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Maternal hepatitis C prevalence and trends by county, US: 2016-2020
Katherine A Ahrens1, Lauren M Rossen2, Amanda R Burgess1
1Maine Rural Health Research Center, Muskie School of Public Service, University of Southern Maine, Portland, Maine, USA.
Paediatric and Perinatal Epidemiology
|November 14, 2022
Summary
Hepatitis C virus (HCV) infection is more prevalent in rural US counties among women giving birth. Rural areas also experienced the largest increases in maternal HCV prevalence from 2016 to 2020.
Area of Science:
- Public Health
- Epidemiology
- Biostatistics
Background:
- Hepatitis C virus (HCV) infection trends among women giving birth may vary between rural and urban US areas.
- Estimating these trends in rural counties is challenging due to small population numbers, potentially leading to unstable estimates.
Purpose of the Study:
- To utilize small area estimation methods for updated county-level prevalence estimates of maternal HCV infection.
- To analyze trends in maternal HCV infection by county-level rurality for the first time.
Main Methods:
- Employed hierarchical Bayesian models with spatiotemporal random effects using cross-sectional natality data (2016-2020).
- Incorporated a 6-level rural-urban county classification, year, maternal characteristics, and county-specific covariates.
- Generated annual county-level estimates of maternal HCV infection and trends.
Main Results:
- Maternal HCV prevalence was higher in rural counties compared to urban counties (4.8 per 1000 births).
- Rural counties (micropolitan and noncore) showed the largest annual increases in prevalence from 2016-2020.
- Urban counties exhibited smaller increases, with the lowest rates in large central and fringe metro areas.
Conclusions:
- Maternal HCV infection prevalence is highest in rural counties, with the greatest average increase observed between 2016-2020.
- County-level data are crucial for monitoring rural-urban trends in maternal HCV infection.
- Addressing geographic disparities in maternal HCV infection is essential.
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