86 Latent Tuberculosis in Foreign-Born Children
Bibliographic record
Abstract
Latent tuberculosis infection (LTBI) remains an important public health concern in Canada. In 2001, the incidence of tuberculosis in Canada and in Quebec was 6/100000. In Montreal the incidence was as high as 11/100000 with 80% in foreign-born residents. To assess differences between immigrant and internationally adopted children with latent tuberculosis infection. We conducted a retrospective chart review of all immigrant and internationally adopted children evaluated at the International Adoption and Immigrant Health Clinic of Sainte-Justine Hospital in Montreal between 01/01/98 and 31/12/01. Demographic data, anthropometric data, BCG vaccination, tuberculin skin test (TST), chest x-ray results, treatment and outcome were reviewed. Microsoft Excel Office XP was used for data compilation and analysis. Our population included 110 immigrants and 561 adopted children. Median age at evaluation was 5.5 years for immigrants and 13 months for adopted children. Twelve percent (77/671) of foreign-born children had a TST =10 mm. Of these 77 children, 42 had skin indurations between 10–15 mm while 35 had indurations =15 mm. Fifty-eight percent of patients had a TST <10 mm and in 30% TST results were not available. Thirty-three percent of the immigrant group and 13% of the adopted group did not have a documented reading of their TST. Thirty-eight percent (33/87) of all immigrants tested had LTBI compared to 10% (44/461) of all tested adopted children (p<0.001). When we excluded children who did not have the results of their TST documented, the prevalence of LTBI was 52% (33/64) in the immigrant group and 11% (44/403) in the internationally adopted group (p<0.001). All 77 patients had chest x-rays and none had radiological evidence of tuberculosis. One adopted child developed active tuberculosis after five months of isoniazid prophylaxis. All children received isoniazid, 75% of patients for 9 months and 86% for at least 6 months. Our study reinforces the importance of routine screening for tuberculosis infection in all foreign-born children. Overall, more than 50% of immigrant children have positive TST compared to 10% of internationally adopted children. Strategies for improving compliance with skin test reading in immigrant children are needed to insure adequate tuberculosis prevention. The high treatment rate with isoniazide prophylaxis illustrates the potential for screening programs to improve both child and public health care.
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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 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".