Reuters (09.13.07) - Friday, September 14, 2007
As international adoptions increase, TB diagnoses in the
infants are also rising, underscoring the importance of
screening this population, a new study revealed. Between 1989
and 2005, international adoptions tripled, especially from
resource-constrained parts of the former Soviet Union and
"These children do have significant risk to be infected with
Mycobacterium tuberculosis," said senior author Dr. Anna M.
Mandalakas of Case Western Reserve University. "They
definitely need to be screened for TB infection."
In the study, researchers looked at 880 children who had been
screened for TB at the University of Minnesota's International
Adoption Clinic between 1986 and 2001. The children were born
in 33 different nations.
Overall, 12 percent tested positive for TB, investigators
found, but TB prevalence rose 7 percent for each year of the
study. Among infants under age 24 months, TB prevalence grew
at a brisk 15 percent per year of the study.
Researchers suggested that infants under age two spent the
most time indoors with caregivers who may have had active TB
as one explanation for the more numerous infections among the
younger group. Mandalakas and colleagues also found evidence
of chronic malnutrition in 28 percent of the children and
acute malnourishment in 5 percent.
"The fact that many children in the current study also were
malnourished puts them at considerable risk of progression to
tuberculosis disease," said Mandalakas. The authors
recommended orphanages screen staff for TB, both for the
children who may be adopted and those who remain in the
The full report, "Predictors of Mycobacterium tuberculosis
Infection in International Adoptees," was published in