Prevalence of infectious diseases among internationally adopted children

Objective. Internationally adopted children are at increased risk of infect ions acquired in their country of origin. Ongoing surveillance of this uniq ue population is needed to detect changing epidemiology and provide appropr iate 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, includin g 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 greater than or equal to 10 mm, but all had normal chest radiog raphs. 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 r isk 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 d etected in 87 (19%) of 461 tested children, and such children were older (m ean: 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 infecti on and G lamblia infection than previously reported. Thus, ongoing surveill ance of internationally adopted children, international trends in infectiou s diseases, and appropriate screening will ensure the long-term health of a dopted children as well as their families.