Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CANADA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Asthma education and management programs in Canada.

OBJECTIVE: To establish the number and type of asthma patient education programs throughout Canada. DESIGN: National survey. SETTING: Canada. METHODS: Over a three-year period, contact was made with individuals and groups offering educational services for patients with asthma. Education given as part of a physician's consultation or a pharmacist's dispensing of medications for asthma was not considered a patient education program for the purposes of the survey. Contact was initially established by asking staff from well known asthma programs to provide lists of other such programs in their provinces or regions. Asthma programs were also identified from notices presented at Canada's Third and Fourth National Conferences on Asthma and Education. Lung associations, lay organizations and industry representatives affiliated with the Canadian Network for Asthma Care helped to supplement the list. Once identified, each patient education program was contacted by telephone and by mail to complete a 26-item questionnaire about their program. The province of Quebec was not included in the survey because it already had a province-wide, structured asthma education program and register. RESULTS: Seventy-four asthma education and management programs were identified outside Quebec. Staff in these programs were registered nurses (n=46), respiratory therapists (n=48) and other health professionals (n=21). Forty-one programs stated that at least one member of their staff had been trained as an asthma educator. In 71 programs, the initial patient encounter was of at least one hour's duration. Physician referral was required by 41 programs. The province of Quebec has a joint asthma education program provided by 114 asthma education centres throughout the province under the umbrella of the Quebec Asthma Education Network (QAEN). This comprehensive program is provided in hospitals and community centres by specialized educators - nurses, pharmacists or respiratory therapists - to patients referred by their physicians. CONCLUSIONS: A three-year search for asthma education programs in Canada identified 74 patient education programs (outside Quebec) for an asthma population estimated to exceed 1.2 million. For the province of Quebec, an integrated asthma education program is provided through a network of 114 education centres - the QAEN. The present survey shows that there has been progress in establishing asthma education programs in Canada, although there are significant regional differences in the availability of such programs.

Adult↗
PubMed1998

Phenotypic variation in heterozygous familial hypercholesterolemia: a comparison of Chinese patients with the same or similar mutations in the LDL receptor gene in China or Canada.

Familial hypercholesterolemia (FH) is caused by mutations in the LDL receptor (LDLR) gene and is usually associated with hypercholesterolemia, lipid deposition in tissues, and premature coronary artery disease (CAD). However, individuals with heterozygous FH in China exhibit a milder phenotype despite having deleterious mutations in the LDLR gene (X.-M. Sun et al, Arterioscler Thromb. 1994;14:85-94). Nineteen Chinese FH heterozygotes living in Canada were screened for the 11 mutations that had been described in FH patients living in China. One Chinese Canadian carried one of these mutations (Trp462Stop), 2 carried a previously unreported single-base substitution (Cysl63Arg), and 1 carried a mutation observed in French-Canadian patients (Glu207Lys). Twelve additional carriers of these mutations were identified in the families of the index patients. Significantly higher LDL cholesterol concentrations were observed in FH heterozygotes with defined mutations living in Canada (mean+/-SD, 7.46+/-1.29, n=16) than in those living in China (4.35+/-1.09, n=18; P<.0001). Six of the 16 FH heterozygotes residingin Canada had evidence of tendon xanthomata and 4 had a history of premature CAD, whereas none of those in China had tendon xanthomata or CAD. Complete segregation between hypercholesterolemia and inheritance of a mutant allele was observed in 3 Canadian Chinese FH families. Thus, Chinese FH heterozygotes living in Canada exhibit a phenotype similar to that of other FH patients in Western societies. The difference between patients living in Canada and those living in China could be ascribed to differences in dietary fat consumption, showing that environmental factors such as diet play a significant role in modulating the phenotype of heterozygous FH.

Adult↗
PubMedDate not supplied

Prostate cancer incidence and mortality rates and trends in the United States and Canada.

OBJECTIVE: The purpose of this study was to compare prostate cancer incidence and mortality trends between the United States and Canada over a period of approximately 30 years. METHODS: Prostate cancer incident cases were chosen from the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) Program to estimate rates for the United States white males and from the Canadian Cancer Registry for Canadian men. National vital statistics data were used for prostate cancer mortality rates for both countries, and age-adjusted and age-specific incidence and mortality rates were calculated. Joinpoint analysis was used to identify significant changes in trends over time. RESULTS: Canada and the U.S. experienced 3.0% and 2.5% growth in age-adjusted incidence from 1969-90 and 1973-85, respectively. U.S. rates accelerated in the mid- to late 1980s. Similar patterns occurred in Canada with a one-year lag. Annual age-adjusted mortality rates in Canada were increasing 1.4% per year from 1977-93 then fell 2.7% per year from 1993-99. In the U.S., annual age-adjusted mortality rates for white males increased 0.7% from 1969-1987 and 3.0% from 1987-91, then decreased 1.2% and 4.5% during the 1991-94 and 1994-99 periods, respectively. CONCLUSIONS: Recent incidence patterns observed between the U.S. and Canada suggest a strong relationship to prostate-specific antigen (PSA) test use. Clinical trials are required to determine any effects of PSA test use on prostate cancer and overall mortality.

Age Factors↗
PubMed1998

Geriatric psychiatry subspecialization in Canada: past, present, and future.

OBJECTIVE: To describe the development, future challenges, and directions of geriatric psychiatry in Canada. METHOD: This review and description of geriatric psychiatry was developed in the context of the criteria established by the Royal College of Physicians and Surgeons of Canada for subspecialization applications. Information from key informants, both nationally and internationally, was combined with a review of relevant literature in the field. RESULTS AND CONCLUSIONS: Canada has provided important contributions to the field of geriatric psychiatry in Canada and abroad. The increased needs of older persons with severe mental illness and their families, combined with a significant body of knowledge and therapeutic options, provide an important foundation for further development. Subspecialization in geriatric psychiatry as part of the overall development of psychiatry in Canada is proposed as critical to meeting the challenges of our aging population.

Age Distribution↗
PubMed2004

Changing treatment patterns for coronary artery revascularization in Canada: the projected impact of drug eluting stents.

BACKGROUND: To evaluate current treatment patterns for coronary artery revascularization in Canada and explore the potential impact of drug eluting stents (DES) on these treatment patterns. METHODS: Eleven cardiologists at multiple Canadian academic centers completed a questionnaire on coronary artery revascularization rates and treatment patterns. RESULTS: Participating physicians indicated slightly higher rates of PTCA, CABG, and stent implantation than reported in CCN publications. Participants estimated that 24% of all patients currently receiving bare metal stents (BMS) would receive DES in the first year following DES approval in Canada, although there was a large range of estimates around this value (5% to 65%). By the fifth year following DES approval, it was estimated that 85% of BMS patients would instead receive DES. Among diabetic patients, estimates ranged from 43% in the first year following approval to 91% in the fifth year. For all patients currently receiving CABG, mean use of DES instead was estimated at 12% in the first year to 42% at five years; rates among diabetic patients currently undergoing CABG were 17% in the first year to 49% in the fifth year. CONCLUSIONS: These results suggest a continued increase in revascularization procedures in Canada. Based on the panel's responses, it is likely that a trend away from CABG towards PTCA will continue in Canada, and will be augmented by the availability of DES as a treatment option. The availability of DES as a treatment option in Canada may change the threshold at which revascularization procedures are considered.

Adult↗
PubMed2006

Relationship between pharmaceutical company user fees and drug approvals in Canada and Australia: a hypothesis-generating study.

BACKGROUND: Since the early- to mid-1990s, drug companies have paid fees for a variety of activities carried out by the Therapeutic Products Directorate in Canada and the Therapeutic Goods Administration in Australia. OBJECTIVE: To explore whether changes in approval times for new active substances and in the percentage of new drug submissions receiving positive decisions coincided with the level of user fees. METHODS: Data were collected from a range of Canadian and Australian government publications on the following topics: total funding for and workload of the regulatory agencies, the percentage of income that came from tax revenue and user fees, the percentage of new drug submissions that received a positive decision, and-for Canada only-the percent of submissions that were approved on first review. RESULTS: In both countries, there was a moderate-to-strong positive association between the level of industry funding and the percent of submissions that received a positive decision and a moderate-to-strong (Canada) and moderate (Australia) negative association between the level of industry funding and approval times. CONCLUSIONS: Changes observed in both countries are favorable to the pharmaceutical industry. Other than user fees leading to a pro-industry bias in the regulatory authorities, other possible explanations include a more efficient use of resources, a smaller workload (Canada), an improvement in the quality of drug submissions (Canada), and more resources (Australia). Further research strategies are needed to either confirm or refute the hypothesis that the level of industry funding affects decisions made in drug regulatory systems.

Australia↗
PubMed2001

Birds disperse ixodid (Acari: Ixodidae) and Borrelia burgdorferi-infected ticks in Canada.

A total of 152 ixodid ticks (Acari: Ixodidae) consisting of nine species was collected from 82 passerine birds (33 species) in 14 locations in Canada from 1996 to 2000. The Lyme disease spirochete Borrelia burgdorferi Johnson, Schmidt, Hyde, Steigerwaldt & Brenner was cultured from the nymph of a blacklegged tick, Ixodes scapularis Say, that had been removed from a common yellowthroat, Geothlypis trichas L., from Bon Portage Island, Nova Scotia. As a result of bird movement, a nymphal I. scapularis removed from a Swainson's thrush, Catharus ustulatus incanus (Godfrey), at Slave Lake, Alberta, during spring migration becomes the new, most western and northern record of this tick species in Canada. Amblyomma longirostre Koch, Amblyomma sabanerae Stoll, and Ixodes baergi Cooley & Kohls are reported for the first time in Canada. Similarly, Amblyomma americanum L., Arnblyomma maculatum Koch, and ixodes muris Bishopp & Smith are reported for the first time on birds in Canada. After removal of an I. muris gravid female from a song sparrow, Melospiza melodia Wilson, at St. Andrews, New Brunswick, eggs were laid, which developed into larvae, and this new tick-host record demonstrates that birds have the potential to start a new tick population. We conclude that passerine birds disperse several species of ixodid ticks in Canada, and during spring migration translocate ticks from the United States, and Central and South America, some of which are infected with B. burgdorferi.

Animals↗
PubMed2006

Effect of a therapeutic maximum allowable cost (MAC) program on the cost and utilization of proton pump inhibitors in an employer-sponsored drug plan in Canada.

BACKGROUND: Therapeutic maximum allowable cost (MAC) is a managed care intervention that uses reference pricing in a therapeutic class or category of drugs or an indication (e.g., heartburn). Therapeutic MAC has not been studied in Canada or the United States. The proton pump inhibitor (PPI) rabeprazole was used as the reference drug in this therapeutic MAC program based on prices for PPIs in the province of Ontario. No PPI is available over the counter in Canada. OBJECTIVE: To evaluate the utilization and anticipated drug cost savings for PPIs in an employer-sponsored drug plan in Canada that implemented a therapeutic MAC program for PPIs. METHODS: An employer group with an average of 6,300 covered members, which adopted the MAC program for PPIs in June 2003, was compared with a comparison group comprising the book of business throughout Canada (approximately 5 million lives) without a PPI MAC program (non-MAC group). Pharmacy claims for PPIs were identified using the first 6 characters of the generic product identifier (GPI 492700) for a 36-month period from June 1, 2002, through May 31, 2005. The primary comparison was the year prior to the intervention (from June 1, 2002, through May 31, 2003) and the first full year following the intervention (June 1, 2004, through May 31, 2005). Drug utilization was evaluated by comparing the market share of each of the PPIs for the 2 time periods and by the days of PPI therapy per patient per year (PPPY) and days of therapy per prescription (Rx). Drug cost was defined as the cost of the drug (ingredient cost), including allowable provincial pharmacy markup but excluding pharmacy dispense fee. Cost savings were calculated from the allowed drug cost per claim, allowed cost per day, and allowed cost PPPY. RESULTS: (All amounts are in Canadian dollars.) The MAC intervention group experienced an 11.7% reduction in the average cost per day of PPI drug therapy, from 2.14 US dollars in the preperiod to 1.89 US dollars in the postperiod, compared with a 3.7% reduction in the comparison group (2.16 US dollars vs. 2.08 US dollars). Utilization dropped by 11.9% in the intervention group, from 166.7 days of PPI drug therapy PPPY to 146.9 days PPPY, compared with an increase of 7.9% in the comparison group, from 136.1 days to 146.8 days PPPY. The combined effect of the decrease in drug cost per day and utilization was a 22.1% reduction in allowed drug cost PPPY in the intervention (MAC) group (from 357 US dollars to 278 US dollars PPPY) versus a 4.1% increase in the comparison group (from 293 US dollars to 305 US dollars PPPY). CONCLUSION: A MAC program for PPIs for one employer in Canada was associated with savings for the drug plan sponsor of approximately 8% in actual drug cost per day of therapy compared with the comparison group. Total savings after consideration of utilization was approximately 26% for the intervention group versus the comparison group.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1998

Pharmaceutical policies in Canada. Issues and challenges.

Prescription and over-the-counter medications are an important and widely used part of healthcare in Canada. Such drugs represent an increasing proportion of total healthcare expenditures. The objectives of the paper are to examine pharmaceutical expenditures and utilisation in Canada, review the major cost control strategies for pharmaceuticals, and discuss the future issues and challenges for pharmaceutical policy in Canada. Compared with other Organisation for Economic Cooperation and Development (OECD) countries, Canada (until recently) has not been successful in controlling the rate of increase of healthcare expenditures and, more specifically, pharmaceutical costs. The key variables associated with high rates of increase in drug costs relate to increased per capita use of drugs, use of more expensive drugs, and rising prices of existing drugs. If policies are going to address the fundamental societal issues behind both the price and utilisation elements of pharmaceuticals, policy makers and third-party payers in Canada will probably have to focus, primarily, on manufacturers and major healthcare providers and, secondarily, on consumers. They will need to develop an internally valid package of consistent policies.

Canada↗
PubMed2004

How much might universal health insurance reduce socioeconomic disparities in health? : A comparison of the US and Canada.

A strong association between lower socioeconomic status and worse health has been documented within many countries, but little work has been done to compare the strength of this relationship across countries. We compare the strength of the relationship between income and self-reported health in the US and Canada. We find that being below median income raises the likelihood that a middle-aged person is in poor or fair health by about 15 percentage points in the US, compared with less than 8 percentage points in Canada. We also find that this 7 percentage points stronger relationship between low income and poor health in the US compared with Canada is reduced by about 4 percentage points after age 65, the age at which virtually all US citizens receive basic health insurance through the Medicare programme. Income differences in the probability that an individual lacks a usual source of care are also significantly larger in the US than in Canada before the age of 65, but about the same after age 65. Our results are therefore consistent with the theory that the availability of universal health insurance in the US, or at least some other difference that occurs around the age of 65 in one country but not the other, decreases the difference in the strength of the income-health relationship in the US compared with Canada.

Adult↗
PubMed1989

Accommodating rapid growth in physician supply: lessons from Israel, warnings for Canada.

Most developing countries find themselves grappling with the implications of rapid growth in physician supply. The purpose of this article is to search for lessons or warnings for Canada (and, ultimately, elsewhere) in the manner in which Israel has chosen to accommodate its huge supply of physicians. Under extremely conservative assumptions about immigration, and assuming rates of domestic training of physicians at levels somewhat lower than at present, Canada's physician supply will continue to grow at rates in excess of general population growth for at least the next 45 years. In this article we describe the Israeli health care system from a perspective of identifying the consequences of accommodating a physician supply about 50 percent higher than that in Canada. A number of key "accommodation attributes" (low physician incomes, restricted access to hospitals for general practitioners, intramedical-professional conflicts over income and authority, a flourishing black market) are argued to be more than simply products of a unique cultural and political system, but also symptoms of a system vastly oversupplied with physicians. Early signs in Canada of similar "products" of a growing physician supply are noted. While a two-country comparison makes drawing lessons somewhat speculative, the coincidence of events suggests that these trends in Canada warrant, if not immediate action, at least careful monitoring.

Adult↗
PubMedDate not supplied

Evaluation of yellow fever vaccination centers in Canada.

BACKGROUND: Health Canada regulates the designation of yellow fever vaccination centers (YFVCs) in Canada to ensure a national standard in the safe, effective, and appropriate use of yellow fever vaccine for Canadian travelers. The process for the designation of YFVC has evolved over the years, particularly with the development and implementation of specific criteria for designation. Standardized site visits in 1999 to 2001 demonstrated that noncompliance with the criteria jeopardized the objectives of the federal program. METHODS: A pilot evaluation questionnaire was developed and tested in seven YFVCs. The results provided the data necessary to appropriately adapt the questionnaire for on-site evaluations. The final questionnaire captured graded data on professional training, reference sources, services provided, and physical facilities and supplies. A minimum of 60% was needed to pass the evaluation. The YFVCs were given individual feedback on their results and the opportunity to comply with standards. RESULTS: During the period of 2000 to 2001, 183 YFVCs were in operation in Canada. A random sample of 69 YFVCs were visited and evaluated for compliance to the circulated criteria. Fifty-two (75%) of the YFVCs received satisfactory results (range 70% and higher), and specific remedial recommendations were made to 8 (12%) clinics with a borderline result (range 60-69%). Nine (13%) of the YFVCs failed (range 0-59%) the evaluation, with consequences ranging from notification of the infractions in writing to decertification. CONCLUSIONS: Although a majority of YFVCs met the evaluation criteria, a significant percentage (25%) of unsatisfactory and borderline compliance with Health Canada's criteria for designation of YFVCs means that there is a need for greater clarity and communication of the criteria and inspections for designated centers. To ensure that previously designated YFVCs and centers seeking designation consistently fulfill all the requirements, Health Canada is developing new methodologies of evaluation. The authors anticipate that all new and existing YFVCs will fully comply with the objective and specific criteria for designation.

Canada↗
PubMed2000

Suicide prevention in Canada: a history of a community approach.

Suicide is a major mental health and public health problem in Canada. Canada's suicide rate ranks above average in comparison to countries around the world. The prevention of suicide predates the European presence in Canada and much can be learned from these endeavours. Current efforts grew largely from the grass roots, with little government support or initiative (with a few provincial/territorial exceptions). Canada's community efforts have been diverse and inclusive. Among such efforts have been: (a) traditional approaches among Native peoples, (b) the establishment of the first crisis centre in Sudbury in the 1960s, (c) the development of a comprehensive model in Alberta, (d) the beginning of a survivor movement in the 1980s, and (e) the national prevention efforts of the Canadian Association for Suicide Prevention. There are, however, striking lacks--most notable among them the paucity of support for research in Canada. Future efforts will call for even greater community response to prevent suicide and to promote wellness.

Canada↗
PubMed1999

Downward trend in prostate cancer mortality in Quebec and Canada.

PURPOSE: If new treatment strategies and screening for prostate cancer are effective they should reduce prostate cancer mortality. In this review we monitored prostate cancer mortality rates in Quebec and in Canada. MATERIALS AND METHODS: We obtained data on all deaths from prostate cancer between 1976 and 1997 in Quebec, and 1976 and 1996 in Canada. We calculated age standardized mortality rates and assessed changes with time. RESULTS: Prostate cancer mortality rates increased regularly until 1991 in Quebec and Canada. After 1991 the rates decreased moderately until 1995 and then more markedly in 1996. There was a further decline in 1997 in Quebec. Overall, age standardized prostate cancer mortality rates declined by 23% in Quebec between 1991 and 1997, and by 9.6% in Canada between 1991 and 1996. The mortality decline was observed for all age groups but was more pronounced among men younger than 75 years. CONCLUSIONS: Until 1995 the trends in prostate cancer mortality in Quebec and Canada were similar to those observed in the United States. Our data suggest that a sharper decline has occurred since 1995. It is of primary importance to identify the causes of the mortality decline. As prostate cancer mortality rates declined relatively early after the initiation of widespread screening with prostate specific antigen, it is unlikely that screening has as yet contributed in a major way to the decline. It is more likely that the mortality reduction is a consequence of better prostate cancer management or improved treatment modalities.

Age Distribution↗
PubMed1998

Avoiding fundamental reform: current cost containment strategies in Canada.

Provincial governments in Canada are trying very hard to contain and possibly reduce health care expenditure. The wide ranging effort and frequent announcements of yet another cost cutting measure, including deinsurance, stand in marked contrast to the complacency of earlier periods. This activist and serious effort to reform the system is certainly welcome, yet the reforms are not adequate and ignore some fundamental and structural problems of Canada's health care system. Health care reform must do one or more of three things, i.e., improve efficiency, effectiveness, and/or equity of the system. Many cost-cutting measures in Canada achieve none of these objectives and merely postpone costs to a later time or shift the burden on to the sick. Fundamental health reforms include the incentive systems influencing physician behavior and choices; efficiency gains via manpower substitution; more effective control over the supply and distribution of medical manpower; and changes in the organization and design of health care delivery systems. But these fundamental reforms are not being pursued in Canada even though this is an opportune time for such reforms. Also discussed is the potential for and problems associated with managed and/or public sector competition. This article is essentially a critical review of current cost containment efforts in Canada.

Canada↗
PubMed2000

New drug approval times and 'therapeutic potential' in Canada, Australia, Sweden and the United States during the period 1992 to 1998.

In two previous studies, the times required to approve new drugs in Canada, Australia, Sweden, the United Kingdom and the United States during the periods 1992 to 1995 and 1996 to 1998 were compared. However, during each of these two periods, only a fraction of the drugs that were approved in any of the countries were approved in all of them. Because an analysis based solely on drugs approved in all the countries would provide additional information, data from the previous studies have been used to compare drugs approved in each of Canada, Australia, Sweden and the United States during the period 1992 to 1998. In addition, applications that received a 'priority' or a 'standard' review by the United States Food and Drug Administration were analyzed separately to determine whether differences between the countries diminished for drugs considered to be of potentially greater therapeutic value. For the 87 drugs identified as being approved for marketing in all four countries during the period 1992 to 1998, approval times in Canada and Australia were not significantly different, but both Canada and Australia had significantly longer times than those of the United States and Sweden (P<0.001). Of the 87 drugs, 37 (43%) received a priority review in the United States. In both the priority and standard review categories, the Australian and Canadian median approval times were significantly longer than those in Sweden and the United States. The results demonstrate that, in general, both priority and standard new drug applications are reviewed more expeditiously in Sweden and the United States than in Canada. Canadian patients continue to experience delayed access to potentially valuable medicines.

Australia↗
PubMed2000

Dying in Canada: is it an institutionalized, technologically supported experience?

Although preliminary evidence shows that people generally prefer to die at home, very little is known about where Canadians die. Understanding the epidemiology of dying in Canada may illuminate opportunities to improve quality of end-of-life care and related health policy. We conducted a cross-sectional analysis of death records in Canada to determine the proportions of deaths occurring in hospitals and special care units. Our analysis found that deaths in Canada occur in hospitals with provincial and territorial proportions ranging from 87% in Quebec to 52% in the Northwest Territories. In hospitals recording deaths in special care units, 18.64% of all deaths occurred in special care units. The proportion of deaths in special care units ranged from 25% in Manitoba to 7% in the Northwest Territories. The proportion of deaths in special care units varied by size and nature (teaching vs. non-teaching) of hospitals. It increased with the size of the hospital from 8% in hospitals with 1-49 beds, to 23% for hospitals with 400 or more beds. In teaching hospitals, 27% of deaths occurred in special care units, and in non-teaching hospitals the proportion was 15%. In conclusion, the majority of deaths in Canada occur in hospitals and a substantial proportion occur in special care units, raising questions about the appropriateness and quality of current end-of-life care practices in Canada.

Canada↗
PubMedDate not supplied

Drug resistance study of Mycobacterium tuberculosis in Canada, February 1, 1993 to January 31, 1994.

OBJECTIVE: To estimate the prevalence of resistance of Mycobacterium tuberculosis to first-line antituberculosis drugs in Canada. METHODS: M. tuberculosis isolates from one third of all culture-positive tuberculosis (TB) cases diagnosed between February 1, 1993 to January 31, 1994 in Canada were collected prospectively. Proportion of drug-resistant isolates and the factors related to drug resistance were measured. RESULTS: Of 458 study cases, 40 (8.7%) had resistance to at least one first-line antituberculosis drug, of which 5.9% had mono-resistance, 0.7% had multidrug-resistance(MDR-TB)--i.e., resistance to at least isoniazid and rifampin--and 2.2% had other patterns. The overall prevalence of resistance among the foreign-born cases was 10.6% with the highest level among those who resided in Canada for less than four years (15.5%). CONCLUSIONS: Canada has a relatively low prevalence of antituberculosis drug resistance and a very low prevalence of MDR-TB. Some new immigrants to Canada may be at higher risk for drug resistance and their initial treatment needs to be tailored accordingly.

Adolescent↗