Estimating and comparing the burden of chronic Hepatitis C in the immigrant and the non-immigrant population in Québec
Notice bibliographique
Résumé
Background: Immigrants have higher mortality from chronic viral hepatitis and hepatocellular carcinoma as compared to those born in Canada. Approximately 20% of this burden is likely due to hepatitis C (HCV). Despite this disparity there are no screening programs to detect chronic HCV in immigrants after arrival in Canada. This is partly due to a lack of population-based data describing the burden of chronic HCV in immigrants.Methods: To fill this gap, we created a case series of all cases of chronic hepatitis C reported from 1991-2008 in Québec through linking the MADO (Québec Reportable Disease) database to 5 other Québec administrative databases; the MICC (Québec Landed Immigrants), the RAMQ (Québec provincial health insurance and physician billing) and the hospitalization databases. Reported rates were estimated using the reported number of cases in immigrants and non-immigrants during the study period. Québec census data from 1991, 1996, 2001, and 2006 (stratified by immigrant and non-immigrant status) was used for the denominator. Rates, rate ratios, and 95% CIS were calculated using the Poisson distribution. Proportions of cases with chronic hepatitis C associated complications were calculated and compared in immigrants and non-immigrants. Results: A total of 20,459 cases of chronic hepatitis C (1,980 immigrants and 18,479 non-immigrants) were reported between 1998-2007. Cases from 1991-1997 were excluded due to incomplete laboratory reporting during this period. Immigrant cases were older (mean age 47.1 vs. 43.1 years, p < 0.0001) and were less likely to be male (53.1% vs. 68.2%, p <0.0001). The overall rate of chronic hepatitis C was similar for immigrants and non-immigrants [rates/100,000 (95%CI) were 25.2 (24.1-26.4) vs. 27.8 (27.4-28.2), rate ratio= 0.91]. Immigrants from several world regions however had higher rates of chronic hepatitis C as compared to the non-immigrant population; Eastern Europe/Central Asia [77.6 (68.2-87.0) rate ratio = 2.8], Sub-Saharan Africa [60.2 (51.5-68.8), rate ratio = 2.2], South Asia [48.1 (41.5-54.7), rate ratio = 1.7]. Immigrants had a higher proportion of compensated cirrhosis (15.1% vs. 12.9%, p= 0.007) and hepatocellular carcinoma (1.2% vs. 0.6%, p= 0.005) compared to non-immigrantsConclusions: Immigrants from several world regions are at increased risk for chronic hepatitis C, have a higher proportion of hepatitis C related complications and are diagnosed a mean of > 8 years after arrival in Canada. Many immigrants would therefore benefit from early screening and appropriately timed treatment for chronic hepatitis C to decrease associated morbidity and mortality.
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 | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| 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 ».