The Characteristics of Tuberculosis Transmission in the Indigenous people of the Canadian Prairies
Bibliographic record
Abstract
Tuberculosis (TB) incidence in the Indigenous people of Canada continues to be disproportionately higher than that of the non-Indigenous and foreign-born people. For more than a decade, the rate of TB in the Indigenous people of Canada has remained relatively constant despite recent population growth. Most researchers have speculated that demographic and geographic risk factors along with the colonially and historically rooted poor social circumstances are associated with the ongoing transmission in the Indigenous people, thus raising concerns for TB control efforts. This thesis combined conventional and molecular DNA fingerprinting of Mycobacterium tuberculosis isolates to (1) identify and describe the demographic and geographic characteristics of all transmission events from Canadian-born pulmonary TB cases on the Prairie Provinces in 2007 and 2008; and (2) describe the predictors of new infection and secondary cases based on host, environmental, and behavioral characteristics of the transmitters. We found that transmission was most common from Registered First Nations potential transmitters who resided in reserve communities. Recent infection was slightly higher in contacts with reportedly lower exposure to the transmitter, but active disease was most notable in the infected close contacts. A significant proportion of transmission events suggested extensive geographic mobility between the residence of transmitters and their contacts, which poses a considerable challenge to jurisdictionally contain TB transmission. Upon further investigation, the likelihood of observing a transmission event was significantly greater in transmitters with advanced stages of pulmonary disease and in those that resided in households with poor ventilation. In light of these findings, it is clear that provincial TB control programs must strive to prioritize the demographic, geographic, clinical, and social determinants in the Indigenous people of the Prairies. Collaborative effort of healthcare workers, educators, and community leaders is required to disrupt the chain of transmission in this population group, whilst acknowledging traditional Indigenous values.
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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 | 0.001 | 0.002 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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".