Congenital cytomegalovirus infection in Canada: Active surveillance for cases diagnosed by paediatricians
Bibliographic record
Abstract
OBJECTIVE: To determine the rate of diagnosis; demographic, clinical and laboratory characteristics; and management of congenital cytomegalovirus (cCMV) cases identified by paediatricians in routine clinical practice in Canada. METHODS: National active monthly surveillance of all clinically practicing general and subspecialty paediatricians in Canada was performed for cCMV from March 1, 2005 to February 28, 2008, through the Canadian Paediatric Surveillance Program. RESULTS: Forty-nine cases of cCMV infection were reported (4.5 per 100,000 births): 40.8% were born before 36 weeks' gestation; 55.1% had a birth weight <2500 g; and 28.6% and 30.6% were below the third percentile for weight and head circumference, respectively. The median maternal age was 23 years, and 18.4% were <20 years of age. Eight mothers (16.3%) were Aboriginal (non-Aboriginal birth prevalence 3.9 per 100,000; Aboriginal birth prevalence 15.8 per 100,000; P<0.005). The most common laboratory abnormality was thrombocytopenia (53.1%). Thirty-three (67.3%) infants exhibited neurological manifestations; ganciclovir therapy was administered to 12 (36.4%) and was not administered to 21 (63.6%) of the infants with neurological manifestations. CONCLUSION: Only a minority of the expected number of symptomatic cCMV-infected infants were reported in the present study. The majority of these severely affected infants, including those with neurological disease, are not being treated with ganciclovir. The present description of current diagnosis and practice highlights the need for more complete case identification in the population as well as the need for increased awareness of the optimal therapy for symptomatic cCMV.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".