Introducing the Sixth Edition of the <i>Canadian Tuberculosis Standards</i>

The sixth edition of the Canadian Tuberculosis Standards will soon be available in hard copy through the offices of the Canadian Lung Association (CLA), and the individual provincial and territorial lung associations, and in PDF format at . Historically, the Standards became important when effective treatment of tuberculosis became available and sanatoria closed. In contrast to the first (1972), second (1981), third (1988) and fourth (1996) editions, which were products of the Canadian Thoracic Society (CTS)/CLA alone, the fifth (2000) and sixth editions of the Standards were jointly produced by the CTS/CLA and Health Canada (fifth), and the Public Health Agency of Canada (PHAC) (sixth). The evolution of the Standards as a document dependent on the CTS for medical and scientific input, and on the PHAC for public health and policy input, was part of a broader shift from nongovernmental to governmental organization of tuberculosis prevention and control activity in Canada. The Tuberculosis Prevention and Control Program of the PHAC is the sponsor of the Canadian Tuberculosis Committee, a national committee with representation from each province and territory, Citizenship and Immigration Canada, First Nations and Inuit Health Branch of Health Canada, Correctional Service Canada, Canadian Public Health Laboratory Network, Association of Medical Microbiology and Infectious Disease, CLA, CTS and PHAC (both the National Microbiology Laboratory and the Tuberculosis Prevention and Control Program). It also houses the Canadian Tuberculosis Surveillance System and the Canadian Tuberculosis Laboratory Surveillance System, as well as represents Canada internationally. The major role of the Tuberculosis Committee of the CTS is now the preparation of the Standards. In fact, the membership of the CTS Tuberculosis Committee and the editorial committee of the Standards are one and the same; the editors of the Standards are the Chair of the CTS Tuberculosis Committee and the Manager of the Tuberculosis Prevention and Control Program of the PHAC. The sixth edition of the Standards is a substantial revision to its predecessor the fifth edition (see below). Chapters or appendixes already in the fifth edition were redacted, and new chapters and appendixes were added (Chapters 14, 15 and 18; Appendixes D, E, F, G, H and J) after a systematic survey of end-user satisfaction with the fifth edition undertaken by the CTS. In addition to the chapter-specific table of contents and expanded bibliographies, the text is populated with a series of Web resources that will be regularly updated by PHAC and other agencies. As in the fifth edition, treatment recommendations are rated using a roman numeral (I, II or III), which indicates the quality of evidence supporting the recommendation (1). The Standards are meant to be a definitive resource on issues pertaining to tuberculosis prevention and control in Canada. In contrast to provincial and territorial guidelines, which describe how an action is to be accomplished and how the structure of care is framed, the Canadian Tuberculosis Standards, like the International Standards for Tuberculosis Care (available at ), provide the foundation on which care can be based, presenting what should be done.

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