This dashboard presents provincial tuberculosis (TB) and sexually transmitted and blood borne infection (STBBI) case and STBBI testing trends.

We acknowledge that the presented data represent people in British Columbia who have been diagnosed with TB disease or a STBBI. The pathogens that cause these conditions are transmitted among populations as a result of a complex mix of social, cultural, economic and structural factors. We continue to work towards enhancing surveillance systems to advance the understanding of the prevention, acquisition and transmission of STBBIs and TB disease and the key populations that are affected by specific syndemics.

Other CPS surveillance reports can be found at:

HIV - http://www.bccdc.ca/health-professionals/data-reports/hiv-aids-reports/
HCV - http://www.bccdc.ca/health-professionals/data-reports/hepatitis-c-reports/
STIs - http://www.bccdc.ca/health-professionals/data-reports/sti-reports/
TB - http://www.bccdc.ca/health-professionals/data-reports/tuberculosis-reports/

Data are presented up to 2024Q1 (March 31, 2024). Data are preliminary and subject to change.

Report updated on May 14, 2024.

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Infectious Syphilis Case Reports in BC

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• Age group

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Interior Fraser Vancouver Coastal Island Northern

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Syphilis Non-Prenatal Testing Episodes and Percent Positivity in BC

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Chlamydia (CT) Case Reports in BC

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• Genital and
  extra-genital CT
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  by gender
• Genital CT
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Gonorrhea (GC) Case Reports in BC

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• Genital and
  extra-genital GC
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Interior Fraser Vancouver Coastal Island Northern

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New HIV Diagnoses in BC

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HIV Non-Prenatal Testing Episodes and Percent Positivity in BC

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New Hepatitis C Cases in BC

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<5 Years 5-9 Years 10-14 Years 15-19 Years 20-24 Years 25-29 Years 30-39 Years 40-59 Years 60+ Years

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HCV Antibody Testing Episodes and Percent Positivity in BC

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Tuberculosis Disease Cases in BC

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<1 Year 1-4 Years 5-9 Years 10-19 Years 20-39 Years 40-59 Years 60+ Years

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Tuberculosis Infection Treatment Starts in BC

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If you are experiencing technical difficulties or have feedback to share on the dashboard, please contact: [email protected].

Supplementary Information

Technical appendix

Case data: This report contains preliminary data on infectious syphilis, chlamydia, gonorrhea, HIV, hepatitis C, and tuberculosis disease. Provincial counts and geographic distribution of cases are expected to change with improvement in data quality and algorithms.

Testing data: This report contains non-prenatal HIV and syphilis testing (that is, tests not flagged as a prenatal test) conducted by the BCCDC Public Health Laboratory (PHL). The BCCDC PHL performs >95% of all screening tests for HIV and HCV, and >99% of all tests for syphilis. A test episode for syphilis and HIV consists of all tests for that infection conducted for an individual in a 30-day period (as follow-up or simultaneous test may be required to clarify test results within this period, for example). A test episode for HCV consists of all HCV antibody tests conducted for an individual in a 1-day period.

Treatment data: This report contains preliminary data on documented tuberculosis infection (TBI) treatment starts. TBI is a clinical diagnosis in which an individual is suspected to have the non-infectious or dormant phase of TB. The recommendation to treat TBI is based on a clinical assessment of the patient balancing the risks for progression to TB disease against the risks associated with treatment. Not everyone with TBI receives treatment.

Data notes

PHSA’s Data Analytics, Reporting and Evaluation (DARE) team implemented an update to their patient matching algorithm within PHSA data holdings in December 2023. The patient matching algorithm groups historical case and testing data across all health records for an individual. The new patient matching algorithm has been applied retrospectively to the STBBI Data Mart resulting in the following minor changes compared with previous CPS reports:

• Small decreases in hepatitis C case numbers

• Small decreases in HCV testing volumes

• Minor changes in HIV testing volumes

• Minor changes in syphilis testing volumes

As a result of changes to testing volumes there may be minimal impact on the reported test positivity for HCV, HIV, and syphilis. Note that HIV, syphilis, chlamydia, and gonorrhea case counts are unaffected.

Data sources

Data in this report were extracted from STIBBI Data Mart on April 9, 2024, Intrahealth Profile EMR on April 10, 2024 and CD Data Mart on April 15, 2024.

Infectious Syphilis case data: Data extracted from STIBBI Data Mart (source system = STIIS) and Intrahealth Profile EMR

Syphilis testing episodes: Data extracted from STIBBI Data Mart

Chlamydia: Data extracted from STIBBI Data Mart (source system = STIIS and Panorama) and Intrahealth Profile EMR

Gonorrhea: Data extracted from STIBBI Data Mart (source system = STIIS and Panorama) and Intrahealth Profile EMR

HIV case data: Data extracted from STIBBI Data Mart (source system = HAISYS)

HIV testing episodes: Data extracted from STIBBI Data Mart

HCV case data: Data extracted from STIBBI Data Mart

HCV testing episodes: Data extracted from STIBBI Data Mart

Tuberculosis case data: Data extracted from CD Data Mart (source system = Panorama)

Tuberculosis infection data: Data extracted from CD Data Mart (source system = Panorama)

British Columbia case definitions

http://www.bccdc.ca/health-professionals/clinical-resources/case-definitions/

Note on gender and sex

This report includes information from several different data systems. Information on gender and sex are collected and reported differently across these data systems resulting in the inability to standardize the reporting on these variables. We recognize this may cause misperception as gender and sex have different meanings. We are working with our partners to improve the way that sex and gender identity data are collected for STBBI and TB surveillance.

Gender and sex for STIs

The reporting of sex and gender are conflated in the current STI case reporting systems:

• In Intrahealth Profile EMR (used from March 13, 2018 onwards), depending on what information is available per client, information collected on sex (options: male, female, X, or unknown) via laboratory serology requisitions or information collected on “gender“ (typically a mix of sex and gender options) via clinic intake forms is entered into a field labelled “Administrative Sex” (options: female, male, intersex, transgender, X, or unknown). This field then subsequently auto-populates another field in the STI case reporting form labelled “Gender”.

• In Panorama (used for gonorrhea and chlamydia cases entered by Northern Health and Interior Health), information is collected on “gender”, with available options being female, male, undifferentiated, or unknown.

• In the historical STI Information System (STIIS; used prior to March 13, 2018), information on sex/gender was similarly collected using male, female, transgender, or unknown as options for reporting within a single question field.

While the majority of the information collected on sex/gender seem to reflect sex values, to prevent the erasure of the reporting of transgender as a gender value from our case data, we have included all reported sex/gender values as entered into the STI case reporting systems. Within the current dashboard, we report male, female, X, and intersex values under Sex and report transgender values under Gender; however, these sex/gender values are all collected under a single question field in the case data. For interpreting the reported information on sex/gender, please note that whether information on sex or gender was collected will vary between cases, and sex is likely best considered to be unknown for those cases reporting as transgender.

Abbreviations

CT: Chlamydia trachomatis

GC: Neisseria gonorrhoea

HIV: Human immunodeficiency virus

HCV: Hepatitis C virus

TB: Tuberculosis

TBI: Tuberculosis infection

Acknowledgements

We acknowledge the assistance of the BC Centre for Disease Control; BC Centre for Disease Control Public Health Laboratory; Data Analytics, Reporting and Evaluation (DARE); BC Centre for Disease Control’s Public Health Reporting Data Warehouse (PHRDW); STBBI Community Leadership Council; Sexual Health Advisory Group (SHAG); Provincial Health Services Authority; Fraser Health; Interior Health; Island Health; Northern Health; Vancouver Coastal Health; and First Nations Health Authority partners involved in data collection, access, management, analysis and reporting.

All components of this report were developed using the R computing language. Graphics and visualization were created using the tidyverse, shiny and plotly packages. R Core Team (2024). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/.

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This dashboard, and data contained in it, are provided “as is” without representations or warranties of any kind, either expressed or implied, including but not limited to, representations or warranties regarding the accuracy of the information in the dashboard and associated data, implied warranties of merchantability and fitness for a particular purpose, non-infringement or other violation of rights. The British Columbia Centre for Disease Control operates in a live database environment. Data are updated regularly and may change over time as the source data feeds are refreshed. Information presented in this report may not reflect the current situation, and therefore should only be used for reference purposes. Access to this dashboard and associated data may be suspended or discontinued, and the content of the dashboard may be altered, in part or in whole, at any time and for any reason, with or without prior notice, at the discretion of the British Columbia Centre for Disease Control and the Provincial Health Services Authority. All inferences, opinions, and conclusions drawn in this report are those of the authors, and do not reflect the opinions or policies of the Data Steward(s). Anyone using this information does so at their own risk. In no event will the British Columbia Centre for Disease Control or the Provincial Health Services Authority be liable for any direct, indirect, special, punitive, incidental, or consequential damages arising from the use of, or the inability to use, this dashboard.

Please direct questions and feedback to the BCCDC: [email protected]