Blanchi S, Chabasse D, Pichard E, Darviot E, de Gentile L
Unité fonctionnelle de médecine des voyages, laboratoire de parasitologie-mycologie, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France.
Service des maladies infectieuses et tropicales, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France.
Med Mal Infect. 2014 Feb;44(2):69-75. doi: 10.1016/j.medmal.2013.12.003. Epub 2014 Jan 31.
The authors had for aim to describe infectious diseases in internationally adopted child at arrival in France.
We made a retrospective descriptive study of the children's files having undergone medical check-ups between 2009 and 2012.
One hundred and eighty-two files were included: 80% of the children came from Africa, 15% from South America and the Caribbean, 3% from Asia, and 2% from Europe. Forty-three percent were diagnosed with tinea. HIV, hepatitis C, and syphilis blood tests were all negative. Six children presented with acute or chronic hepatitis B, another 5 children with acute hepatitis A. One blood test for cysticercosis was positive. Two children presented with malaria. 58% of the children carried an intestinal parasite; the most prevalent was Giardia duodenalis. Bacteriological stool culture was positive for 17 children, for 9 with an antibiotic resistant bacterium. Twenty-seven children had a positive virological stool culture, 2 for a poliovirus.
A systematic infectious check-up should be performed for a child adopted internationally when he/she arrives in France. This allows diagnosing diseases requiring an emergency treatment, or asymptomatic but severe diseases when chronic. Some blood tests must be double-checked when the child arrives, because of possible false negative initial tests results in the country of origin. Screening, early treatment, and implementing prophylaxis can decrease the risk of transmission to relatives. It also allows monitoring the antimicrobial resistance of some pathogens and the reintroduction of the poliovirus in France.
作者旨在描述国际领养儿童抵达法国时的传染病情况。
我们对2009年至2012年间接受过医学检查的儿童档案进行了回顾性描述性研究。
纳入了182份档案：80%的儿童来自非洲，15%来自南美和加勒比地区，3%来自亚洲，2%来自欧洲。43%的儿童被诊断患有癣。艾滋病毒、丙型肝炎和梅毒血液检测均为阴性。6名儿童患有急性或慢性乙型肝炎，另有5名儿童患有甲型肝炎。一项囊尾蚴病血液检测呈阳性。2名儿童患有疟疾。58%的儿童携带肠道寄生虫；最常见的是十二指肠贾第虫。17名儿童的粪便细菌培养呈阳性，其中9名感染了耐药菌。27名儿童的粪便病毒培养呈阳性，2名感染了脊髓灰质炎病毒。
国际领养儿童抵达法国时应进行系统的传染病检查。这有助于诊断需要紧急治疗的疾病，或慢性时无症状但严重的疾病。由于原籍国的初始检测结果可能出现假阴性，儿童抵达时一些血液检测必须复查。筛查、早期治疗和实施预防措施可降低传染给亲属的风险。这也有助于监测某些病原体的抗菌耐药性以及脊髓灰质炎病毒在法国的再次传入。
