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Prevalence of infectious diseases among internationally adopted children
1Department of Pediatrics, Columbia University, College of Physicians & Surgeons, New York, New York 10032, USA. ls5@columbia.edu
Insights
Internationally adopted children show higher rates of latent tuberculosis infection and Giardia lamblia infection. Ongoing surveillance and screening are crucial for their long-term health.
Area of Science:
- Pediatric Infectious Diseases
- Global Health
- Epidemiology
Background:
- Internationally adopted children face unique health risks, including infectious diseases from their countries of origin.
- Timely detection and management of these infections are essential for the well-being of adopted children.
Purpose of the Study:
- To determine the prevalence of infectious diseases in internationally adopted children.
- To identify risk factors associated with these infections in this population.
Main Methods:
- Retrospective cohort study of 504 internationally adopted children evaluated between 1997 and 1998.
- Assessment included tuberculin skin tests, hepatitis B and C, HIV, syphilis, and Giardia lamblia antigen testing.
Main Results:
- 19% of children had latent tuberculosis infection, with BCG vaccination and Russian origin as risk factors.
- Hepatitis B surface antigen was detected in 2.8% of children; no cases of active hepatitis C, HIV, or syphilis were found.
- Giardia lamblia infection was present in 19% of children, associated with older age and Eastern European origin.
Conclusions:
- Internationally adopted children exhibit elevated rates of latent tuberculosis and Giardia lamblia infections.
- Continuous surveillance of infectious disease epidemiology and targeted screening are vital for adopted children's health.
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.