Analysis of the 2007-2018 National Health Interview Survey (NHIS): Examining Neurological Complications among Children with Sickle Cell Disease in the United States.
Analysis of the 2007-2018 National Health Interview Survey (NHIS): Examining Neurological Complications among Children with Sickle Cell Disease in the United States.
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DOI：
10.3390/ijerph20126137
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发表时间：
2023-06-15
影响因子：
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通讯作者：
Ogedegbe G
中科院分区：
文献类型：
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作者：
Peprah E;Gyamfi J;Lee JT;Islam F;Opeyemi J;Tampubolon S;Ojo T;Qiao W;Mai A;Wang C;Vieira D;Meda S;Adenikinju D;Osei-Tutu N;Ryan N;Ogedegbe G
本研究比较了美国全国范围内患有或不患有镰状细胞病（SCD）儿童的神经系统并发症，并评估了健康状况、医疗保健和特殊教育利用模式、护理障碍以及SCD状态和人口统计学/社会经济地位（SES）与合并症和医疗保健利用的相关性。数据来自2007-2018年国家健康访谈调查（NHIS）样本儿童核心问卷数据集，其中包括133，542名儿童。孩子的监护人的确认确定了SCD的存在。回归分析用于比较SCD和人口统计学/SES对神经系统疾病的相关性，p < 0.05。此外，还估计了患有各种神经系统疾病的调整后优势比（AOR）。在纳入NHIS的133，481名儿童中，平均年龄为8.5岁（SD：0.02），215名患有SCD。在SCD儿童中，样本组成包括男性（n = 110）和黑人（n = 82%）。SCD样本具有更高的神经发育状况的几率（p < 0.1）。黑人儿童家庭（55%加权）报告家庭收入<联邦贫困线的100%。黑人儿童更有可能经历更长的等待时间去看医生（AOR，0.3; CI 0.1-1.1）。与没有SCD的儿童相比，患有SCD的儿童在12个月内看专科医生的机会更大（AOR 2.3; CI 1.5-3.7）。美国SCD儿童的代表性样本显示，发生神经系统并发症的几率更高，医疗保健和特殊教育服务的利用率增加，黑人儿童的负担不成比例。这就迫切需要通过实施医疗保健干预措施和增加教育援助计划来解决SCD儿童的健康负担，以对抗神经认知障碍，特别是黑人儿童。
This study compared neurological complications among a national sample of United States children with or without sickle cell disease (SCD) and evaluated health status, healthcare and special education utilization patterns, barriers to care, and association of SCD status and demographics/socioeconomic status (SES) on comorbidities and healthcare utilization. Data was acquired from the National Health Interview Survey (NHIS) Sample Child Core questionnaire 2007–2018 dataset that included 133,542 children. An affirmation from the guardian of the child determined the presence of SCD. Regression analysis was used to compare the associations between SCD and demographics/SES on neurological conditions at p < 0.05. Furthermore, adjusted odds ratios (AORs) were estimated for having various neurological conditions. Of the 133,481 children included in the NHIS, the mean age was 8.5 years (SD: 0.02) and 215 had SCD. Of the children with SCD, the sample composition included male (n = 110), and Black (n = 82%). The SCD sample had higher odds of having neuro-developmental conditions (p < 0.1). Families of Black children (55% weighted) reported household incomes < 100% of federal poverty level. Black children were more likely to experience longer wait times to see the doctor (AOR, 0.3; CI 0.1–1.1). Compared to children without SCD, those with SCD had a greater chance of seeing a medical specialist within 12 months (AOR 2.3; CI 1.5–3.7). This representative sample of US children with SCD shows higher odds of developing neurological complications, increased healthcare and special education services utilization, with Black children experiencing a disproportionate burden. This creates the urgency to address the health burden for children with SCD by implementing interventions in healthcare and increasing education assistance programs to combat neurocognitive impairments, especially among Black children.