P3.82 An upward trend in ocular syphilis cases in british columbia, canada, 2013–2016: a descriptive analysis
Bibliographic record
Abstract
Introduction HIV-positive individuals are generally considered higher risk for early and more serious neurologic complications related to syphilis. In 2014–2015, clusters of ocular syphilis cases were reported in the US. Simultaneously, the Canadian province of British Columbia (BC) saw a dramatic rise in infectious syphilis cases by 40%. Here, we describe ocular syphilis cases diagnosed in BC. Methods All neurosyphilis cases diagnosed in BC since 2013 were reviewed to identify ocular cases. Ocular syphilis was defined as having signs/symptoms of ocular disease (e.g. uveitis, blurred vision) and syphilis of any stage, as defined by the Centres for Disease Control and Prevention. Results Between January 1st, 2013 and October 31st, 2016, 35 cases of ocular syphilis were recorded in BC. Most were male (32/35; 91.4%) and identified as white (20/35; 57.1%). The mean age was 49.7 years. A majority (18/35; 51.4%) were living with HIV. The most frequent ophthalmologic diagnoses were uveitis (41.9%), optic neuritis (12.9%), and retinitis (9.7%). Twenty-three cases had lumbar puncture data available: 13 (56.5%) had elevated cerebrospinal fluid (CSF) protein, 15 (65.2%) had elevated CSF cell count, and 6 (26.1%) had positive CSF VDRL. As a proportion of all syphilis cases, ocular syphilis accounted for 0.80% of all cases during the 2013–2015 period, versus 1.54% for 2016 (p=0.05). Stratified by HIV serostatus, there was a significant increase in the proportion of ocular syphilis cases in those living with HIV between the 2013–2015 and 2016 time periods (1.17% vs. 3.21%, p=0.03). Conclusion Paralleling trends observed in some US jurisdictions, BC is experiencing an increase in ocular syphilis cases, and an increasing proportion of syphilis cases in those living with HIV are being diagnosed with ocular findings. These results further highlight the importance of continuing efforts to respond to the syphilis epidemic, and focused screening for ocular symptoms, particularly in those at highest risk.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.005 | 0.012 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".