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PEDIATRICS Vol. 108 No. 3 September 2001, pp. 608-612

Prevalence of Infectious Diseases Among Internationally Adopted Children

Received Nov 17, 2000; accepted Jan 22, 2001.

Lisa Saiman*, Jane AronsonDagger , Juyan Zhou*, Cabilla Gomez-Duarte*, Pablo San Gabriel*, Maria AlonsoDagger , Susan Maloney§, and Joann Schulteparallel

From the * Department of Pediatrics, Columbia University, College of Physicians & Surgeons, New York, New York; Dagger  Department of Pediatrics, Winthrop-University Hospital, Mineola, New York; and Divisions of § Quarantine and parallel  Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia.

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 lamblia antigen 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.  Key words:  international adoption, latent tuberculosis infection, hepatitis B, hepatitis C.


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