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

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 15^th to May 29^th, 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.