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General screening for infectious disease in foster children not cost effective
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Routine screening for infectious diseases in children and teenagers entering foster care does not demonstrate cost-effectiveness because the lab testing confirms a prevalence of less than 1% for hepatitis B and C, tuberculosis and syphilis in this population, according to a study published in Pediatrics.
“In the context of high-value, cost-conscious care, evaluating medical practice is important and necessary,” Mary Greiner, MD, a physician at Cincinnati Children’s Hospital, said in a press release. “Targeted screening should take local prevalence rates and other clinical implications into account.”
“Routine screening is generally accepted when screening tools are sensitive and specific and early detection improves outcomes,” Greiner continued. “But costs must be reasonable in relation to the anticipated benefits.”
To examine the prevalence of illness in children entering foster care within a single, urban county in Ohio as identified by lab screening, the researchers conducted a study in which children were assessed at a consultation foster care clinic and received lab screening. This screening included testing for diseases like HIV, HVB and HVC, syphilis and tuberculosis. Additionally, lead and hemoglobin levels were also assessed.
Between 2012 and 2015, 1,977 children and adolescents aged younger than 21 years were tested within the consultative foster care clinic. HBV and HVC, syphilis and TB all had a prevalence of less than 1%. No cases of HIV were observed. The most prevalent infectious disease noted by the researchers in adolescents entering foster care was chlamydia, for which 7% of teenagers tested positive. Greiner and colleagues also note that 54% of children lacked a detected immunity to HBV as they tested HBV surface antibody-negative.
“Replicating this work with other foster care populations and developing an algorithm for targeted screening are important areas for future research,” Greiner said in the release. – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.
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