Infectious Diseases in Internationally Adopted Children and Intercountry Discrepancies Among Screening Protocols, A Narrative Review.

Elena Chiappini,Sara Sollai,Tommaso Matucci,Sara Borgi,Barbara Bortone,Maurizio De Martino,Luisa Galli

doi:10.3389/fped.2019.00448

Abstract

Internationally adopted children (IAC) require thorough health assessments at time of arrival in the host country. As these children are at higher risk for infectious diseases, such as gastrointestinal parasites, tuberculosis, hepatitis, syphilis, and human immunodeficiency virus, early diagnosis of infectious diseases is fundamental for the optimal management of the child and, also, to reduce the risk of transmission to the adopting community. Comparative analysis of the screening protocols adopted in Europe, the United States, and Canada revealed different approaches to the adopted children. A homogeneous and internationally shared standard of care in the management of IAC should be provided.

Highlights

Infectious diseases are commonly reported in internationally adopted children (IAC) (1), and their need for rapid, cautious, and thorough screenings has been underlined by several authors (1–5)
Post-adoption screening protocols were identified by searching the guidelines websites and national adoption association websites of countries reported to receive the highest number of Internationally adopted children (IAC) (United States, Italy, Spain, Canada, and France) (8)
This paper focuses on the screening protocols for infectious diseases in newly arrived IAC

Summary

Introduction

Infectious diseases are commonly reported in internationally adopted children (IAC) (1), and their need for rapid, cautious, and thorough screenings has been underlined by several authors (1–5). A recent Italian study indicated that clinical conditions affecting IAC, ranging from congenital malformations, to complex infectious diseases, such as tuberculosis infection (observed in 15% of children included) and parasitosis (in more than 20%), to non-severe and treatable infections, such as Molluscum contagiosum and fungal skin infections, have been frequently reported. About 40% of IAC presented at least one infectious disease (2). IAC require medical evaluation and health certifications before adoption, many diseases may remain undiagnosed (3–5). Diagnosis of infectious diseases is crucial both for the optimal management of IAC and to reduce risk of transmission to the community (1, 6, 7). Cases of transmission of the Hepatitis A and Hepatitis B viruses, scabies, tuberculosis, Tinea capitis/corporis, and measles to adoptive families have been reported in the literature (1, 6, 7)

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Results

Conclusion