14 Pediatric Community-Acquired Needlestick Injuries: Description and Risk of Seroconversion
Bibliographic record
Abstract
Community-acquired needlestick injuries (CA-NSI) are an emerging phenomenon. Although anxiety exists concerning the perceived risk of transmission of blood-borne viruses, seroconversion in this setting appears to be a rare event. To describe the circumstances surrounding pediatric CA-NSI and to document the rate of seroconversion of HIV, HBV and HCV in these children. We conducted a retrospective chart review of a cohort of children presenting with a CA-NSI to the Emergency Department of the Montreal Children's Hospital between January 1, 1988 and October 30, 2003. Patients were identified by review of the Infectious Disease Clinic records. The variables collected included demographics (date of birth, sex, postal code), circumstances of injury, prophylaxis offered (HIV, HBV), vaccination status and follow-up serology at 6 months post-injury. Data were analyzed using descriptive statistics. Ninety-two cases were identified over a period of 14 years and 10 months. Mean age was 8.2 years±3.4 years, ranging from 2.6 to 17.7 years of age. Sixty-three (68.5%) were boys. Most injuries occurred in streets (38.0%) and most children purposely picked up the needle (76.1%). Only 11 (12.0%) patients reported a syringe containing blood. Sixty-nine (75.0%) presented on the day of the injury. Among the 86 patients not known to have been previously vaccinated for HBV, 74 (86.0%) received HBIG and 83 (96.5%) received HBV vaccine. Seventy-two of the 83 (86.7%) who received HBV vaccine completed a 3-dose course in follow-up. Prophylactic antiretroviral therapy (ART) was offered as of 1998. Of the 51 patients who presented thereafter, 30 (58.8%) received ART, of whom 26 (86.7%) completed a four-week course of therapy. At 6 months, 62 were tested for HBV, 71 for HIV and 41 for HCV. There was no seroconversion. Fourteen patients were lost to our follow-up and testing is pending for 3 patients. The majority of pediatric NSI can be prevented. Therefore, children and parents need to be educated about the risks of discarded needles. Our study showed no infections in this setting.
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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 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| 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".