Risk Factors for Mycobacterium Tuberculosis Infection among Children in Greenland/Facteurs De Risque D'une Infection a Mycobacterium Tuberculosis Chez Les Enfants Au Groenland/Factores De Riesgo De la Infeccion per Mycobacterium Tuberculosis En Ninos De Groenlandia
Notice bibliographique
Résumé
Introduction Although Greenland has experienced steady improvement in general living standards since World War II, tuberculosis (TB) remains a major health problem throughout the country. (1,2) Overall TB incidence in Greenland doubled in the 1990s (3) and still remained at 130 cases per 100 000 in 2010. (1) The proportion of TB cases comprised of children under the age of 15 years rose from 8% in 1990 to 25% in 1997. (3) Because of this resurgence of TB, in 1999 national health authorities launched a TB control programme consisting of the vaccination of all neonates with bacille Calmette-Guerin (BCG), early case detection and the monitoring of treatment outcomes. (4) In 2007 the programme was revised to include routine screening of children for Mycobacterium tuberculosis infection (MTI) at the ages of 6 and 16 years. Despite this effort, TB incidence and the risk of MTI among children remain high. (4,5) Surprisingly, the resurgence of TB in Greenland is not linked to human immunodeficiency virus (HIV) infection or to multidrug resistant TB, both of which are still very uncommon in the country. As of 2010, only 157 HIV-positive cases had been registered despite free HIV testing and only one case of multidrug resistant TB had been documented. (1,6) Instead, it appears to result from microepidemic outbreaks in small towns and remote settlements. TB is 20 times more common among the Inuits of Arctic Canada and Alaska than among non-native white populations.(7-11) This elevated risk suggests that even in resource-rich countries, TB control is difficult in small, hard-to-reach communities with limited health resources. In 2009, a World Health Organization group proposed a revision of current TB control, targeting strategies to minimize exposure to TB as measured by the presence of MTI. (12) The revision raises the need to better understand the risk factors associated with MTI, especially at the local and regional level, since risk factor profiles vary from place to place and one programme will not necessarily be effective everywhere. The objective of this study was to explore the risk factors for MTI among Greenlandic children to help identify the children at highest risk of infection. Methods Study sites and population An ice cap covers 82% of Greenland's territory, permitting settlements only in coastal areas. The population, which numbers 57 000, is 90% Inuit. Greenland is an integral part of the Kingdom of Denmark but is self-governing. Although its population is less affluent than that of Denmark, it is nonetheless wealthy by developing country standards, with a gross national product per capita of 20 000 United States dollars. Health care is provided by the government at Danish standards. (13) The capital, Nuuk, has one national hospital; a local hospital exists in each of the country's five administrative districts, along with additional health centres and nursing stations or clinics. Care is free of charge. However, inequities have not been fully eradicated mainly because small and isolated communities have limited health-care resources and the least experienced health-care workers. (14) Physicians, typically from Denmark, have difficulty communicating with the Inuit population and are usually on short-term assignments, so that gaps between postings sometimes occur. Living in a small community is an independent risk factor for TB disease. (15) The current study, cross-sectional in design, included all schoolchildren in five different towns and nearby settlements across Greenland: Tasiilaq (November, 2005) in eastern Greenland; Narsaq (May, 2006), Qaqortoq (August, 2006) and Nanortalik (September 2006) in southern Greenland; and Sisimiut (May, 2007), in western Greenland. School attendance is mandatory everywhere in the country for children aged from 6 to 16 years. On 31 December 2006, the study area had 2880 eligible children in that age group (i.e., 25% of the entire Greenlandic population of children 6 to 16 years old), all of whom were invited to participate in the study. …
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».