University of Texas Southwestern Medical School, 5323 Harry Hines Blvd., Dallas, TX 75219, United States.
University of Texas Southwestern Medical School, 5323 Harry Hines Blvd., Dallas, TX 75219, United States; Children's Health System, 1935 Medical District Drive, Dallas, TX 75219, United States.
Child Abuse Negl. 2021 Jul;117:105074. doi: 10.1016/j.chiabu.2021.105074. Epub 2021 Apr 28.
Children in foster care are considered at high risk for infectious diseases, and guidelines recommend screening for tuberculosis, hepatitis B and C, syphilis, gonorrhea and chlamydia. Little is known about the prevalence of infectious disease in children in foster care.
Describe infectious disease screening practices in a primary care clinic dedicated to caring for children in foster care.
Patients evaluated at a foster care primary care clinic at a southwestern academic center.
Retrospective chart review.
From January 1, 2017 through December 31, 2018, 2868 unique patients were evaluated (53 % male, 41 % white, 30 % black, 19 % Hispanic); 1638 (57 %) had any infectious disease laboratory screening done. About 50 % of children had completed screens for tuberculosis, HIV, syphilis and hepatitis C. Tuberculosis screens were positive in 3.6 % of children, 5.5 % of adolescents were positive for chlamydia and <1 % of children were positive for HIV, syphilis or hepatitis C. Increasing age and number of visits were associated with completed tuberculosis, HIV, syphilis and hepatitis C screenings (p < 0.01); female adolescents with completed labs were more likely to be screened for gonorrhea and chlamydia than male adolescents.
Few positive infectious disease screenings were identified in children evaluated in a dedicated foster care primary care clinic despite presence of risk factors. Multiple visits to a primary care foster care clinic may increase the likelihood of completed screenings. Targeted infectious disease screening based on age and local epidemiology may be less traumatizing but still clinically appropriate.
寄养儿童被认为具有较高的传染病风险，因此指南建议对结核病、乙型肝炎和丙型肝炎、梅毒、淋病和衣原体进行筛查。然而，我们对寄养儿童中传染病的流行情况知之甚少。
描述一家专门为寄养儿童提供护理的初级保健诊所进行传染病筛查的情况。
在西南部学术中心的一家寄养儿童初级保健诊所接受评估的患者。
回顾性病历审查。
从 2017 年 1 月 1 日至 2018 年 12 月 31 日，共有 2868 名患者（53%为男性，41%为白人，30%为黑人，19%为西班牙裔）接受了评估；其中 1638 名（57%）进行了任何传染病实验室筛查。约 50%的儿童完成了结核病、HIV、梅毒和丙型肝炎的筛查。3.6%的儿童结核病筛查呈阳性，5.5%的青少年衣原体筛查呈阳性，不到 1%的儿童 HIV、梅毒或丙型肝炎筛查呈阳性。年龄和就诊次数的增加与结核病、HIV、梅毒和丙型肝炎筛查的完成有关（p<0.01）；完成实验室检查的女性青少年比男性青少年更有可能接受淋病和衣原体筛查。
尽管存在危险因素，但在专门的寄养儿童初级保健诊所接受评估的儿童中，发现的阳性传染病筛查结果很少。多次到初级保健寄养诊所就诊可能会增加完成筛查的可能性。基于年龄和当地流行病学情况进行有针对性的传染病筛查可能不会造成创伤，但仍具有临床意义。
