Hospital admissions for acute respiratory tract infections among infants from Nunavut and the burden of respiratory syncytial virus: a 10-year retrospective cohort study
Bibliographic record
Abstract
Background: Nunavut is a northern Canadian territory where a high proportion of infants are admitted to hospital with acute respiratory tract infection (ARI). Previous studies have been limited in regional and/or short duration of coverage. This study aimed to estimate the incidence rate, microbiology and outcomes of ARI hospitalizations in Nunavut infants. Methods: We conducted a retrospective cohort study of infants aged <1 year from Nunavut hospitalized for ARI at two regional and four tertiary pediatric hospitals in Canada, January 1, 2010, to June 30, 2020. One regional hospital was located in Nunavut; others were located across Canada. Descriptive statistics and multivariable logistic regression were performed. Findings: We identified 1189 ARI admissions, with an incidence rate of 133.9 per 1000 infants per year (95% confidence interval (CI): 126.8, 141.3). Of these admissions, 56.0% (n = 666) were to regional hospitals alone, 72.3% (n = 860) involved hospitalization outside of Nunavut, 15.6% (n = 185) were admitted into intensive care, and 9.2% (n = 109) underwent mechanical ventilation. Among 730 admissions with a pathogen identified, 45.8% had respiratory syncytial virus (RSV; n = 334), for a yearly incidence rate of 37.8 RSV-associated hospitalizations per 1000 infants (95% CI: 33.9, 42.1). Among RSV-associated hospitalizations, 41.1% (n = 138) were infants 0-2 months of age and 32.1% (n = 108) were >6 months. Compared with non-RSV admissions, infants with RSV had higher odds of admission into intensive care, oxygen therapy, CPAP/BiPAP respiratory support and length of hospital stay over a week. Interpretation: Understanding the high burden of ARI among Nunavut infants can inform health policy and serve as a baseline for assessing the impact of any new interventions targeting infant ARIs. Funding: Public Health Agency of Canada and Canadian Institutes of Health Research via the Canadian Immunization Research Network (CNF 151944).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".