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Multicenter Study
. 2025 Jan;60(1):e27313.
doi: 10.1002/ppul.27313. Epub 2024 Dec 26.

Impact of social determinants of health on the outcomes of Latin American children with Multisystem Inflammatory Syndrome (MIS-C)

Danilo Buonsenso  1   2 , Anna Camporesi  3 , Charles Sawaya  4 , Rolando Ulloa-Gutierrez  5   6   7 , Enrique Faugier-Fuentes  8 , Lourdes Dueñas  9 , Rolando A Paternina-de la Ossa  10 , Beatriz A Llamas-Guillén  11 , Luisa B Gámez-González  12 , Nancy Gálvez-Rafael  13 , Andrea Gatica  14 , Patricia Saltigeral-Simental  15 , Adán Cuatecontzi-Romero  16 , Flávia Jacqueline Almeida  17 , Shirley Cuan  18   19 , Elmer H Zapata-Yarlequé  20 , Sandra Beltrán  21 , Erika Reina-Bautista  22 , Adrián Collia  23 , Gabriela Ivankovich-Escoto  24 , Jaime Fernández-Sarmiento  25 , Adriana H Tremoulet  26 ; REKAMLATINA‐3 MIS‐C Study Group Investigators
Collaborators, Affiliations
Multicenter Study

Impact of social determinants of health on the outcomes of Latin American children with Multisystem Inflammatory Syndrome (MIS-C)

Danilo Buonsenso et al. Pediatr Pulmonol. 2025 Jan.

Abstract

Importance: There is growing understanding that Social Determinants of Health (SDH) impact on the outcomes of different pediatric conditions. We aimed to determine whether SDH affect the severity of MIS-C.

Design: Retrospective cohort study, 2021-2023. Children and adolescents with MIS-C younger than 18 years of age fulfilling the MIS-C CDC definition within the REKAMLATINA network were invited to participate. We assessed the impact of SDH on the risk of children with MIS-C to be diagnosed with shock, need of inotropes, respiratory support, transfusion, and death.

Results: Two hundred and seventy seven patients from 30 centers in 13 countries were included. Of them, 241 children from the four most-represented countries were included in the final analysis. Food insecurity, higher distance from a health center, not possessing a private vehicle to transport the patient to hospital, and having a home in poor condition, were associated with low LVEF, need of transfusion, shock, and need for respiratory support, when controlling for age, BMI, and ethnicity. The Score of Social Disadvantage was associated with Shock (OR: 1.35, P: 0.011, 95% CI: 1.07-1.71), Respiratory support (OR: 1.39, P: 0.005, 95% CI: 1.1-1.75), Transfusion (OR: 1.63, P0.013, 95% CI 1.1-2.41), but not death (OR: 0.76, P: 0.38, 95% CI: 0.41-1.40).

Conclusions: Among a large cohort of Latin American children with MIS-C, SDH negatively affect outcomes. These findings reinforce the need for better investigation of the role of SDH in MIS-C and other inflammatory conditions and may guide public health interventions.

Keywords: Latin America; children; multisystem inflammatory syndrome; risk factors; social determinants of health.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Items included in the Score of Social Disadvantage. [Color figure can be viewed at wileyonlinelibrary.com]
Figure 2
Figure 2
Representation of education of the mother and father in the study cohort.
Figure 3
Figure 3
Representation of family composition, household condition, income and means of transport to hospital in the study cohort.
See this image and copyright information in PMC

References

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