■面临卫生差距的农村服务不足地区获得卫生资源的机会不平等。到美国SARS-CoV-2感染的第三和第四波,COVID-19检测减少了,更依赖家庭测试,那些寻求测试的人大多是有症状的。
这项研究确定了与COVID-19测试相关的因素,这些个体是在西弗吉尼亚州对服务不足人群的快速加速诊断2期(RADx-UP2)测试地点观察到的有症状和无症状的个体。
■人口统计学,临床,和行为因素是通过调查从被测试个体中收集的。Logistic回归用于确定与在测试部位出现症状的个体存在相关的因素。进行了空间自相关的全局测试,以检查有症状的个体与邮政编码测试的总个体的比例。创建了双变量地图,以显示较高比例的受测试个体之间的地理分布,这些个体是健康的症状和社会决定因素。
■在预测因子中,存在身体(调整后的比值比[aOR]1.85,95%CI1.3-2.65)或精神(aOR1.53,95%CI0.96-2.48)合并症,与住宿/居住地点相关的挑战(aOR307.13,95%CI1.46-10,6372),没有社区社会经济困境(aOR0.99,95%CI0.98-1.00),在获得所需药物(aOR0.01,95%CI0.00-0.82)或运输(aOR0.23,95%CI0.05-0.64)方面没有挑战,社区社会经济困境与未获得所需药物之间的相互作用(aOR1.06,95%CI1.00-1.13),没有社区社会经济困难,同时没有面临与住宿/居住地相关的挑战(aOR0.93,95%CI0.87-0.99),在统计学上与首次测试访视时出现症状的个体相关.
这项研究解决了当前COVID-19测试文献的关键限制,它几乎完全使用人群水平的疾病筛查数据来告知公共卫生应对措施。
UNASSIGNED: Rural underserved areas facing health disparities have unequal access to health resources. By the third and fourth waves of SARS-CoV-2 infections in the United States, COVID-19 testing had reduced, with more reliance on home testing, and those seeking testing were mostly symptomatic.
UNASSIGNED: This study identifies factors associated with COVID-19 testing among individuals who were symptomatic versus asymptomatic seen at a Rapid Acceleration of Diagnostics for Underserved Populations phase 2 (RADx-UP2) testing site in West Virginia.
UNASSIGNED: Demographic, clinical, and behavioral factors were collected via survey from tested individuals. Logistic regression was used to identify factors associated with the presence of individuals who were symptomatic seen at testing sites. Global tests for spatial autocorrelation were conducted to examine clustering in the proportion of symptomatic to total individuals tested by zip code. Bivariate maps were created to display geographic distributions between higher proportions of tested individuals who were symptomatic and social determinants of health.
UNASSIGNED: Among predictors, the presence of a physical (adjusted odds ratio [aOR] 1.85, 95% CI 1.3-2.65) or mental (aOR 1.53, 95% CI 0.96-2.48) comorbid condition, challenges related to a place to stay/live (aOR 307.13, 95% CI 1.46-10,6372), no community socioeconomic distress (aOR 0.99, 95% CI 0.98-1.00), no challenges in getting needed medicine (aOR 0.01, 95% CI 0.00-0.82) or transportation (aOR 0.23, 95% CI 0.05-0.64), an interaction between community socioeconomic distress and not getting needed medicine (aOR 1.06, 95% CI 1.00-1.13), and having no community socioeconomic distress while not facing challenges related to a place to stay/live (aOR 0.93, 95% CI 0.87-0.99) were statistically associated with an individual being symptomatic at the first test visit.
UNASSIGNED: This study addresses critical limitations to the current COVID-19 testing literature, which almost exclusively uses population-level disease screening data to inform public health responses.