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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
GLOBAL: TB On the Rise Among International Adoptees
Anne Harding
September 14, 2007
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 China.

"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 orphanage.

The full report, "Predictors of Mycobacterium tuberculosis Infection in International Adoptees," was published in Pediatrics (2007;120(3):e610-e616).