Tuberculosis, incarceration, and HIV at a crossroads in Guyana
Bibliographic record
Abstract
OBJECTIVES: The objective of this study was to describe the sociodemographic and clinical characteristics of patients dually infected with HIV and tuberculosis (TB) in Guyana. METHODS: The data for this study were obtained as part of a related project conducted to determine the prevalence of diabetes mellitus among TB patients in Guyana. From April to June 2006, a convenience sample of 100 patients was selected from those attending three TB clinics in Guyana and a structured questionnaire was used to collect relevant sociodemographic and risk factor data. The sociodemographic and clinical data of HIV-negative and HIV-positive patients with pulmonary TB were compared. Logistic regression was conducted to determine independent relationships between sociodemographic and clinical features. RESULTS: One hundred TB patients were considered for enrolment in the study, but since the HIV status was known for only 77 persons, these were included in the analysis. Thirty-one of the 77 (40.3%) were HIV-positive. Seventy-two of the 77 (93.5%) patients had pulmonary TB, 28 of whom were HIV-positive; the other five had extrapulmonary TB, three of whom were dually infected. Several social factors and clinical manifestations including incarceration at the time of TB diagnosis (p=0.01), cigarette smoking (p=0.05), homelessness (p=0.07), chest pain (p=0.001), hemoptysis (p=0.02), cough (p=0.08), and being acid-fast bacillus (AFB) sputum smear-positive (p=0.06) were associated with HIV-negative pulmonary TB. In the logistic regression model, HIV-negative TB patients demonstrated higher frequencies of complaints of chest pain (odds ratio (OR) 34.48, 95% confidence interval (CI) 4.35-250) and were more likely to be AFB sputum smear-positive (OR 11.97, 95% CI 1.91-74.76) than HIV-positive TB patients. CONCLUSIONS: Guyana is faced with a particularly high burden of HIV infection among TB patients. Given the impact of HIV on the clinical presentation of TB, physicians managing HIV patients should demonstrate a high level of suspicion for TB among these patients. Incarceration is a strong correlate of TB, overall.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 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".