Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy.
Acta Paediatr. 2019 Mar;108(3):411-418. doi: 10.1111/apa.14625. Epub 2018 Nov 19.
This systematic review aimed to provide an overview of the immunisation of internationally adopted children and to discuss possible vaccination strategies.
A literature search was performed covering papers published in English from 1988 to 15 June 2018 using the Ovid MEDLINE, EMBASE and Cochrane Library databases. This identified 749 studies and 41 full texts were evaluated.
Overall, 19 studies conducted between 1988 and 2016 fulfilled our inclusion criteria. These covered 7663 children aged 1.1-5.7 years adopted from Asia, Eastern Europe, Africa and South and Central America. Tetanus protective antibody levels ranged from 35 to 95%, and similar data were reported for diphtheria. A higher percentage of adoptees had protective antibody levels for polio (50-93%) and measles (62-95%). More than a third (35%) did not have protective antibody titres for hepatitis B. Only one study investigated adoptees with protective antibodies against haemophilus influenza, and it reported that this was around 66%.
The appropriate immunisation of internationally adopted children is a major challenge for primary health care and a number of different approaches have been suggested, with no clear conclusions. Further studies on the cost-effectiveness of different approaches should be performed to optimise screening strategies and develop recommendations.
本系统评价旨在概述国际收养儿童的免疫接种情况，并讨论可能的疫苗接种策略。
使用 Ovid MEDLINE、EMBASE 和 Cochrane 图书馆数据库，对 1988 年至 2018 年 6 月 15 日发表的英文文献进行了检索，共识别出 749 项研究，并对 41 篇全文进行了评估。
总体而言，1988 年至 2016 年期间进行的 19 项研究符合我们的纳入标准。这些研究涵盖了来自亚洲、东欧、非洲以及中南美洲的 7663 名 1.1-5.7 岁的儿童。破伤风保护性抗体水平为 35%至 95%，白喉也有类似的数据报道。更高比例的收养儿对脊髓灰质炎（50%-93%）和麻疹（62%-95%）具有保护性抗体水平。超过三分之一（35%）的收养儿没有乙型肝炎的保护性抗体滴度。只有一项研究调查了具有流感嗜血杆菌保护性抗体的收养儿，报告称这一比例约为 66%。
国际收养儿童的适当免疫接种是初级保健的一大挑战，已经提出了许多不同的方法，但没有明确的结论。应该进一步研究不同方法的成本效益，以优化筛查策略并制定建议。
