a national disability organization when struck with a disabling autoimmune disorder herself. She has been writing poetry, skits and short stories for friends and family since she was a child and she has two children’s books in the works. Although she has been published in magazines and newspapers, Clara’s Rib was her first adventure in publishing a book.  Anne has been gratified and humbled by the overwhelming response to Clara’s story across the country.

Elizabeth Rea Dr. Elizabeth Rea is an Associate Medical Officer of Health at Toronto Public Health, where she has worked primarily with the Tuberculosis program since 2005. She is originally from Manitoba, where she did her medical degree. She worked in general practice before completing her residency in Public Health and Preventive Medicine and an MSc in Epidemiology at the University of Toronto. She is a Fellow of the Royal College in Public Health and Preventive Medicine, and an associate professor at the University of Toronto, where she teaches communicable disease epidemiology at the Dalla Lana School of Public Health as well as undergraduate and post-grad teaching in the Faculty of Medicine. She has worked in public health for 17 years, mainly in communicable disease control and epidemiology, and in public health ethics. She has been involved in TB policy at the national level for several years; her research interests include TB epidemiology and operational research in TB control.

David Rochkind David Rochkind is based in Port-au-Prince, Haiti. David grew up outside of Detroit, Michigan and studied sociology at the University of Michigan. He then moved to Caracas, Venezuela in 2003, where he began to work as a freelance photographer. While covering the entire region, his work appeared in newspapers and magazines, including The New York Times Magazine, Time, Newsweek, Stern, Rolling Stone, Le Monde Magazine and others.  David has also worked for a variety of NGOs and development organizations, including CARE, The Carter Center, UNHCR and the World Health Organization. In 2008, he moved to Mexico City where he began working on the book Heavy Hand, Sunken Spirit, which examines the long-term costs and consequences of the country’s drug war (Dewi Lewis Publishing, October 2012).  For the past 4 years he has worked on a project about the global TB epidemic and recently developed the work into an educational website and curriculum for high schools, that teaches about TB and public health in the developing world (www.tbepidemic.org). His work has been recognized by numerous organizations. He was named as one of PDN’s “30 New and Emerging Photographers to Watch”, and has won awards from the National Press Photographers Association, The Pulitzer Center on Crisis Reporting, the World Health Organization, the Magenta Foundation and others.

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Theresa Samarita

Wendy Wobeser

Theresa Samarita, RN, BScN, graduated from the University of Toronto. She is the DOT Supervisor for the South West Region at Toronto Public Health’s TB Prevention and Control program.  She has 18 years of case management experience and describes herself as someone who “grew up” in the TB program.  Her early work focused on case management and contact follow up for the homeless/underhoused clients and those who work with them. She is currently the lead supervisor for the TB DOT database and VDOT.

Dr. Wendy Wobeser is Associate Professor of Medicine in the Department of Medicine at Queen’s University, with cross appointment to the Department of Biomedical and Molecular Sciences. She is a specialist in Internal Medicine, with a sub-specialty in the field of Infectious Diseases. Dr. Wobeser has made important contributions to tuberculosis control provincially with particular focus on prevention of tuberculosis in persons migrating to Canada and to the optimization of treatment outcome amongst persons with active infectious pulmonary tuberculosis. More recently, she has made a significant contribution to our understanding of the historical tuberculosis dissemination amongst First Nations populations across the country. Her current focus in the field of TB is in the area of Corrections. She is a graduate of the University of Saskatchewan College of Medicine, and holds an M.Sc. in Epidemiology from the University of Toronto.

Jill Seara Jill Seara, Hon. BSc, BScN, RN, is a Public Health Nurse at the Middlesex-London Health Unit. She graduated from the University of Western Ontario in 2003 with an Honours Bachelor of Science in biology and obtained her Bachelor of Science in Nursing in 2008. Since beginning her nursing career, she has worked primarily in communicable and vaccine preventable diseases and has also been a clinical instructor at the University of Western Ontario. Currently, she works on the Infectious Disease Control Team, where she is responsible for the Immigration Medical Surveillance and Latent TB programs.

Adrian Sebastian Adrian Sebastian, RN, BScN, is a Manager for Toronto Public Health’s TB Prevention and Control program. He has been with Toronto Public Health since 2005. Adrian has a Bachelors of Science in Nursing from Ryerson University (2001) and course certificates for emergency nursing (George Brown College) and Infection Control (Centennial College).  

Tom Wong Dr. Thomas Wong, MD, MPH, FRCPC is the Director of Professional Guidelines and Public Health Practice Division, Centre for Communicable Diseases & Infection Control at the Public Health Agency of Canada. He was trained in family medicine, internal medicine, infectious diseases and public health at McGill, Harvard and Columbia. His scientific interests focus on HIV, sexually transmitted infections, hepatitis C, tuberculosis and other infectious diseases, especially among underserved populations. Dr. Wong has academic appointments at both the University of Ottawa and the University of Toronto. He is the Chair of the Expert Working Group on Canadian Guidelines for Sexually Transmitted Infections, Editor-in-Chief of the Canadian Guidelines on Sexually Transmitted Infections and Associate Editor of the Canadian TB Standards.

Jerry Jean Stambaugh Dr. Jerry Jean Stambaugh is licensed in pharmacy in the states of Florida and Alabama, and was formerly the Clinical Pharmacist and Pharmacy Manager at A. G. Holley State Hospital in Florida until its closure this past summer. She is currently affiliated with the Southeastern National TB Center in Florida, is a Clinical Associate Professor at the University of Florida College of Pharmacy and a Clinical Assistant Professor at Southeastern College of Pharmacy, as well as serving as a consultant to and member of numerous programs, colleges and associations. Dr. Stambaugh has received several distinguished awards in the pharmaceutical and drug and alcohol abuse fields, and has authored, participated in, and published many research papers on tuberculosis, HIV and drugs. Her interests also extend to music where she was the Principal Bass Clarinet for the Symphonic Band of the Palm Beaches, and served on their Board of Directors.

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Poster Descriptions 1. Tuberculosis in the First Nations and Métis People of the Canadian Prairies: Epidemiology and Geographic Distribution Richard Long , Vernon Hoeppner , Pamela Orr , Martha Ainslie , Malcolm King1, Sylvia Abonyi4, Maria Mayan5, Dennis Kunimoto1, Deanne Langlosi-Klassen1, Courtney Heffernan1, Angela Lau1 and Dick Menzies6. 1Department of Medicine, University of Alberta, Edmonton, Alberta, 2Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, 3Department of Medicine, University of Manitoba, Winnipeg, Manitoba, 4Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, 5 Faculty of Extension, University of Alberta, Edmonton, Alberta, 6 Department of Medicine, McGill University, Montreal, Quebec. 1

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The marked disparity of TB in Aboriginal peoples of the Prairie Provinces as compared to the Canadian-born “other” population; focality of TB disease presents both concern and opportunity.

2. Tuberculosis Education for Aboriginal and Non-Aboriginal Youth Heffernan C, MA1, McMullin K, Med2 and, Long R, MD1 . 1Tuberculosis Program Evaluation and Research Unit, University of Alberta, Alberta, Canada, 2Saskatchewan Population Health and Evaluation Research Unit, University of Saskatchewan, Saskatchewan, Canada

Tuberculosis (TB) Education for Aboriginal and non-Aboriginal youth in the Prairies; a resource guide for high school teachers.

3. Supporting a 12-dose Regimen for Treatment of Latent TB Cathy Martin RN, BScN, Niagara Region Public Health, Infectious Disease Team, TB Infection and Control

CDC’s new 12-dose regimen for latent tuberculosis, how this was achieved for a resident in Niagara Region.

4. Knowledge Exchange: iPHIS Provides a Secure e-Platform for Nursing Documentation Sandra Romagnoli, Niagara Region Public Health

Nursing documentation of care must meet the College of Nurses Documentation Standard (2008). This poster will demonstrate that the NOTES iPHIS modality meets this standard and can facilitate knowledge transfer when providing case management in a shared situation.

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5. Ideas in Action: Toronto Public Health’s Homeless Team’s Influence on TB Control Alexandra Bain, Julie Seemangal, Dr. Jane Batt (St Michael’s Hospital), Dr. Elizabeth Rea, Rebecca Stuart, Jennifer Fuller, Sheila Scott (Toronto Public Health)

TB management in Toronto’s homeless/under housed population is time and resource intensive due to the transience, instability, and numerous co-morbidities of this population. In 2005, Toronto Public Health developed a new initiative in the form of a dedicated Homeless Team to facilitate stronger TB management and control in this population. This poster summarizes the success of this initiative.

6. Online Tuberculosis Training for Canadian Physicians and Nurses: A Success Story Andrea Coady1, RN; Jocelyne Courtemanche1, RN; Victor Gallant2, MA; Cathy Latham-Carmanico2, RN; Janet Nevala2, RN. 1Health Canada; 2 Public Health Agency of Canada

The purpose of this poster is to highlight the success of the complementary self-directed TB learning modules for physicians, nurses and other health care professionals whose development was led by Health Canada and the Public Health Agency of Canada. It will also highlight next steps with respect to assessing the TB training needs of community health workers working with Aboriginal populations in Canada for the purpose of informing future development of TB and other infectious disease training and education for these workers based on the needs identified.

7. Understanding Liberty and Harm: The Case of Tuberculosis in Persons with Severe and Persistent Mental Illnesses      Diego S. Silva, Dalla Lana School of Public Health & Joint Centre for Bioethics, University of Toronto    

Despite having the responsibility to limit a patient’s liberty for the public’s health, little is known about how healthcare workers in TB units conceptualize liberty and harm. This poster presents the findings of a mixed methods study related to the case of treating TB in persons with severe and persistent mental illnesses in order to begin to understand healthcare workers’ views on liberty and harm.

8. Care After Death: A Practice Report Sharon Stewart, MSW, RSW, West Park Healthcare Centre

A Practice Report describing care after death for TB Service patients, their families/community, fellow patients and TB Service staff at West Park Healthcare Centre.

9. A Descriptive Analysis of Tuberculosis in Ontario, 2007 to 2011 Lee B, Whelan M, Bateman T, Guthrie J & Jamieson F, Public Health Ontario

We describe the epidemiology of TB in Ontario using routinely collected surveillance data. Ontario has a low incidence rate of TB, with foreign-born cases representing the largest proportion of TB cases. Ontario’s reported incidence of TB has remained stable, but continued education of high risk populations on different aspects of TB; identification and appropriate treatment for those with TB remains a priority.

10. Drug Resistance in Canada - 1998-2011: 14 Year Retrospective Review of the Canadian Tuberculosis Laboratory Surveillance System

11. Multi-Drug Resistant Tuberculosis: Management of A Patient Journey May Griffiths-Turner, Anne Bialachowski, St. Joseph’s Healthcare Hamilton

A multidisciplinary team approach to advance planning of a patient journey from admission through to discharge of a patient with multi-drug resistant tuberculosis, while providing safe, empathic patient care and minimizing risks for healthcare workers.

12. TB Contact Tracing Protocols for Homeless Individuals: Management & Surveillance Outcomes Alexandra Bain, Julie Seemangal, Dr. Jane Batt, St. Michael’s Hospital

TB contact tracing in the homeless population is complex, and is best achieved through a combination of extensive case management skills and collaboration with community partners. St. Michael’s TB program developed targeted clinical and process protocols to standardize care and improve service delivery for 41 high risk shelter contacts that were assessed in 2011-2012.

Victor Gallant (PHAC), Jessica Halverson (PHAC)

The Canadian Tuberculosis Laboratory Surveillance System (CTBLSS) monitors anti-tuberculosis drug resistance across Canada. A 14-year (1998 – 2011) retrospective review shows that drug-resistance in Canada remains low compared to global rates, and remained relatively unchanged during the time period. Increased routine reporting of SLD DST results has improved the ability of the CTBLSS to monitor the emergence of highly drug-resistant strains of TB.

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Leaders in Lung Health The Ontario Lung Association has many different ways in which we can help individuals, families and caregivers. Our products and services are free of charge to Ontario residents and only a phone call or click away. Our certified respiratory educators are here to help you breathe easier. Through our Societies for health professionals, the Ontario Respiratory Care Society and the Ontario Thoracic Society, we provide professional education programs, research funding and resources to support The Lung Association’s Vision: To improve lung health.

1-888-344-LUNG (5864) www.on.lung.ca Asthma Chronic Obstructive Pulmonary Disease (COPD) Healthy Air Tobacco Control Tuberculosis Research

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