Planning and implementation of a community-wide tuberculosis screening intervention: a case study from Naujaat, Nunavut, Canada.

In Nunavut, public health management of tuberculosis (TB) remains a challenge due to social and economic inequities, geographic isolation, TB-related stigma, and distrust in healthcare linked to a history of colonialism. A TB outbreak was declared in Naujaat, Nunavut following an increase in reported cases starting in January 2023. In response to this outbreak, the Naujaat community-wide TB screening (CWS) clinic was held from April 15th to May 29th, 2024, with support from the Nunavut Tunavik Incorporated (NTI) leadership and community engagement teams. This article outlines the steps taken in the coordination and implementation of a large public health intervention in this remote, northern community. Despite significant logistical challenges, the CWS clinic screened 89.2% of the 1000-person target consisting of all previously unscreened individuals residing in the community. As a result, 31 individuals with latent TB infection and <5 active TB cases were diagnosed and offered treatment, representing nearly 4% of those undergoing 2-step testing. Although the screening outcomes suggested that community transmission was low at the time of community-wide screening, it nonetheless exceeded the WHO threshold of 0.5% prevalence for community-wide screening. Lessons learned through the Naujaat CWS can help inform future public health actions towards TB elimination in Nunavut and other circumpolar jurisdictions.