Saturday, February 20, 2010

Once your children, adopted from abroad, are home.....

Recommended Screening Tests and Evaluations
as written by Dr. Jane Aronson
for Pediatric Annals, Vol. 29, No 4, April 2000

The following article describes what screening tests and evaluations your child should have when you return home.

Once the child has arrived an initial visit to the doctor should ideally occur within 10-14 days, unless the child has an acute illness and then a sick visit is obviously imperative within 24 hours. Once the family knows their travel dates, they can schedule the adoption consultation appointment long in advance since the initial visit should take at least an hour or more.

There is consensus among adoption medicine specialists about the screening tests that should be performed on every child adopted from abroad initially. For a discussion of some of these screening test recommendations, consult the 2000 Redbook of Pediatric Infectious Diseases. The list in the Redbook should be viewed as just a guideline. The list below is a more comprehensive list recommended by most adoption medicine specialists in the U.S.

list updated August 1, 2002

* Antibody titers for children over one year of age who have a credible vaccine record from the country of origin:
- diphtheria antibodies
- tetanus antibodies
- polio neutralizing antibodies for type 1,2, 3
- chicken pox antibodies (varicella antibodies)
- measles, mumps, rubella (depends on the country and reliability of these vaccines)
* Hepatitis B serology (Hep B surface antibody, Hep B surface antigen, Hep B core antibody total)
* Hep A total with reflex to IgM in case of acute infection
* Syphilis serology (RPR, FTA-ABS)
* lead level (venous)
* Complete Blood count with differential and platelets
* Hemoglobin electrophoresis
* Thyroid screen
* Free T4
* Total T4
* Rickets screen
* Alkaline phosphatase
* calcium
* phosphorus
* Liver Enzymes
* Kidney Function tests
* BUN, Creatinine
* Audiology evaluation for all children adopted from abroad (unknown birth history and possible prematurity)
* Vision screening by a board certified pediatric ophthalmologist for all children adopted from abroad (unknown birth history and possible prematurity)
* Dental visit with a pediatric dentist should be done by 18 months of age
* TB skin test on arrival and again 6 months from the time of arrival (If the BCG site is not healed wait until it is healed and if more than a few months is needed for healing, consider having a chest x-ray; then do the PPD (TB skin test) when the BCG scar is completely healed
* Consider repeating HIV, Hep B, C 6 months after arrival (lengthy incubation periods and exposure just at the time of departure)

1 comment:

  1. Add Stool Samples for Giardia and/or other parasites, Our son had giardia upon return from Russia and this seemed to be very alarming to the health dept here in CA.....Hello? he was just adopted in Russia. He also tested positive for TB which warranted a 9 month regimen of antibiotics. Seems huge but really no big deal at all. Sounds like you are in good hands w/ dr. A.