Community Exposure to Discarded Needles and Other Objects Potentially Contaminated With Blood-Borne Pathogens in Children in Toronto, Canada
Bibliographic record
Abstract
Background. Percutaneous or mucocutaneous exposure to discarded needles or other objects or fluids by children put them at risk for infection with blood-borne pathogens (BBP; HIV, hepatitis B [HBV], hepatitis C [HCV]). The purpose of this project was to retrospectively analyze the epidemiology, management and outcome of children seen at SickKids following such exposures in the community in the Greater Toronto area. Methods. Children < 19 years of age who had community-based exposure to discarded needles or other objects or fluids that could contain BBP between 1 January 2001 and 31 December 2014 were included. Sexual exposures and hospital inpatient exposures were excluded. All medical charts of children who had an HIV test submitted through the SickKids Microbiology Laboratory were reviewed. Results. Of 1492 HIV-tested children, 66 were community-based exposures to objects or fluids that could contain BBP. Needlestick injuries accounted for 68.2% of exposures followed by human bites (7.6%), razors (6.1%), used condoms (4.5%) and various other exposures (13.6%). Median age was 6.3 years (1.3-17.3); 44 were male. Most exposures occurred in schools (31.8%), parks (15.2%) and homes (15.2%). The median interval from exposure to medical attention was 2.4 hours (range: 0 hour-31 days). A source person was identified in 11 (16.7%) cases, all but one being family members. Of known source patients, 7 were known to be HIV infected. Antiretroviral medications were given to 21 (31.8%) children, including 5 exposed to body fluids from a known HIV positive source. 15 (71.4%) completed the recommended 4-week course of antiretroviral therapy. Ten (47.6%) developed adverse events, 4 of whom discontinued therapy early. Follow up serology was done in 42 (66.7%) at 6 weeks and 39 (59.1%) at 3-6 months; 16 (25%) had no follow up testing. None of the children with follow-up testing became infected with HIV, HBV or HCV. Of the 48 children who had not been previously vaccinated against HBV, 23 (47.9%) completed a full series of vaccination. Conclusion. Although no blood-borne infections occurred in this cohort, our findings indicate that public health interventions in schools and other community settings are needed to reduce the risk of exposures that could pose a risk for infection with BBP. Disclosures. All authors: No reported disclosures.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 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".