University of Alberta researchers stress that all children adopted from outside North America should be screened for tuberculosis. The study shows that in the Canadian province of Alberta, from 2004-2006, 40 per cent of foreign-born children under five years of age who were found to have tuberculosis were international adoptees.
Most international adoptees are younger than five years of age and frequently come from resource-poor countries where tuberculosis is common and prenatal screening for infectious diseases is rare, says Richard Long, MD, professor in Pulmonary Medicine at the University of Alberta and lead author of the study.
"Because of the many social and demographic circumstances in North America, the option for domestic adoption is limited so the number of people seeking to adopt children from other parts of the world has increased," says Long.
Specifically, Long reminds that all international adoptees be screened upon arrival in North America for latent tuberculosis infection with the use of the Mantoux tuberculin skin test. Children with positive tuberculin skin test results or who have symptoms suggestive of tuberculosis should be examined for evidence of active disease and have a chest radiograph performed.
Children with latent tuberculosis infection or active tuberculosis disease should be treated in accordance with the North American tuberculosis standards. If the child was previously in an orphanage or children's home, the state tuberculosis program should, in consultation with the adoptive family, notify the orphanage or home, as well as the adoptive agency.
"As many international adoptees have no medical history documents, systematic screening for tuberculosis is imperative, not only to the child, but also the adoptive family and the surrounding community," says Long.
This study is published in the July 2007 issue of the Canadian Medical Association Journal.
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