Affiliation:
1. From the Department of Pediatrics, Columbia University, College of Physicians & Surgeons, New York, New York;
2. Department of Pediatrics, Winthrop-University Hospital, Mineola, New York; and Divisions of
3. Quarantine and
4. Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia.
Abstract
Objective.
Internationally adopted children are at increased risk of infections acquired in their country of origin. Ongoing surveillance of this unique population is needed to detect changing epidemiology and provide appropriate care.
Methods.
We performed a retrospective cohort study of 504 children adopted from abroad and evaluated from 1997 to 1998 to determine the prevalence of and factors associated with various infectious diseases.
Results.
The mean age of the study participants at medical evaluation was 1.6 years; 71% were girls, and they were adopted from 16 countries, including China (48%), Russia (31%), Southeast Asia (8%), Eastern Europe (8%), and Latin America (5%). Overall, 75 (19%) of 404 children tested had tuberculin skin tests ≥10 mm, but all had normal chest radiographs. BCG vaccination (odds ratio [OR]: 7.37; 95% confidence interval [CI]: 3.29, 17.16) and being Russian born (OR: 2.90; 95% CI: 1.68, 5.00) were risk factors for latent tuberculosis infection. Fourteen (2.8%) children had detectable hepatitis B surface antigen, but no child had active hepatitis C, human immunodeficiency virus, or syphilis. Giardia lambliaantigen was detected in 87 (19%) of 461 tested children, and such children were older (mean: 22 months vs 15.5 months) and more likely to have been born in Eastern Europe (OR: 2.82; 95% CI: 1.70, 4.68).
Conclusions.
We demonstrated increased rates of latent tuberculosis infection and G lamblia infection than previously reported. Thus, ongoing surveillance of internationally adopted children, international trends in infectious diseases, and appropriate screening will ensure the long-term health of adopted children as well as their families.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics, Perinatology, and Child Health
Reference27 articles.
1. Unsuspected infectious diseases and other medical diagnoses in the evaluation of internationally adopted children.;Hostetter;Pediatrics,1989
2. Medical evaluation of internationally adopted children.;Hostetter;N Engl J Med,1991
3. A high-yield workup for the new wave of immigrants.;Goldenring;Contemp Pediatr,1986
4. Primary care of international adoptees.;Quarles;Am Fam Physician,1998
Cited by
105 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献