Prevalence of Infectious Diseases Among Internationally Adopted Children

Saiman, Lisa; Aronson, Jane; Zhou, Jia; Gomez-Duarte, Cabilla; Gabriel, Pablo; Alonso, María Carmen Herrero; Maloney, Susan A.; Schulte, Joann

doi:10.1542/peds.108.3.608

Cited by 118 publications

(151 citation statements)

References 19 publications

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“…PCR analysis with the bla SHV primers showed the presence of a 795-bp fragment only in the seven serotype Babelsberg ESBL-producing isolates and in all the serotype Enteridis isolates. The sequence from both strands of PCR 21 isolates. Sequencing of the entire nucleotide sequence from both strands in isolate 2 identified bla TEM-1 .…”

Section: Resultsmentioning

confidence: 99%

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SHV-12-Like Extended-Spectrum-β-Lactamase-Producing Strains of Salmonella enterica Serotypes Babelsberg and Enteritidis Isolated in France among Infants Adopted from Mali

et al. 2004

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cultures of Salmonella enterica serotype Babelsberg and 6 cultures of serotype Enteritidis, isolated in France from internationally adopted children, were identified at the French National Reference Center for Salmonella. All serotype Babelsberg isolates were related, as determined by pulsed-field gel electrophoresis, and all serotype Enteritidis strains displayed the same phage type. All serotype Enteritidis and seven serotype Babelsberg isolates produced an SHV-12-like extended-spectrum ␤-lactamase as determined by sequencing of PCR products and by isoelectrofocusing. Some serotype Enteritidis isolates exhibited additional antimicrobial resistance (aminoglycosides, tetracycline, chloramphenicol, sulfonamides, and trimethoprim). Our investigation indicated that these Salmonella isolates were certainly acquired in the same orphanage in Bamako, Mali, before the children were adopted by French families. An inappropriate use of ceftriaxone was probably the cause of the emergence of such strains. There is an urgent need to determine the origin of the contamination and to introduce adequate antibiotic protocols into this orphanage to prevent further transmission and dissemination. Screening for infections and follow-up, adapted to the origin of the internationally adopted children, should be recommended.

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Section: Resultsmentioning

confidence: 99%

“…Several reports from U.S. authors indicated that children adopted from abroad are at increased risk of infections acquired in their country of origin (7,21). In these studies, the adopted children rarely had infections with Salmonella (less than 2%) compared to tuberculosis or hepatitis B, but none of the children were adopted from Africa.…”

Section: Discussionmentioning

confidence: 97%

SHV-12-Like Extended-Spectrum-β-Lactamase-Producing Strains of Salmonella enterica Serotypes Babelsberg and Enteritidis Isolated in France among Infants Adopted from Mali

et al. 2004

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“…23 Several investigators have evaluated international adoptees for LTBI and TB disease. Saiman et al 24 performed TSTs on 404 internationally adopted children; 19% (75 of 404) had positive TSTs (TST Ն 10 mm) and normal chest radiographs. In contrast, previous rates of LTBI among international adoptees ranged from 0.6% to 5%.…”

Section: International Adoption Of Childrenmentioning

confidence: 99%

Targeted Tuberculin Skin Testing and Treatment of Latent Tuberculosis Infection in Children and Adolescents

2004

Pediatrics

110

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ABSTRACT.Comprehensive new guidelines for screening, targeted testing, and treating latent tuberculosis infection (LTBI) in children and adolescents are presented. The recent epidemiology of TB and data on risk factors for LTBI are reviewed. The evidence-based recommendations provided emphasize the paradigm that children and adolescents should be screened for risk factors by using a risk-factor questionnaire for TB and LTBI and tested with the tuberculin skin test only if >1 risk factor is present. The use of administrative or mandated tuberculin skin tests for entry to day care, school, or summer camp is strongly discouraged. Treatment regimens, suggestions to improve adherence, and methods to monitor toxicities are summarized. Children and adolescents with LTBI represent the future reservoir for cases of TB. Thus, detecting and treating LTBI in children and adolescents will contribute to the elimination of TB in the United

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“…Adoptive parents, adoption agencies, and physicians who care for internationally adopted children have wondered whether the young age at placement and residence in foster care (rather than orphanages) reduce the frequency of health and developmental issues such as those described in children who are adopted from Russia, Romania, China, and other countries. [2][3][4][5][6][7][8][9][10][11][12] Other speculations include the possibility that Guatemalan children are less likely to be exposed prenatally to drugs or alcohol than children from other regions and that their vaccine records are more "believable" than those from some other countries. 13 Moreover, although foster care is widely believed to result in better health and developmental status for children without parents, a direct comparison of the status of children who are raised by these 2 methods of care has not previously been reported.…”

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confidence: 99%

Health of Children Adopted From Guatemala: Comparison of Orphanage and Foster Care

et al. 2005

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ABSTRACT. Objective. Since 1986, American parents have adopted >17 300 children from Guatemala. This study assessed the health, growth, and developmental status of 103 Guatemalan adopted children (48 girls; 55 boys) after arrival in the United States. Physical evidence suggestive of prenatal alcohol exposure and adequacy of vaccinations administered were also reviewed.Methods. Retrospective chart review was conducted of 103 children who were evaluated after arrival in the United States in an international adoption specialty clinic, and a case-matched study was conducted of a subgroup of 50 children who resided in either an orphanage or foster care before adoption. Mean age at arrival was 16 ؎ 19 months. Before adoption, 25 children resided in orphanages, 56 resided in foster care, and 22 resided in mixed-care settings. The 25 children who had resided in orphanages before adoption were matched for age at arrival, interval from arrival to clinic visit, and gender with a child adopted from foster care. Health and developmental status of these matched pairs were compared, allowing the first direct comparison of children raised in orphanages or foster care before adoption.Results. Mild growth delays were frequent among the children. Mean z scores for weight, height, and head circumference were, respectively, ؊1.00, ؊1.04, and ؊1.08. Children from foster care had significantly better z scores for height, weight, and head circumference than those from orphanage or mixed care. Among children who were younger than 2 years at arrival, growth measurements correlated inversely with age at arrival. Infectious diseases included intestinal parasites (8%) and latent tuberculosis infection (7%). Other medical conditions included anemia (30%), elevated lead levels (3%), and (using strict criteria) phenotypic facial features suggestive of prenatal alcohol exposure (28%). Adequacy of vaccine records from Guatemala was assessed: 28% met American Academy of Pediatrics standards for vaccine administration. Unsuspected significant medical diagnoses, including congenital anomalies and ocular, neurologic, and orthopedic problems, were found in 14%. Most children were doing well developmentally (80 -92% of expected performance), but 14% had global developmental delays. Cognition, expressive and receptive language, and activities of daily living skills correlated inversely with age at arrival for children who were younger than 2 years at adoption. Among the 50 matched children, those who resided in foster care before adoption had better measurements for height, weight, and head circumference at arrival to the United States. Moreover, those who resided in foster care scored significantly better for cognitive skills than those who had previously resided in orphanages (96.3% of age-expected compared with 88.3% of age-expected); other skills did not differ between the 2 groups. No differences were found between the 2 groups of children related to prevalence of medical diagnoses or phenotypic evidence suggesting prenatal alcohol exposure.Conclu...

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Prevalence of Infectious Diseases Among Internationally Adopted Children

Cited by 118 publications

References 19 publications

SHV-12-Like Extended-Spectrum-β-Lactamase-Producing Strains of Salmonella enterica Serotypes Babelsberg and Enteritidis Isolated in France among Infants Adopted from Mali

SHV-12-Like Extended-Spectrum-β-Lactamase-Producing Strains of Salmonella enterica Serotypes Babelsberg and Enteritidis Isolated in France among Infants Adopted from Mali

Targeted Tuberculin Skin Testing and Treatment of Latent Tuberculosis Infection in Children and Adolescents

Health of Children Adopted From Guatemala: Comparison of Orphanage and Foster Care

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