Revisiting adoptee screening policies urged for the AAP
The American Academy of Pediatrics “should consider recommending three stool specimens be submitted and evaluated for all internationally adopted children on arrival to the United States, regardless of gastrointestinal symptoms,” according to a study published recently.
Mary Allen Staat, MD, MPH, of Cincinnati Children’s Hospital Medical Center, and colleagues said the AAP currently recommends up to four stool specimens, but that just one sample is sufficient for asymptomatic children. However, after Staat and colleagues evaluated data on 1,042 children from 36 countries who were screened within 120 days of arrival, they found that 27% of the children had an intestinal parasite.
Not all cases were detected with the first stool specimen. The probability of identifying any pathogen with one stool specimen was 79%; with two specimens, it rose to 92%; and rose to 100% with three stool specimens.
The main pathogens were Giardia intestinalis (19%), Blastocystis hominis (10%), Dientamoeba fragilis (5%) and Entamoeba histolytica (1%).
The researchers described several risk factors that predisposed the children to having a parasite, including being from Ethiopia and the Ukraine, being institutionalized and older age. The lowest prevalence of intestinal parasites occurred in children from South Korea, Guatemala and China.
Based on these findings, Staat and colleagues concluded that “multiple stool specimens increased pathogen identification in this high-risk group of children.”
Disclosure: The researchers report no relevant financial disclosures.
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