title: Prevalence of infectious diseases among internationally adopted children.
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 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.
authors.affiliation: Department of Pediatrics, Columbia University, College of Physicians & Surgeons, New York, New York 10032, USA. ls5@columbia.edu
authors.forename: L
authors.initials: L
authors.lastname: Saiman
authors.forename: J
authors.initials: J
authors.lastname: Aronson
authors.forename: J
authors.initials: J
authors.lastname: Zhou
authors.forename: C
authors.initials: C
authors.lastname: Gomez-Duarte
authors.forename: P S
authors.initials: PS
authors.lastname: Gabriel
authors.forename: M
authors.initials: M
authors.lastname: Alonso
authors.forename: S
authors.initials: S
authors.lastname: Maloney
authors.forename: J
authors.initials: J
authors.lastname: Schulte
mesh_terms: D000300:Adoption / Q000208:ethnology*; D001208:Asia / Q000208:ethnology; D015331:Cohort Studies; D003141:Communicable Diseases / Q000453:epidemiology*; D005060:Europe / Q000208:ethnology; D005260:Female; D005873:Giardiasis / Q000453:epidemiology; D006509:Hepatitis B / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data; D007223:Infant; D007843:Latin America / Q000208:ethnology; D008297:Male; D008403:Mass Screening; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012426:Russia / Q000208:ethnology; D014376:Tuberculosis / Q000453:epidemiology; D014481:United States / Q000453:epidemiology