Inequalities in access to COVID-19 diagnostic testing - A cohort study for children in Amadora, Metropolitan Area of Lisbon, Portugal

• Autor(a) principal: Alves, Iolanda B.
• Data de Publicação: 2024
• Outros Autores: Carmesim, Sofia, Silva, António C., O. Martins, Maria do Rosário
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.25761/anaisihmt.452

Introduction: Scientific literature suggests that immigrant children often face more barriers in accessing healthcare than non-immigrant children. However, little is known about immigrant children’s access to healthcare during the COVID-19 pandemic in Portugal.   Objective: This study aimed to analyze immigration as a determinant of access to COVID-19 testing in children residing in Amadora, Metropolitan Area of Lisbon, Portugal.   Methods: This cohort study included 420 children aged 6/7 years, users of the Health Units in Amadora (52% immigrants; 48% non-immigrants). Data were collected through questionnaires and confirmed COVID-19 cases were extracted from the national laboratory surveillance system for COVID-19 (SINAVE Lab) between March 2020 and June 2022. The percentage of children who underwent at least one test and the median number of tests performed were calculated disaggregated by immigrant and non-immigrant status. Parametric and non-parametric tests were used to compare groups. Poisson and Robust Poisson regression models were estimated to analyze test performance determinants.   Results: 355 COVID-19 tests were performed, and 84.8% underwent at least one test. Immigrant children had a lower testing rate (75.1% vs. 95.1%) and underwent fewer tests per child (2 vs. 3). Adjusting for other factors, immigrant children had an 18% lower probability of having undergone at least one test (PR = 0.82, 95% CI: 0.75-0.90; p < 0.001) and performed 27% fewer tests compared to non-immigrant children (RR = 0.77, 95% CI: 0.68-0.88). Other associated factors include the caregiver’s gender, family structure, health insurance, and caregiver’s perception of the child’s health status.   Conclusion: Our results reveal that immigrant children residing in Amadora faced increased barriers to accessing and undergoing COVID-19 testing during the pandemic.