Chiappini Elena, Zaffaroni Mauro, Bianconi Martina, Veneruso Giuseppina, Grasso Nicolino, Garazzino Silvia, Arancio Rosangela, Valentini Piero, Ficcadenti Anna, Da Riol Maria Rosalia, La Placa Simona, Galli Luisa, de Martino Maurizio, Bona Gianni
Department of Health Sciences, Meyer University Hospital, University of Florence, Florence, Italy.
Division of Pediatrics, Department of Health Sciences, IRCAD (Interdisciplinary Research Center of Autoimmune Diseases), University of Piemonte Orientale Amedeo Avogadro, Novara, Italy.
Acta Paediatr. 2018 Sep;107(9):1581-1586. doi: 10.1111/apa.14237. Epub 2018 Feb 8.
This study evaluated the prevalence of infectious diseases and immunisation status of children adopted from Africa.
We studied 762 African children referred to 11 Italian paediatric centres in 2009-2015. Clinical and laboratory data were retrospectively collected and analysed.
The median age of the children (60.3% males) was 3 years and 6 months, 52.6% came from Ethiopia and 50.1% had at least one infectious disease. Parasitic infections accounted for the majority of the infectious diseases (409 of 715), and the most common were Giardia lamblia (n = 239), Toxocara canis (n = 65) and skin infections (n = 205), notably Tinea capitis/corporis (n = 134) and Molluscum contagiosum (n = 56) Active tuberculosis (TB) was diagnosed in nine children (1.2%). Latent TB infections were diagnosed in 52 (6.8%) children, and only 23 had concordant positive tuberculin skin tests and Quantiferon Gold In-Tube results. Discordant results were associated with Bacille de Calmette-Guérin vaccinations (odd ratio 6.30 and 95% confidence interval of 1.01-39.20, p = 0.011). Nonprotective antitetanus or antihepatitis B antibody titres were documented in 266 (34.9%) and 396 (51.9%) of the 762 children.
The prevalence of infectious conditions and not-protective titres for vaccine-preventable diseases observed in our population underlines the need for prompt and complete medical screening of children adopted from Africa.
本研究评估了从非洲收养儿童的传染病患病率及免疫状况。
我们研究了2009年至2015年间转至11家意大利儿科中心的762名非洲儿童。回顾性收集并分析了临床和实验室数据。
儿童的中位年龄为3岁6个月(男性占60.3%),52.6%来自埃塞俄比亚,50.1%患有至少一种传染病。寄生虫感染占传染病的大多数(715例中的409例),最常见的是蓝氏贾第鞭毛虫(n = 239)、犬弓首线虫(n = 65)和皮肤感染(n = 205),尤其是头癣/体癣(n = 134)和传染性软疣(n = 56)。9名儿童(1.2%)被诊断为活动性结核病(TB)。52名(6.8%)儿童被诊断为潜伏性结核感染,只有23名儿童的结核菌素皮肤试验和全血γ干扰素释放试验结果一致呈阳性。结果不一致与卡介苗接种有关(比值比为6.30,95%置信区间为1.01 - 39.20,p = 0.011)。762名儿童中,有266名(34.9%)和396名(51.9%)的破伤风或乙肝抗体效价未达到保护水平。
在我们的研究人群中观察到的传染病患病率以及疫苗可预防疾病的非保护性抗体效价,凸显了对从非洲收养儿童进行及时、全面医学筛查的必要性。