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. 2020 Feb 7;8:16. doi: 10.3389/fpubh.2020.00016

Table 1.

Current Canadian recommendations for chest X-rays upon admission to long-term care facilities, by province and territory.

Province/
Territory
Source on TB procedures LTCF definition TB screening on admission Other
Alberta Alberta Health and Wellness. Tuberculosis prevention and control guidelines for Alberta Edmonton, AB: Government of Alberta; 2010 https://open.alberta.ca/dataset/ffaa5ef8-dffd-4516-9ffe-0deaa6a945d1/resource/42bcee8b-60cf-442e-a3cb-f2f3cb8c4904/download/tb-prevention-control.pdf Include supportive living and long-term care accommodations with different levels of care PA and lateral chest X-ray Within 6 months of application for admission
British Columbia BC Center for Disease Control. Tuberculosis manual. Chapter 4: TB screening and testing. Vancouver, BC: BC Center for Disease Control; 2015. http://www.bccdc.ca/health-professionals/clinical-resources/communicable-disease-control-manual/tuberculosis Include long term care, extended care, nursing homes and assisted living each offering different levels of care
  • <60 X-ray if symptomatic or TST positive

  • >60 X-ray if symptomatic

  • <60 receive TST to monitor for LTBI

Manitoba Manitoba Health, Healthy Living, and Seniors. Manitoba tuberculosis protocol. Winnipeg, MB: Manitoba Health, Healthy Living, and Seniors; 2014 https://gov.mb.ca/health/publichealth/cdc/protocol/tb.pdf Include personal care homes, nursing homes, chronic care facilities, supportive housing and assisted living with different levels of care Baseline PA and lateral chest X-ray on admission for certain populations
  • Born before 1955

  • Aboriginal born or resided in high TB incidence countries

New Brunswick Government of New Brunswick. Eligibility for publically funded TST and testing policy in Non-Hospital Settings. Fredericton, NB: Government of New Brunswick; 2016. https://www2.gnb.ca/content/dam/gnb/Departments/h-s/pdf/en/CDC/TuberculosisTestingRecommendationsUpdate.pdf Nursing homes providing 24 h nursing and supervision No current recommendations on admission
Newfoundland and Labrador Government of Newfoundland and Labrador. Guideline for preventing the transmission of Mycobacterium tuberculosis across the continuum of care. St. John's, NL: Government of Newfoundland and Labrador; 2015 https://health.gov.nl.ca/health/publichealth/cdc/tuberculosis_management.pdf Homes for the aged, nursing homes, chronic care facilities, hospices, retirement homes and designated assisted living centers PA and lateral chest X-ray on admission
Nova Scotia Nova Scotia Department of Health and Wellness, Infection Prevention and Control Nova Scotia. Infection prevention and control: guidelines for long-term care facilities. Halifax, NS: Nova Scotia Department of Health and Wellness; 2015 https://ipc.gov.ns.ca/sites/default/files/IPCNS%20Infection%20Prevention%20and%20Control%20LTC%20Final(1).pdf Nursing homes (24 h care) and residential homes (limited medical care)
  • >65 with symptoms require chest X-ray

  • <65 high risk populations receive TST and chest X-ray if positive

High Risk Populations
  • Former employees/residents of homeless shelters or correctional facilities

  • Former IV drug users

  • Aboriginal Canadians

  • Positive HIV status People born in high TB incidence countries

Northwest Territories Northwest Territories Health and Social Services. Tuberculosis. Yellowknife, NT: Northwest Territories Health and Social Services; 2014. https://www.hss.gov.nt.ca/en/services/tuberculosis Include Long term care and Extended Care offering different levels of care No current recommendations on admission
Nunavut Government of Nunavut. Tuberculosis manual. Iqaluit; NU: Government of Nunavut; 2018 https://gov.nu.ca/sites/default/files/nunavut-tuberculosis-manual-2018.pdf Include assisted living, residential care and nursing homes No current recommendations on admission
Ontario Ontario Agency for Health Protection and Promotion (Public Health Ontario). Tuberculosis screening on admission to long-term care homes in Ontario. Toronto, ON: Queen's Printer for Ontario; 2019. https://www.publichealthontario.ca/-/media/documents/report-tb-screening-ltch.pdf?la=en Facilities that provide 24 h nursing and personal care PA and lateral chest X-ray Within 14 days of admission unless X-ray done 90 days prior admission
Prince Edward Island Department of Health and Wellness. (2016). Tuberculin Skin Testing Policy. Chief Public Health Office- Government of Prince Edward Island: 2016. https://www.princeedwardisland.ca/sites/default/files/publications/tuberculin_skin_testing_policy_web.pdf Nursing homes providing 24 h nursing and supervision No current recommendations on admission
Quebec Ministère de la santé et des services sociaux du Québec. Tuberculose. Québec, QC: Gouvernement du Québec; 2018 http://www.msss.gouv.qc.ca/professionnels/maladies-infectieuses/tuberculose/ Temporary or permanent accommodation facilities that provide 24 h care and supervision; continuing care homes No current recommendations on admission
Saskatchewan Government of Saskatchewan. Tuberculosis control: a reference guide to the tuberculosis program in Saskatchewan Saskatoon, SK: Saskatoon Health Region; 2005 https://www.saskatoonhealthregion.ca/locations_services/Services/TB-Prevention/Documents/Resources/Tuberculosis%20Control%20-%20A%20Reference%20Guide%20to%20the%20TB%20Program%20in%20Saskatchewan.pdf Include nursing homes and special care homes with 24 h nursing supervision Chest X-ray done on admission Unless X-ray completed within 90 days of admission
Yukon Government of the Yukon. (2015). TB Control Manual. Retrieved from: http://www.hss.gov.yk.ca/tbmanual.php Include long term care and assisted living homes offering different levels of care No current recommendations on admission

TST, tuberculin skin test; PA, posterior-anterior; LTBI, latent tuberculosis infection.