{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:07:32Z","timestamp":1753877252363,"version":"3.41.2"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Stanley and Susan Plotkin"},{"name":"Sanofi Pasteur Fellowship"},{"DOI":"10.13039\/100005886","name":"Pediatric Infectious Diseases Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005886","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Pediatric tuberculosis infection (TBI) disproportionately affects those in complex social situations. Neighborhood characteristics may influence access to care and TBI-related outcomes. We sought to examine links between neighborhood-level socioeconomic deprivation and clinical outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this retrospective cohort study, we identified children with TBI treated at our pediatric infectious diseases clinics between 2012 and 2023. We geocoded each child\u2019s address to identify neighborhood-level material community deprivation index (MCDI) scores. Outcomes included missed clinic visits, missed antibiotic doses, and changes in antibiotic therapy due to adherence concerns. We assessed the time between referral and first visit, first and second visits, and first and last visits. Kruskal\u2013Wallis rank sum test and chi-squared tests examined relationships between DI quartile and clinical outcomes. Log-rank testing and Cox proportional hazard regression models evaluated time-to-event analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 150 children with TBI. There were no differences across MCDI quartiles in rates of missed clinic visits, missed antibiotic doses, changed therapy, or therapy completion. Higher deprivation was associated with a longer time between referral and first visit (median 12 days for low\/moderate-low deprivation quartiles vs. 24 days for high\/moderate-high deprivation quartiles, P\u2005=\u2005.004). The high\/moderate-high deprivation category had a 39% lower hazard of getting to the first clinic visit after referral compared to the low\/moderate-low deprivation category (HR 0.61; 95% CI, .43, .85) after adjustment for race, insurance, and language.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Children with TBI from socioeconomically deprived neighborhoods have longer times from referral to first clinical evaluation. Exploring drivers of differences could promote more equitable TBI care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jpids\/piaf020","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T14:03:00Z","timestamp":1740492180000},"source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Tuberculosis Infection-Related Outpatient Clinical Outcomes Across Neighborhood-Level Deprivation Quartiles"],"prefix":"10.1093","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2131-0177","authenticated-orcid":false,"given":"Melissa E","family":"Day","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Duan","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Carol","family":"Burkhardt","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH ,","place":["United States"]},{"name":"Division of General and Community Pediatrics, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH ,","place":["United States"]},{"name":"Division of General and Community Pediatrics, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5280-4439","authenticated-orcid":false,"given":"Elizabeth P","family":"Schlaudecker","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH ,","place":["United States"]},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew F","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH ,","place":["United States"]},{"name":"Division of General and Community Pediatrics, Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,2,25]]},"reference":[{"year":"2024","author":"Centers for Disease Control and Prevention","key":"2025052711432759200_CIT0001"},{"author":"Centers for Disease Control and Prevention","key":"2025052711432759200_CIT0002"},{"key":"2025052711432759200_CIT0003","doi-asserted-by":"crossref","first-page":"e2021054663","DOI":"10.1542\/peds.2021-054663","article-title":"Tuberculosis infection in children and adolescents: testing and treatment","volume":"148","author":"Nolt","year":"2021","journal-title":"Pediatrics"},{"author":"Centers for Disease Control and Prevention","key":"2025052711432759200_CIT0004"},{"key":"2025052711432759200_CIT0005","doi-asserted-by":"crossref","first-page":"2153","DOI":"10.1186\/s12889-022-14579-7","article-title":"The socioeconomic impact of tuberculosis on children and adolescents: a scoping review and conceptual framework","volume":"22","author":"Atkins","year":"2022","journal-title":"BMC Public Health"},{"key":"2025052711432759200_CIT0006","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.annepidem.2018.11.008","article-title":"Material community deprivation and hospital utilization during the first year of life: an urban population-based cohort study","volume":"30","author":"Brokamp","year":"2019","journal-title":"Ann Epidemiol"},{"year":"2018","author":"Brokamp","key":"2025052711432759200_CIT0007"},{"key":"2025052711432759200_CIT0008","doi-asserted-by":"crossref","first-page":"E8","DOI":"10.3171\/2023.8.FOCUS23448","article-title":"Utility of the material community deprivation index as a metric to identify at-risk children for severe traumatic brain injury","volume":"55","author":"Gaulden","year":"2023","journal-title":"Neurosurg Focus"},{"key":"2025052711432759200_CIT0009","article-title":"Active tuberculosis","volume-title":"StatPearls [Internet]","author":"Jilani","year":"2024"},{"key":"2025052711432759200_CIT0010","doi-asserted-by":"crossref","first-page":"1804","DOI":"10.1377\/hlthaff.2022.00482","article-title":"Use of area-based socioeconomic deprivation indices: a scoping review and qualitative analysis","volume":"41","author":"Trinidad","year":"2022","journal-title":"Health Aff (Millwood)"},{"author":"Centers for Disease Control and Prevention","key":"2025052711432759200_CIT0011"},{"key":"2025052711432759200_CIT0012","doi-asserted-by":"crossref","first-page":"723","DOI":"10.15585\/mmwr.mm6725a5","article-title":"Update of recommendations for use of once-weekly isoniazid","volume":"67","author":"Borisov","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025052711432759200_CIT0013","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1186\/s12889-021-12005-y","article-title":"Barriers and strategies to successful tuberculosis treatment in a high-burden tuberculosis setting: a qualitative study from the patient\u2019s perspective","volume":"21","author":"Pradipta","year":"2021","journal-title":"BMC Public Health"},{"key":"2025052711432759200_CIT0014","doi-asserted-by":"crossref","first-page":"723","DOI":"10.15585\/mmwr.mm6725a5","article-title":"Update of recommendations for use of once-weekly isoniazid","volume":"67","author":"Borisov","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"}],"container-title":["Journal of the Pediatric Infectious Diseases Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jpids\/advance-article-pdf\/doi\/10.1093\/jpids\/piaf020\/62166293\/piaf020.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jpids\/article-pdf\/14\/5\/piaf020\/62166293\/piaf020.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jpids\/article-pdf\/14\/5\/piaf020\/62166293\/piaf020.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T15:43:34Z","timestamp":1748360614000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jpids\/article\/doi\/10.1093\/jpids\/piaf020\/8042073"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,25]]},"references-count":14,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5,13]]}},"URL":"https:\/\/doi.org\/10.1093\/jpids\/piaf020","relation":{},"ISSN":["2048-7207"],"issn-type":[{"type":"electronic","value":"2048-7207"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2025,2,25]]},"article-number":"piaf020"}}