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Mycobacterium tuberculosis infection in foreign born adoptees
W R Lange1, E Warnock-Eckhart, M E Bean
1Johns Hopkins Medical Institutions, Baltimore, MD 21205.
The Pediatric Infectious Disease Journal
|September 1, 1989
Summary
Children involved in international adoption, particularly Korean adoptees, show a significantly higher risk for tuberculosis (TB). Early detection and inclusion of TB in differential diagnoses are crucial for these high-risk pediatric groups.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- International adoption presents unique health considerations for children.
- Tuberculosis (TB) screening is vital for identifying at-risk populations.
- Previous studies have identified refugees and minority groups as high-risk for TB.
Observation:
- A study monitored 873 Korean adoptees placed between 1985-1988 for tuberculosis.
- Nine children showed signs of TB, including two with active disease.
- Seven children were asymptomatic tuberculin reactors, with a median age of 1 year.
Findings:
- The observed TB reactivity rate in Korean adoptees was approximately 50 times higher than in age-matched US-born children.
- Active TB cases were skin test-negative, highlighting limitations of standard screening.
- One child with active TB died from tuberculous meningitis.
Implications:
- Children undergoing international adoption should be considered a high-risk group for TB.
- Relying solely on tuberculin skin tests for screening may be insufficient.
- TB should be included in the differential diagnosis for high-risk children with symptoms like recurrent pneumonia or failure to thrive.