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Characterizing lupus in African American children in Southern United States
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Journal Article
Characterizing lupus in African American children in Southern United States
2025
Overview
Objective
To characterize the clinical, demographic, and socioeconomic profile of childhood systemic lupus erythematous (cSLE) in the Black Belt of the Southern United States in comparison to the current literature of predominantly Caucasian cohorts.
Methods
This is a cross-sectional study characterizing patients with cSLE from two centers in the Southeastern United States– University of Mississippi Medical Center (UMMC) and University of Alabama at Birmingham (UAB). Demographic, social, and clinical data was retrospectively collected by medical chart review for prevalent and incident cSLE patients via electronic medical records for UMMC and the Childhood arthritis and rheumatology research alliance (CARRA) registry database for UAB. The data was combined and analyzed using SPSS statistical software.
Results
Of the 45 patients,82.2%were female, 82.2% were of AA ethnicity, and 66.7% had Medicaid insurance. Mean age at diagnosis was 13.5 years (+/- 2.8). Mean American College of Rheumatology (ACR) score at diagnosis was 5.1 (+/- 1.27), the Systemic Lupus International Collaborating Clinics (SLICC score) was 8.4 (+/- 2.5). Average baseline Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) was 13.06 (+/- 9.3), SLEDAI at 6 months and 1 year respectively was 7.4 and 4.7. Average distance traveled to see a rheumatologist was 74.83 miles compared to a national average of 42.8 miles. 37/45 patients (82%) belonged to medium-high or high Social Vulnerability Index (SVI) group based on zip code.
Conclusion
Compared to previously described multiethnic cohorts of cSLE, this predominantly AA patient population in the Southern United States has significantly higher disease activity and greater damage accrual. Social risk factors for this population include a higher SVI, longer distance from an academic pediatric rheumatology center, and having Medicaid insurance. The effect of these factors on disparity of disease outcomes needs to be further explored with larger cohorts.
Significance and innovations
• There is limited literature on childhood systemic lupus erythematosus (cSLE) in Black patients from the Southern United States. This descriptive cohort focuses on patients from two states in the geographical Black Belt of the United States, a region that has not been previously explored in this context.
• This study examines the potential association between adverse socioeconomic factors and disparities in outcomes in cSLE, an area that remains understudied.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Age
/ Analysis
/ Black or African American - statistics & numerical data
/ Child
/ Female
/ Females
/ Humans
/ Lupus
/ Lupus Erythematosus, Systemic - diagnosis
/ Lupus Erythematosus, Systemic - epidemiology
/ Lupus Erythematosus, Systemic - ethnology
/ Male
/ Medicaid
/ Medicine
/ Southeastern United States - epidemiology
/ Southeastern United States - ethnology
