Evaluation of Mycobacterium tuberculosis transmission from a pediatrician and initial compliance to prophylaxis of contacts in an outpatient pediatric clinic
Bibliographic record
Abstract
OBJECTIVE: The risk that latent infection will progress to active tuberculosis is greater in infants and children than for most other age groups. We set out to determine the rate of transmission of Mycobacterium tuberculosis to pediatric patients exposed to a pediatrician with smear-negative and culture-positive pulmonary tuberculosis. We also explored factors associated with compliance to prophylaxis. METHODS: Clinic and hospital billing records were used to identify patients age 5 or less who were seen during the pediatrician's potential contagious period. Patient were notified by registered mail of their putative exposure and were offered a tuberculin skin test screening with 5 tuberculin units of purified protein derivative (Tubersol, Connaught) and chest radiography of children with a tuberculin skin test > or =5 mm. RESULTS: A total of 456 patients were identified as exposed; 140 contacts never responded for evaluation and 93 letters were not delivered because of incorrect mailing addresses. Of the 223 who completed screening 1 (0,4%) had a initial skin test result of 8 mm. The remaining 222 contacts had repeated negative test results. The only positive child (15 months old) was born in Honduras and had received Calmette-Guerin bacillus at birth. No active tuberculosis cases were identified in the 456 contacts up to 2 years after exposure. Compliance with prophylaxis was associated with having two or less children in the household (odds ratio, 2.5; 95% confidence interval, 1.1 to 5.9). CONCLUSION: We found no evidence of transmission of M. tuberculosis in an outpatient pediatric setting. Only 43% of exposed children completed screening, and 38% of those offered prophylaxis completed their initial 3 months of therapy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".