Alves, Iolanda B.Panunzi, SilviaSilva, António C.Loesch, Regina B. R.Pereira, Sofia C. R.Martins, M. Rosário O.2024-10-072024-10-0720242296-2565PURE: 100811345PURE UUID: 426b7bff-fc11-4851-8786-8902b132e320Scopus: 85188535673WOS: 001190362800001PubMed: 38532979PubMedCentral: PMC10963449ORCID: /0000-0002-7941-0285/work/169106434http://hdl.handle.net/10362/173138Funding Information: The authors acknowledge the support from the Executives Directorates and the Clinical and Health Councils of the Health Center Groups (ACES) of Amadora and Arco Ribeirinho, the Directorate-General of Health, as well as the parents/caregivers of the participating children for their collaboration. This work was only possible with the involvement and dedication of all partners. Funding Information: The authors of this article received financial support for their research, authorship, and publication. The Asylum, Integration, and Migration Fund (AMIF) provided funding for the project through grants PT/2018/FAMI/350 and PT/2021/699. The National Foundation for Science and Technology (FCT) granted funding through RESEARCH4COVID19–065 and PTDC/SAU-SER/4664/2020. The project received support from the Multiannual Financial Framework 2014/20 and the Global Health and Tropical Medicine (GHTM) unit with the identifier UID/04413/2020. Additionally, the authors acknowledge the FCT for providing funds through GHTM – UID/04413/2020 and LA-REAL – LA/P/0117/2020. Publisher Copyright: Copyright © 2024 Alves, Panunzi, Silva, Loesch, Pereira and Martins.Immigrant children often encounter additional barriers in accessing health care than their peers. However, there is a lack of evidence globally regarding how migrant status may have affected access to COVID-19 testing during the pandemic. This study aimed to analyze migrant status as a determinant of COVID-19 testing rates among children in the Lisbon metropolitan area, Portugal. This cross-sequential study included 722 children aged 2–8 years (47% non-immigrants; 53% immigrants). We collected data from a national surveillance system on laboratory-confirmed COVID-19 tests conducted between March 2020 and May 2023 and assessed whether children were ever tested for COVID-19 and testing frequency. We employed robust and standard Poisson regression models to estimate Adjusted Prevalence Ratios and Relative Risks with 95% confidence intervals. A total of 637 tests were performed. Immigrant children had lower testing rates (53% vs. 48%) and fewer tests per child (median: 2 vs. 3). Moreover, they were 17% less likely to be ever tested (PR = 0.83, 95% CI: 0.76–0.89) and performed 26% fewer tests (RR = 0.74, 95% CI: 0.67–0.82) compared to non-immigrant children. Caregiver’s age, education, employment status, child’s birth weight, and perceived health status were associated factors. Our findings suggest that the COVID-19 pandemic has left immigrant children somewhat behind. We conclude that specific interventions targeting vulnerable populations, such as immigrant children, are needed in future health crises.1028716engaccess to health careCOVID-19 pandemicCOVID-19 testing ratesimmigrant childrensocial inequalitiestesting for SARS-COV-2vulnerable populationPublic Health, Environmental and Occupational HealthSDG 3 - Good Health and Well-beingjournal article10.3389/fpubh.2024.1286829https://www.scopus.com/pages/publications/85188535673