AI Article Synopsis
- Current guidelines suggest that children exposed to HCV in utero should be screened by 18 months of age, but only a small percentage actually receive this screening in Canada.
- A study analyzed data from children born between 2000 and 2016 to mothers with HCV, discovering that only 29% were screened by age two and highlighting significant maternal social determinants of health such as income and neighborhood stability.
- The findings indicate that factors like rural living and residing in high-dependency areas are linked to lower screening rates, while younger maternal age, HIV co-infection, and specialist involvement are associated with higher screening rates.
Article Abstract
Background: Current guidelines recommend HCV screening by 18 months of age for those exposed to HCV in utero; yet, screening occurs in the minority of children.
Objectives: To evaluate the association between maternal neighbourhood-level social determinants of health (SDOH) and paediatric HCV screening in the general population in a publicly funded healthcare system in Canada.
Methods: Retrospective cohort study using administrative healthcare data held at ICES. Children born to individuals positive for HCV RNA in pregnancy from 2000 to 2016 were identified and followed for 2 years. Major SDOH were identified, and the primary outcome was HCV screening in exposed children (HCV antibody and/or RNA). Associations between SDOH and HCV screening were determined using multivariate Poisson regression models adjusting for confounding.
Results: A total of 1780 children born to persons with +HCV RNA were identified, and 29% (n = 516) were screened for HCV by age two. Most mothers resided in the lowest income quintile (42%), and most vulnerable quintiles for material deprivation (41%), housing instability (38%) and ethnic diversity (26%) with 11% living in rural locations. After adjustment for confounding, maternal rural residence (risk ratio [RR] 0.82, 95% confidence interval [CI] 0.62, 1.07) and living in the highest dependency quintile (RR 0.83, 95% CI 0.65, 1.07) were the SDOH most associated with paediatric HCV screening. Younger maternal age (RR 0.98 per 1-year increase, 95% CI 0.97, 0.99), HIV co-infection (RR 1.69, 95% CI 1.16, 2.48) and GI specialist involvement (RR 1.18, 95% CI 1.00, 1.39) were associated with higher probabilities of screening.
Conclusions: Among children exposed to HCV during pregnancy, rural residences and living in highly dependent neighbourhoods showed a potential association with a lower probability of HCV screening by the age of 2. Future work evaluating barriers to paediatric HCV screening among rural residing and dependent residents is needed to enhance the screening.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299768 | PMC |
| http://dx.doi.org/10.1111/ppe.13042 | DOI Listing |
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