Pediatric Crohn’s disease (PCD) disparities in health treatment for racial/ethnic minority children in the US were not well known.
The ImproveCareNow database at Texas Children’s Hospital was examined retrospectively from 2007 to 2015. Patients with CD who had undergone at least a 2-year follow-up and whose symptoms could be directly linked to inflammatory bowel disease were included. Researchers sought to find racial and ethnic differences in therapy, presentation, diagnostic delay, and 2-year results for a study. They also looked at relationships between early vs. late diagnosis (i.e., less than 6 months after illness starts), and these characteristics were unrelated to race or ethnicity.
The selection criteria were satisfied by 166 PCD patients [57.8% non-Hispanic White (NH-White), 18.1% African American (AA), and 15.7% Hispanic]. Hispanic patients had a quicker time to diagnosis (P<0.01) and were older at diagnosis than NH-White individuals (P=0.0164). Granuloma detection rates were lower in AA patients (33%, P<0.01) and Hispanic patients (35%, P<0.05) than in NH-White patients (63%). In comparison to NH-White patients, AA patients showed reduced rates of steroid-free remission (SFR) after 2 years (P<0.05). Early diagnosis was linked to higher ESR and lower hemoglobin levels (P<0.01). Within 2 years of diagnosis, the earlier diagnosis was linked to greater rates of surgery (P<0.05). SFR at 2 years was negatively correlated with diagnostic fecal calprotectin levels (P<0.05). Early use of corticosteroids was adversely connected with 2-year SFR, while early use of biologics was favorably correlated (P<0.05).
The results of PCD therapy, diagnosis, and diagnosis may be influenced by race and ethnicity. Therefore, this acknowledgment is a starting point for creating equity in PCD care.
Reference: journals.lww.com/jpgn/Abstract/2022/09000/Racial_and_Ethnic_Variation_in_Presentation,.18.aspx
