Goutines Juliette, Miller Laurie C, Sorge Frederic
Department of Paediatrics, Necker-Enfants-Malades University Hospital, Paris, France.
Acta Paediatr. 2021 Apr;110(4):1359-1365. doi: 10.1111/apa.15612. Epub 2020 Nov 9.
In the context of global changes in the epidemiology of internationally adopted children (IACs), the prevalence of infectious diseases and nutritional impairment has not been recently reviewed. Moreover, in France, these characteristics of the children according to their continents of origin and preadoption special needs (SN) status have been incompletely explored.
Demographic, infectious data and anthropometric of all the newly arrived IACs seen in a specialised clinic for international adoptees in Paris, France, between 2013 and 2016 were retrospectively reviewed.
Three hundred and fifty IACs [mean age: 3.4 years (±2.7), 204 male] from 39 countries were included; 55% had SN. Ninety-nine patients had at least one infection, 42% being classified as 'serious' (chronic viral infection, tuberculosis or malaria). Chronic viral infection was diagnosed in 26 (7%) patients (HIV: 16 cases, HBV: 5, HCV: 4) and affected especially Asian children (P < .001). The prevalence of stunting, underweight, wasting and microcephaly was, respectively, 25%, 22%, 15% and 8%. Stunting was more frequent in children from Eastern Europe (P = .02), while SN children were more often microcephalic or underweight (respectively P = .03 and .02).
The prevalence of serious infections and nutritional impairment remains high in IACs and requires early detection and careful follow-up.
在国际收养儿童（IAC）流行病学全球变化的背景下，近期尚未对传染病患病率和营养障碍情况进行综述。此外，在法国，尚未充分探讨这些儿童根据其原籍大陆和收养前特殊需求（SN）状况的特征。
回顾性分析了2013年至2016年期间在法国巴黎一家国际收养儿童专科诊所就诊的所有新到IAC的人口统计学、感染数据和人体测量数据。
纳入了来自39个国家的350名IAC[平均年龄：3.4岁（±2.7），男性204名]；55%有特殊需求。99名患者至少有一种感染，42%被归类为“严重”（慢性病毒感染、结核病或疟疾）。26名（7%）患者被诊断为慢性病毒感染（HIV：16例，HBV：5例，HCV：4例），尤其影响亚洲儿童（P<.001）。发育迟缓、体重不足、消瘦和小头畸形的患病率分别为25%、22%、15%和8%。东欧儿童发育迟缓更为常见（P=.02），而有特殊需求的儿童小头畸形或体重不足更为常见（分别为P=.03和.02）。
IAC中严重感染和营养障碍的患病率仍然很高，需要早期发现和密切随访。
