Rates of reported cases of acute and chronic Hepatitis B infection in the immigrant and non-immigrant populations in Quebec from 1991-2008
Bibliographic record
Abstract
BackgroundEarly screening and appropriately timed treatment for chronic hepatitis B (HBV) can prevent the development of cirrhosis, end stage liver disease or liver cancer. New infections can be prevented through vaccination. Immigrants have increased mortality from viral hepatitis and liver cancer, most of which is likely due to undetected chronic HBV, as they are not routinely screened before or after arrival in Canada. The aim of this study was to estimate and compare the rates of newly reported cases of acute and chronic HBV among immigrant and Canadian-born populations. MethodsA population-based cohort study of all reported cases of acute and chronic hepatitis B identified in the Quebec reportable disease database (MADO) from 1991-2008 were deterministically linked to the Quebec immigration database (MIDI). Annual cumulative incidence of reported cases of acute and chronic HBV were estimated and stratified by age, sex, and region of origin. Comparative rate ratios in immigrants vs. non-immigrants were calculated. Numerators were derived from the linked database and denominators were estimated from census data. Poisson regression was used to model and compare the trends in change of disease-specific rates over the study period. ResultsFrom 1991 to 2008, a total of 2,750 acute HBV and 14,633 chronic HBV reported cases were identified and linked. Immigrants accounted for only 5.5% (N=151) of acute HBV infections and they were younger than non-immigrants (30.2 vs. 37.7 years, p< .01). Crude annual cumulative incidence rates of reported cases of acute HBV decreased by 12.7% per year in non-immigrants, but only by 4.2% per year in immigrants over the study period. Immigrants accounted for 43% (N=6,306) of chronic HBV reported cases and they were younger and less likely to be male compared to non-immigrants. Immigrants from South East Asia, Sub-Saharan Africa and Eastern Europe/Central Asia had the highest rates of chronic HBV [191.4/100,000 population; 95% CI (189.2, 201.9), 170 (156.8, 181.2) and 44.9 (40.7, 49.2) respectively] with rates ratios ranging from 6.2 (5.6, 6.9) to 26.9 (25.9, 28.1) compared to non-immigrants. Over the study period, crude annual cumulative incidence rates of reported cases of chronic HBV decreased by 7.2% annually in non-immigrants whereas they increased by 1.9% per year in immigrants. ConclusionsIncreasing cumulative incidence rates of reported cases of chronic HBV over the study period in immigrants and very high cumulative incidence rates in certain sub-groups suggest that many immigrants groups could benefit from targeted HBV screening programs.
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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 | 0.001 | 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 | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".