Khan, Faiz Ahmad, Greg J. Fox, Robyn S. Lee, Mylene Riva, Andrea Benedetti, Jean-François Proulx, Shelley Jung, Karen Hornby, Marcel A. Behr, and Dick Menzies (2016) Housing and tuberculosis in and Inuit village in Northern Quebec: a case-control study, CMAJ Open 4(3): 496-506

Keywords: crowdingindoor air qualityNunaviktuberculosis

Between November 2011 and November 2012, an Inuit village in Nunavik, Quebec experienced a surge of active tuberculosis (TB). Tests confirmed that in 5.4% of the village’s 933 inhabitants had TB, and 2.0% had clinically probable TB disease. This research focuses on the relation between TB outcomes and housing characteristics.

From February and July 2013, case–control study was conducted with the 695 people who were tested for TB between November 2011 and November 2012. The objectives were to determine whether characteristics of one’s dwelling were associated with 1) acquisition of newly diagnosed TB infection, and 2) progression to confirmed or probable disease among those with TB infection. Trained staff administered questionnaires assessing housing, nutrition, socioeconomic and lifestyle factors. Parents or guardians provided responses for children aged up to 12 years old.

The researchers were unable to identify the factors that the elevated disease rate of TB. They suggest that droplet particles that contained TB could have been more concentrated in homes during social interactions, and the air exchange increased the probability of transmission. It is plausible that exposure intensity is greater in people’s homes compared with other settings, owing to greater duration or closer physical proximity of interactions. The researchers suggest that improved nutrition and less crowding in households may contribute to reducing the risk of TB infection.