title: Expected and actual case ascertainment and treatment rates for children infected with hepatitis C in Florida and the United States: epidemiologic evidence from statewide and nationwide surveys.
abstract: OBJECTIVE
  To evaluate the rate of pediatric hepatitis C virus (HCV) case ascertainment relative to the estimated number of actual cases.
  
  
  METHODS
  Data from Florida and United States health departments were used to assess pediatric HCV case ascertainment rates in Florida and nationwide. The percentage of children infected with HCV from Miami-Dade County receiving medical care by a pediatric gastroenterologist was estimated based on data obtained from physician questionnaires.
  
  
  RESULTS
  From 2000 through 2009, 2007 children were identified as having positive HCV antibody tests in Florida, only 12% of the expected number (n = 12 155). An estimated 1.6% of the expected children with HCV who tested Ab-positive (37 of 1935) were actively followed by a pediatric gastroenterologist in Miami-Dade County, Florida. Across the United States, only 4.9% of the expected cases have been identified.
  
  
  CONCLUSIONS
  The identification of children infected with HCV in the nation as a whole is grossly inadequate. Only a small fraction of cases are identified. In Florida, less than 2% of children identified receive treatment. Lack of identification and lack of treatment of children infected with HCV constitute critical public health problems. Strategies to increase awareness of HCV infection and to screen at-risk individuals could substantially improve morbidity and mortality while reducing health care costs.
authors: Department of Pediatrics, Batchelor Children's Research Institute, University of Miami Miller School of Medicine, Miami, FL, USA. adelgado5@med.miami.edu
authors: Aymin
authors: A
authors: Delgado-Borrego
authors: Lesley
authors: L
authors: Smith
authors: Maureen M
authors: MM
authors: Jonas
authors: Cyndena A
authors: CA
authors: Hall
authors: Betania
authors: B
authors: Negre
authors: Sergio H
authors: SH
authors: Jordan
authors: Matthew
authors: M
authors: Ogrodowicz
authors: Roshan
authors: R
authors: Raza
authors: David A
authors: DA
authors: Ludwig
authors: Tracie
authors: T
authors: Miller
authors: Steven E
authors: SE
authors: Lipshultz
authors: Regino
authors: R
authors: Gonzalez-Peralta
authors: Raymond T
authors: RT
authors: Chung
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005431:Florida; D006306:Health Surveys; D016174:Hepacivirus / Q000378:metabolism; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D018937:Hepatitis C Antibodies / Q000276:immunology; D006801:Humans; D055552:Infectious Disease Medicine / Q000379:methods; D008297:Male; D009749:Nutrition Surveys; D010372:Pediatrics / Q000379:methods; D015995:Prevalence; D011634:Public Health / Q000379:methods; D014481:United States
chemical_list: D018937:Hepatitis C Antibodies