- 1University of Texas Southwestern Medical School, 5323 Harry Hines Blvd., Dallas, TX 75219, United States. Electronic address: Sarah.Lairmore@utsw.edu.
- 2University 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.
- 3Children's Health System, 1935 Medical District Drive, Dallas, TX 75219, United States.
Background: 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.
Objectives: Describe infectious disease screening practices in a primary care clinic dedicated to caring for children in foster care.
Participants and setting: Patients evaluated at a foster care primary care clinic at a southwestern academic center.
Methods: Retrospective chart review.
Results: 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.
Conclusions: 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