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Predictors of Mycobacterium tuberculosis infection in international adoptees.
Pediatrics. 2007 Sep; 120(3):e610-6.Ped

Abstract

OBJECTIVE

The objective of this study was to measure the factors that are associated with Mycobacterium tuberculosis infection in international adoptees.

METHODS

A retrospective chart review was conducted on 880 international adoptees who presented to the International Adoption Clinic at the University of Minnesota between 1986 and 2001. Five tuberculin units of purified protein derivative were placed intradermally on the left forearm. The largest diameter of induration was measured in millimeters between 48 and 72 hours. Nutritional status was assessed using anthropometric measures at initial screening. Data on age, birth country, and year of adoption were assessed.

RESULTS

Adoptees (mean age: 26 months; range: 1-200 months; 62% female) came from 33 birth countries. Twenty-eight percent and 5% had evidence of chronic and acute malnutrition, respectively. Twelve percent had evidence of M. tuberculosis infection. The odds of M. tuberculosis infection increased 7% for each subsequent year during the period studied, increased 142% with each additional year of age for children < or = 24 months of age at baseline screening, and increased 15% with each additional year of age for children > 24 months of age at the time of evaluation. Tuberculin skin test induration response was not associated with nutritional status or birth region.

CONCLUSIONS

Our study demonstrated a high prevalence of M. tuberculosis infection and malnutrition in internationally adopted children, placing them at considerable risk for progression to tuberculosis disease. These findings also support current guidelines recommending completion of tuberculin screening immediately after adoption.

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Authors+Show Affiliations

Mandalakas AM
Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA. amm13@po.cwru.edu
Kirchner HL
No affiliation info available
Iverson S
No affiliation info available
Chesney M
No affiliation info available
Spencer MJ
No affiliation info available
Sidler A
No affiliation info available
Johnson D
No affiliation info available

MeSH

AdoptionChild Nutrition DisordersChild, PreschoolEmigration and ImmigrationFemaleHumansInfantInfant, NewbornMaleMinnesotaMycobacterium tuberculosisOutpatient Clinics, HospitalRetrospective StudiesTuberculin TestTuberculosis

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17766501

Citation

Mandalakas, Anna M., et al. "Predictors of Mycobacterium Tuberculosis Infection in International Adoptees." Pediatrics, vol. 120, no. 3, 2007, pp. e610-6.
Mandalakas AM, Kirchner HL, Iverson S, et al. Predictors of Mycobacterium tuberculosis infection in international adoptees. Pediatrics. 2007;120(3):e610-6.
Mandalakas, A. M., Kirchner, H. L., Iverson, S., Chesney, M., Spencer, M. J., Sidler, A., & Johnson, D. (2007). Predictors of Mycobacterium tuberculosis infection in international adoptees. Pediatrics, 120(3), e610-6.
Mandalakas AM, et al. Predictors of Mycobacterium Tuberculosis Infection in International Adoptees. Pediatrics. 2007;120(3):e610-6. PubMed PMID: 17766501.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of Mycobacterium tuberculosis infection in international adoptees. AU - Mandalakas,Anna M, AU - Kirchner,H Lester, AU - Iverson,Sandra, AU - Chesney,Mary, AU - Spencer,Mary Jo, AU - Sidler,Angela, AU - Johnson,Dana, PY - 2007/9/4/pubmed PY - 2007/11/9/medline PY - 2007/9/4/entrez SP - e610 EP - 6 JF - Pediatrics JO - Pediatrics VL - 120 IS - 3 N2 - OBJECTIVE: The objective of this study was to measure the factors that are associated with Mycobacterium tuberculosis infection in international adoptees. METHODS: A retrospective chart review was conducted on 880 international adoptees who presented to the International Adoption Clinic at the University of Minnesota between 1986 and 2001. Five tuberculin units of purified protein derivative were placed intradermally on the left forearm. The largest diameter of induration was measured in millimeters between 48 and 72 hours. Nutritional status was assessed using anthropometric measures at initial screening. Data on age, birth country, and year of adoption were assessed. RESULTS: Adoptees (mean age: 26 months; range: 1-200 months; 62% female) came from 33 birth countries. Twenty-eight percent and 5% had evidence of chronic and acute malnutrition, respectively. Twelve percent had evidence of M. tuberculosis infection. The odds of M. tuberculosis infection increased 7% for each subsequent year during the period studied, increased 142% with each additional year of age for children < or = 24 months of age at baseline screening, and increased 15% with each additional year of age for children > 24 months of age at the time of evaluation. Tuberculin skin test induration response was not associated with nutritional status or birth region. CONCLUSIONS: Our study demonstrated a high prevalence of M. tuberculosis infection and malnutrition in internationally adopted children, placing them at considerable risk for progression to tuberculosis disease. These findings also support current guidelines recommending completion of tuberculin screening immediately after adoption. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/17766501/full_citation L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=17766501 DB - PRIME DP - Unbound Medicine ER -