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Reported patterns of TB drug resistance in Canada

Tuberculosis drug resistance is monitored by the Public Health Agency of Canada through two systems:

  1. Canadian Tuberculosis Reporting System for reporting both new and re-treatment (known as relapsed prior to 2008) TB cases.  The following tables are based on these case reports.
  2. Canadian Tuberculosis Laboratory Surveillance System for reporting drug resistance among Mycobacterium tuberculosis isolates tested for antibiotic susceptibility.  For these data, please see <http://www.publichealth.gc.ca/tuberculosis> for annual Tuberculosis Drug Resistance in Canada reports.
Table 1 - Patterns of Susceptibility and Resistance to Isoniazid (INH) and Rifampin (RMP) in the Initial Positive Culture from TB Cases by Disease Type and Patient's Country of Birth, Canada, 2003 - 2007*

* Based on the Canadian Tuberculosis Reporting System of TB cases, Public Health Agency of Canada.

As of 2008 in Canada, the term "relapse" was replaced with the term "re-treatment" case (see Canadian Tuberculosis Standards, 6th ed., http://www.phac-aspc.gc.ca/tbpc-latb/index-eng.php, Appendix C for definitions).

Totals may not always equal 100 due to rounding.

Resistance Pattern Disease Type Country of Birth Total
Canadian-born Foreign-born Unknown
Cases (%) Cases (%) Cases (%) Cases (%)
Susceptible to INH and RMP NEW ACTIVE 1,584 (84.7) 3,458 (80.2) 109 (78.6) 5,151 (81.6)
RELAPSE† 188 (10.1) 203 (4.7) 5 (3.6) 396 (6.3)
UNKNOWN 21 (1.1) 87 (2.0) 9 (6.4) 117 (1.9)
Resistant to INH, susceptible to RMP; with or without resistance
to another drug
NEW ACTIVE 43 (2.3) 317 (7.4) 3 (2.1) 363 (5.8)
RELAPSE 8 (0.4) 26 (0.6) 1 (0.7) 35 (0.6)
UNKNOWN 0 (0.0) 11 (0.3) 3 (2.1) 14 (0.2)
Resistant to RMP, susceptible to INH; with or without resistance
to another drug
NEW ACTIVE 1 (0.1) 6 (0.1) 0 (0.0) 7 (0.1)
RELAPSE 2 (0.1) 2 (0.1) 0 (0.0) 4 (0.1)
UNKNOWN 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)
Resistant to INH and RMP with or without resistance to another drug (MDR-TB) NEW ACTIVE 1 (0.1) 38 (0.9) 0 (0.0) 39 (0.6)
RELAPSE 1 (0.1) 23 (0.5) 0 (0.0) 24 (0.4)
UNKNOWN 1 (0.1) 4 (0.1) 0 (0.0) 5 (0.1)
UNKNOWN NEW ACTIVE 17 (0.9) 116 (2.7) 5 (3.6) 138 (2.2)
RELAPSE 2 (0.1) 7 (0.2) 3 (2.1) 12 (0.2)
UNKNOWN 1 (0.1) 14 (0.3) 1 (0.7) 16 (0.3)
TOTAL   1,870 (100) 4,312 (100) 139 (100) 6,321 (100)

 

 

Table 2 A - Type of TB Drug Resistance By Country of Birth for New Cases in Canada, 2003 - 2007* and Internationally Reported MDR-TB Rates by Country

* Based on the Canadian Tuberculosis Reporting System of TB cases, Public Health Agency of Canada.

The totals for positive cultures will differ between Table 1 and Table 2. Table 2 does not include the data for the 152 cases for whom disease type (new and relapsed) was unknown.

Some laboratories do not routinely report pyrazinamide or streptomycin resistance.

§ Source (unless otherwise indicated): The WHO/IUALTD Global Project on Anti-tuberculosis Drug Resistance Surveillance 2002-2007. Anti-Tuberculosis Drug Resistance in the World: Fourth Global Report (WHO/HTM/TB/2008.394) Geneva: World Health Organization, 2008.

Zignol M, Hosseii MS, Wright A et al. Global incidence of multidrug-resistant tuberculosis. J Infect Dis 2006;194:479-85.

Country of Birth Total No. of Positive Cultures Any Resistance INH Resistant/ RMP Sensitive MDR-TB Internationally Reported MDR-TB Rates by Country, (%) §
Cases (%) Cases (%) Cases (%)
Total 5,698 482 (8.5) 363 (6.4) 39 (0.7) -
Afghanistan 65 9 (13.8) 8 (12.3) 1 (1.5) 3.4
Albania 3 0 0 0 1.5
Algeria 12 0 0 0 1.2
Andorra 0 0 0 0 0
Angola 7 1 (14.7) 1 (14.3) 0 2
Antigua & Barbuda 0 0 0 0 1.3
Argentina 3 0 0 0 2.2
Armenia 0 0 0 0 9.4
Australia 1 0 0 0 0.8 ║
Austria 1 0 0 0 1.9
Azerbaijan 1 0 0 0 22.3
Bahamas 0 0 0 0 1.2
Bahrain 0 0 0 0 2.2
Bangladesh 55 6 (10.9) 3 (5.5) 1 (1.8) 3.6
Belarus 0 0 0 0 11.6
Belgium 1 0 0 0 1.2
Belize 0 0 0 0 1.5
Benin 0 0 0 0 0.3
Bhutan 1 0 0 0 3.2
Bolivia 2 0 0 0 1.2
Bosnia & Herzegovina 7 0 0 0 0.4
Botswana 2 0 0 0 0.8
Brazil 3 1 (33.3) 1 (33.3) 0 0.9
Brunei Darussalam 3 0 0 0 2.3
Bulgaria 1 0 0 0 10.7
Burkina Faso 2 0 0 0 2.1
Burundi 17 1 (5.9) 1 (5.9) 0 2.4
Cambodia 44 7 (15.9) 5 (11.4) 1 (2.3) 0
Cameroon 10 0 0 0 1.7
Canada 1,646 73 (4.4) 43 (2.6) 1 (0.1) 0.8
Cape Verde 0 0 0 0 1.6
Central African Republic 1 0 0 0 1.1
Chad 6 1 (16.7) 1 (16.7) 0 2
Chile 6 0 0 0 0.7
China 484 51 (10.5) 38 (7.9) 9 (1.9) 5
China Hong Kong SAR 132 5 (3.8) 4 (3.0) 0 0.9
China Macao SAR 3 0 0 0 2.3
Colombia 21 21 (4.8) 1 (4.8) 0 1.5
Comoros 0 0 0 0 1.8
Congo 49 6 (12.2) 6 (12.2) 0 1.7
Costa Rica 5 0 0 0 1.5
Côte d’Ivoire 4 0 0 0 2.5
Croatia 5 0 0 0 0.5
Cuba 1 0 0 0 0
Cyprus 0 0 0 0 1.1
Czech Republic 3 0 0 0 1.2
Denmark 0 0 0 0 1.6
Djibouti 5 0 0 0 3.3
Dominica 0 0 0 0 1.5
Dominican Republic 5 1 (20.0) 1 (20.0) 0 6.6
DPR Korea 7 1 (14.3) 1 (14.3) 0 3.7
DR Congo 9 1 (11.1) 1 (11.1) 0 2.4
Ecuador 0 0 0 0 4.9
Egypt 5 0 0 0 2.2
El Salvador 12 2 (16.7) 1 (8.3) 0 0.3
Eritrea 26 2 (7.7) 2 (7.7) 0 2.3
Estonia 1 0 0 0 13.3
Ethiopia 110 13 (11.8) 10 (9.1) 1 (0.9) 1.6
Ethiopia (former) 7 0 0 0 -
Fiji 6 0 0 0 1.4║
Finland 1 0 0 0 1
France 15 2 (13.3) 2 (13.3) 0 1.1
French Polynesia 0 0 0 0 2.1
Gabon 1 0 0 0 1.4
Gambia 3 0 0 0 0.5
Georgia 0 0 0 0 6.8
Germany 11 0 0 0 1.8
Ghana 5 1 (20.0) 1 (20.5) 0 1.9
Greece 10 0 0 0 1.1
Grenada 1 0 0 0 -
Guatemala 3 0 0 0 3
Guinea 4 1 (25.5) 1 (25.5) 0 0.6
Guinea-Bissau 1 0 0 0 2.3
Guyana 19 0 0 0 1.7
Haiti 108 12 (11.1) 12 (11.1) 0 1.9
Honduras 3 0 0 0 1.8
Hungary 4 0 0 0 1.3
Iceland 0 0 0 0 0
India 663 50 (7.5) 43 (6.5) 0 2.8
Indonesia 19 4 (21.1) 4 (21.1) 0 2
Iran 19 1 (5.3) 1 (5.3) 0 5
Iraq 5 0 0 0 3
Ireland 3 0 0 0 0.5
Israel 1 0 0 0 5.7
Italy 31 1 (3.2) 1 (3.2) 0 1.6
Jamaica 15 0 0 0 1.4
Japan 7 0 0 0 0.7
Jordan 0 0 0 0 5.4
Kazakhstan 2 0 0 0 14.2
Kenya 37 0 0 0 0
Kiribati 0 0 0 0 3.2
Kuwait 1 0 0 0 1.9
Kyrgyzstan 0 0 0 0 14.7
Lao PDR 7 0 0 0 3.7
Latvia 1 0 0 0 10.8
Lebanon 8 1 (12.5) 1 (12.5) 0 1.1
Liberia 5 0 0 0 -
Lesotho 0 0 0 0 0.9
Libyan Arab Jamahiriya 0 0 0 0 2.6
Lithuania 0 0 0 0 9.8
Luxembourg 0 0 0 0 0
Madagascar 6 0 0 0 0.5
Malawi 1 0 0 0 2.4
Malaysia 4 0 0 0 0.1
Maldives 3 1 (33.3) 1 (33.3) 0 2.9
Mali 1 0 0 0 2
Malta 0 0 0 0 0
Marshall Islands 0 0 0 0 2.9
Mauritius 0 0 0 0 1.3
Mexico 17 5 (29.4) 2 (11.8) 0 2.4
Micronesia 0 0 0 0 3
Mongolia 0 0 0 0 1
Morocco 25 0 2 (8.0) 1 (4.0) 0.5
Mozambique 1 0 0 0 3.5
Myanmar 23 1 (4.3) 1 (4.3) 0 4
Namibia 0 0 0 0 1.5
Nepal 16 2 (12.5) 1 (6.25) 1 (6.25) 2.9
Netherlands 6 3 (50.0) 1 (16.7) 0 0.7
New Zealand 0 0 0 0 0.4
Nicaragua 4 0 0 0 0.6
Niger 2 0 0 0 2.2
Nigeria 22 3 (13.6) 1 (4.5) 1 (4.5) 1.9
Norway 1 0 0 0 1.6
Oman 0 0 0 0 1.3
Pakistan 138 15 (10.9) 13 (9.4) 0 3.4
Palau 0 0 0 0 2.4
Panama 1 0 0 0 1.4
Papua New Guinea 0 0 0 0 3.6
Paraguay 1 0 0 0 2.1
Peru 23 3 (13.0) 0 1 (4.3) 5.3
Philippines 502 79 (15.7) 65 (12.9) 10 (2.0) 4
Poland 28 3 (10.7) 1 (3.6) 0 0.3
Portugal 24 1 (4.2) 1 (4.2) 0 0.9
Rep Korea 80 7 (8.8) 7 (8.8) 0 2.7
Republic of Moldova 0 0 0 0 19.4
Romania 24 0 0 0 2.8
Russian Federation 20 5 (25.0) 3 (15.0) 2 (10.0) 13
Rwanda 8 1 (12.5) 1 (12.5) 0 3.9
Saint Lucia 0 0 0 0 1.5
Samoa 0 0 0 0 3
Saudi Arabia 2 1 (50.0) 1 (50.0) 0 2.2
Senegal 5 0 0 0 2.1
Serbia 3 0 0 0 0.4
Seychelles 0 0 0 0 1.3
Sierra Leone 13 1 (7.7) 1 (7.7) 0 0.9
Singapore 1 0 0 0 0.2
Slovakia 0 0 0 0 1.6
Slovenia 1 0 0 0 0
Somalia 92 19 (17.4) 12 (13.0) 1 (1.1) 1.8
South Africa 16 3 (18.8) 1 (6.3) 1 (6.3) 1.8
Spain 4 0 0 0 0.1
Sri Lanka 92 5 (5.4) 2 (2.2) 0 0.2
St Vincent Grenadines 1 0 0 0 1.7
Sudan 47 6 (12.8) 2 (4.3) 1 (2.1) 1.9
Swaziland 1 0 0 0 0.9
Sweden 1 0 0 0 0.5
Switzerland 0 0 0 0 0.6
Syrian Arab Republic 4 0 0 0 3.1
Tajikistan 1 0 0 0 16
TFYR Macedonia 1 0 0 0 1.6
Thailand 11 1 (9.1) 1 (9.1) 0 1.7
Timor-Leste 0 0 0 0 3.4
Togo 1 0 0 0 2
Tonga 0 0 0 0 3.1
Trinidad and Tobago 2 0 0 0 -
Tunisia 1 0 0 0 2.7
Turkey 9 2 (22.2) 2 (22.2) 0 1.4
Turkmenistan 2 0 0 0 3.8
Uganda 7 1 (14.3) 1 (14.3) 0 0.5
Ukraine 21 1 (14.3) 1 (4.8) 2 (9.5) 16
United Arab Emirates 1 0 0 0 2.3
United Kingdom 21 1 (4.8) 0 0 0.7
United States of America 18 0 0 0 1.1║
UR Tanzania 7 1 (14.3) 1 (14.3) 0 1.1
Uruguay 0 0 0 0 0
Uzbekistan 1 0 0 0 14.8
Venezuela 0 0 0 0 0.5
Viet Nam 297 43 (14.5) 36 (12.1) 4 (1.3) 2.7
West Bank and Gaza Strip 0 0 0 0 3.1
Yemen 3 0 0 0 2.9
Yugoslavia 16 1 (6.3) 1 (6.3) 0 -
Zambia 4 0 0 0 1.8
Zimbabwe 17 2 (11.8) 1 (11.8) 0 1.9
Unknown 180 5 (2.8) 5 (2.3) 0 -

 

 

Table 2 B - Type of TB Drug Resistance By Country of Birth for Relapsed* Cases in Canada, 2003 - 2007† , and Internationally Reported MDR-TB Rates by Country

* As of 2008 in Canada, the term "relapse" was replaced with the term "re-treatment" case (see Canadian Tuberculosis Standards, 6th ed., http://www.phac-aspc.gc.ca/tbpc-latb/index-eng.php, Appendix C for definitions).

Based on the Canadian Tuberculosis Reporting System of TB cases, Public Health Agency of Canada.

The totals for positive cultures will differ between Table 1 and Table 2. Table 2 does not include the data for the 152 cases for whom disease type (new, relapsed) was unknown.

§ Some laboratories do not routinely report pyrazinamide or streptomycin resistance.

Source (unless otherwise indicated): The WHO/IUALTD Global Project on Anti-tuberculosis Drug Resistance Surveillance 2002-2007. Anti-Tuberculosis Drug Resistance in the World: Fourth Global Report (WHO/HTM/TB/2008.394) Geneva: World Health Organization, 2008.

** Zignol M, Hosseii MS, Wright A et al. Global incidence of multidrug-resistant tuberculosis. J Infect Dis 2006;194:479-85.

Country of Birth Total No. of Positive Cultures‡  Any Resistance§  INH Resistant/ RMP Sensitive MDR-TB Internationally Reported MDR-TB Rates by Country ( %) ║
Cases (%) Cases (%) Cases (%)
Total 471 65 (13.8) 35 (7.4) 26 (5.5) -
Afghanistan 8  3 (37.5) 1 (12.5) 2 (25.0) 37.0
Albania 0 0 0 0 10.3
Algeria 0 0 0 0 9.8
Andorra 0 0 0 0 10.4
Angola 0 0 0 0 13.5
Antigua & Barbuda 0 0 0 0 10.6
Argentina 0 0 0 0 15.4
Armenia 0 0 0 0 43.2
Australia 0 0 0 0 8.6**
Austria 0 0 0 0 12.5
Azerbaijan 0 0 0 0 55.8
Bahamas 0 0 0 0 9.4
Bahrain 0 0 0 0 36.5
Bangladesh 2 0 0 0 19.3
Belarus 0 0 0 0 40.2
Belgium 0 0 0 0 7.3
Belize 0 0 0 0 9.8
Benin 0 0 0 0 9.2
Bhutan 0 0 0 0 19.9
Bolivia 0 0 0 0 4.7
Bosnia and Herzegovina 2 1 (50.0) 1 (50.0) 1 (50.0) 6.6
Botswana 1 0 0 0 10.4
Brazil 0 0 0 0 5.4
Brunei Darussalam 0 0 0 0 19.5
Bulgaria 0 0 0 0 37.8
Burkina Faso 0 0 0 0 9.6
Burundi 2 1 (50.0) 0 1 (50.0) 9.0
Cambodia 1 1 (100.0) 0 1 (100.0) 3.1
Cameroon 0 0 0 0 8.5
Canada 201 12 (6.0) 8 (4.0) 1 (0.5) 7.5
Cape Verde 0 0 0 0 10.2
Central African Republic 0 0 0 0 18.2
Chad 0 0 0 0 9.6
Chile 1 0 0 0 3.8
China 49 11 (22.4) 7 (14.3) 4 (8.2) 25.6
China Macao SAR 1 0 0 0 15.8
Colombia 0 0 0 0 9.7
Comoros 0 0 0 0 10.1
Congo (Democratic Rep) 0 0 0 0 9.1
Congo (Republic) 3 1 (33.3) 0 1 (33.3) 8.8
Costa Rica 1 0 0 0 4.8
Cote D'Ivoire 0 0 0 0 8.6
Croatia 0 0 0 0 4.9
Cuba 0 0 0 0 5.3
Cyprus 0 0 0 0 9.6
Czech Republic 1 0 0 0 30.0
Denmark 1 0 0 0 0.0
Djibouti 0 0 0 0 35.4
Dominica 0 0 0 0 10.6
Dominican Republic 0 0 0 0 19.7
Ecuador 0 0 0 0 24.3
Egypt 0 0 0 0 38.2
El Salvador 0 0 0 0 7.0
Eritrea 0 0 0 0 9.7
Estonia 0 0 0 0 52.1
Ethiopia 4 1 (25.0) 1 (25.0) 1 (25.0) 11.8
Ethiopia (former) 3 1 (33.3) 0 0 -
Fiji 0 0 0 0 14.3**
Finland 1 0 0 0 4.5
France 1 0 0 0 7.1
French Polynesia 0 0 0 0 18.8
Gabon 0 0 0 0 8.2
Gambia 0 0 0 0 0.0
Georgia 0 0 0 0 27.4
Germany 0 0 0 0 12.4
Ghana 0 0 0 0 9.2
Greece 0 0 0 0 10.3
Guatemala 0 0 0 0 26.5
Guinea 1 0 0 0 28.1
Guinea-Bissau 0 0 0 0 9.7
Guyana 2 0 0 0 9.4
Haiti 7 0 0 0 9.0
Honduras 0 0 0 0 12.3
Hong Kong 13 1 (7.7) 0 1 (7.7) 8.0
Hungary 1 0 0 0 11.6
Iceland 0 0 0 0 0.0
India 32 4 (12.5) 3 (9.4) 1 (3.1) 17.2
Indonesia 1 0 0 0 18.9
Iran 0 0 0 0 48.2
Iraq 2 0 0 0 38.0
Ireland 0 0 0 0 10.0
Israel 4 0 0 0 0.0
Italy 0 0 0 0 17.7
Jamaica 0 0 0 0 8.1
Japan 2 0 0 0 9.8
Jordan 0 0 0 0 40.0
Kazakhstan 1 0 0 0 56.4
Kenya 4 0 0 0 0.0
Kiribati 0 0 0 0 18.9
Korea. Democratic Peoples Republic of (North Korea) 0 0 0 0 22.4
Korea. Republic of (South Korea) 14 5 (35.7) 2 (14.3) 3 (21.4) 14.0
Kuwait 0 0 0 0 36.5
Kyrgyzstan 0 0 0 0 40.0
Lao People's Democratic Republic 0 0 0 0 19.4
Latvia 0 0 0 0 36.3
Lebanon 0 0 0 0 62.5
Lesotho 0 0 0 0 5.7
Liberia 1 0 0 0 -
Libyan Arab Jamahiriya 0 0 0 0 38.7
Lithuania 1 0 0 0 47.5
Luxembourg 0 0 0 0 9.8
Madagascar 0 0 0 0 3.9
Malawi 0 0 0 0 5.6
Malaysia 0 0 0 0 0.0
Maldives 0 0 0 0 19.3
Mali 0 0 0 0 9.9
Malta 0 0 0 0 9.8
Marshall Islands 0 0 0 0 21.3
Mauritius 0 0 0 0 9.5
Mexico 0 0 0 0 22.4
Micronesia 0 0 0 0 21.0
Mongolia 0 0 0 0 20.5
Morocco 0 0 0 0 12.2
Mozambique 0 0 0 0 3.3
Myanmar 2 0 0 0 15.5
Namibia 0 0 0 0 7.1
Nepal 1 1 (100.0) 1 (100.0) 0 11.7
Netherlands 1 0 0 0 3.3
New Zealand 0 0 0 0 0.0
Nicaragua 0 0 0 0 7.8
Niger 0 0 0 0 10.2
Nigeria 2 0 0 0 9.3
Norway 0 0 0 0 0.0
Oman 0 0 0 0 35.7
Pakistan 4 1 (25.0) 0 1 (25.0) 36.5
Palau 0 0 0 0 20.3
Panama 0 0 0 0 10.2
Papua New Guinea 0 0 0 0 19.5
Paraguay 0 0 0 0 3.9
Peru 2 0 0 0 23.6
Philippines 33 8 (24.4) 4 (12.1) 4 (12.1) 20.9
Poland 1 0 0 0 8.2
Portugal 1 0 0 0 9.3
Republic of Moldova 0 0 0 0 50.8
Romania 6 1 (16.7) 0 1 (16.7) 11.0
Russian Federation 1 1 (100.0) 0 1 (100.0) 48.6
Rwanda 0 0 0 0 9.4
Saint Lucia 0 0 0 0 11.1
Samoa 0 0 0 0 21.1
Saudi Arabia 0 0 0 0 36.4
Senegal 0 0 0 0 16.7
Serbia 0 0 0 0 4.1
Seychelles 0 0 0 0 11.5
Sierra Leone 0 0 0 0 23.1
Singapore 0 0 0 0 1.0
Slovakia 0 0 0 0 7.1
Slovenia 0 0 0 0 3.6
Somalia 7 2 (28.6) 1 (14.3) 1 (14.3) 9.8
South Africa 0 0 0 0 6.7
Spain 0 0 0 0 4.3
Sri Lanka 2 0 0 0 0.0
St. Vincent and the Grenadines 0 0 0 0 14.7
Sudan 1 1 (100.0) 1 (100.0) 0 9.8
Swaziland 0 0 0 0 9.1
Sweden 0 0 0 0 11.8
Switzerland 0 0 0 0 6.7
Syrian Arab Republic 0 0 0 0 36.8
Tajikistan 0 0 0 0 42.4
Tanzania. United Republic of 0 0 0 0 0.0
TFYR Macedonia 0 0 0 0 11.4
Thailand 0 0 0 0 34.5
Timor-Leste 0 0 0 0 18.8
Togo 0 0 0 0 9.1
Tonga 0 0 0 0 20.3
Trinidad and Tobago 0 0 0 0 -
Tunisia 0 0 0 0 36.1
Turkey 1 0 0 0 10.6
Turkmenistan 0 0 0 0 18.4
Uganda 0 0 0 0 4.4
Ukraine 2 0 0 0 44.3
United Arab Emirates 0 0 0 0 36.7
United Kingdom 3 1 (33.3) 1 (33.3) 0 2.6
United States of America 0 0 0 0 5.2**
Unknown 12 2 (16.7) 2 (16.7) 0 -
Uruguay 0 0 0 0 6.1
Uzbekistan 0 0 0 0 60.0
Venezuela 0 0 0 0 13.5
Viet Nam 18 3 (16.7) 1 (5.6) 1 (5.6) 19.3
West Bank and Gaza Strip 0 0 0 0 36.8
Yemen 0 0 0 0 11.3
Yugoslavia 0 0 0 0 -
Zambia 2 0 0 0 2.3
Zimbabwe 0 0 0 0 8.3