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Screening for imported infections in pediatric patients prior to immunosuppressive therapy

Teresa Del Rosal1, María López-Jorrín2, Ana Méndez-Echevarría3

  • 1General Pediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain; La Paz Research Institute (IdiPAZ), Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.

Travel Medicine and Infectious Disease
|June 9, 2026
PubMed

Insights

Imported infections are common in children needing immunosuppression, highlighting the need for systematic screening. A structured protocol detected infections like toxoplasmosis and strongyloidiasis in nearly 30% of pediatric patients.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • Public Health

Background:

  • Children undergoing immunosuppressive therapy are at high risk for opportunistic infections.
  • Pre-transplant and pre-chemotherapy screening protocols are crucial for managing infection risks.
  • Identifying imported infections in pediatric populations requires targeted diagnostic approaches.

Purpose of the Study:

  • To determine the prevalence of imported infections in pediatric patients before initiating immunosuppressive therapy.
  • To evaluate the effectiveness of a structured screening protocol in identifying these infections.
  • To assess adherence to the screening protocol and its diagnostic yield.

Main Methods:

  • A retrospective study was conducted on pediatric patients (<18 years) from non-Western countries.
  • Screening occurred between 2020-2024 at a tertiary hospital in Madrid, Spain.
  • The protocol included serology, tuberculosis testing, stool analysis, and vaccination assessment.

Main Results:

  • Sixty-three children were included, primarily from Latin America, with hematologic malignancies or awaiting solid organ transplants.
  • Only 19% of patients completed the full screening protocol.
  • Imported infections were detected in 28.6% of patients, including toxoplasmosis, strongyloidiasis, and malaria. Suboptimal immunity to hepatitis B, measles, and varicella was also noted.

Conclusions:

  • Imported infections are frequent in pediatric patients requiring immunosuppression.
  • Systematic screening prior to immunosuppressive therapy is supported by these findings.
  • Adherence to screening protocols needs improvement to maximize diagnostic yield.
Abstract

Keywords:
Communicable diseasesImmunosuppressionImportedLatent infectionMass screeningPediatricsTransplantation

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