Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Division of Biostatistics, School of Public Health and Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA.
Matern Child Health J. 2023 Jul;27(7):1165-1175. doi: 10.1007/s10995-022-03574-4. Epub 2023 Feb 4.
Haiti remains a principal placement country for intercountry adoptees to the United States. This project reports the health status of children adopted from Haiti arriving to the U.S. and compares them to intercountry adoptees from other regions.
A retrospective chart review was conducted of adoptees placed in the U.S. from Haiti (n=87), age and sex matched with intercountry adoptees placed in the U.S. from Asia (n=87) and Latin America (n=87) between January 2010 and November 2019. Data on immunization status, contagious diseases, and nutrition and growth were analyzed via linear, logistic, and multinomial regression.
After adjusting for age, sex, and standardized height, children adopted from Haiti, compared to adoptees from Latin America and Asia, demonstrated a lack of immunity to hepatitis B (OR=5.89;6.87), increased immunity to hepatitis A (OR=0.38;0.30), infection by two or more parasites (OR=8.43;38.48), high lead levels (OR=23.79;7.04), and anemia (OR=15.25;9.18). Unexpectedly, children adopted from Haiti had greater standardized height (-1.28 vs. -1.82 and -2.13) and standardized weight (-0.32 vs. -0.57 and -1.57) than their counterparts from Latin America and Asia.
Children adopted from Haiti face complex medical challenges undoubtedly related to the country's low socioeconomic status (SES) and the impact of recurrent natural disasters and governmental neglect on public health infrastructure. Appropriate care is critical in preventing and avoiding transmission of infectious diseases in adoptees and family members. The high incidence of anemia and elevated lead levels may further exacerbate the developmental effects of early institutional deprivation.
海地仍是美国国际收养儿童的主要安置国。本项目报告了抵达美国的海地国际收养儿童的健康状况，并将其与来自其他地区的国际收养儿童进行了比较。
对 2010 年 1 月至 2019 年 11 月期间，被安置在美国的来自海地（n=87）、年龄和性别与来自亚洲（n=87）和拉丁美洲（n=87）的国际收养儿童相匹配的收养儿童进行了回顾性图表审查。通过线性、逻辑和多项回归分析了免疫状况、传染病以及营养和生长情况的数据。
在调整了年龄、性别和标准化身高后，与来自拉丁美洲和亚洲的收养儿童相比，来自海地的收养儿童对乙型肝炎的免疫不足（OR=5.89；6.87），对甲型肝炎的免疫增强（OR=0.38；0.30），感染两种或更多寄生虫（OR=8.43；38.48），铅含量高（OR=23.79；7.04）和贫血（OR=15.25；9.18）。出乎意料的是，与来自拉丁美洲和亚洲的收养儿童相比，来自海地的收养儿童的标准化身高（-1.28 比-1.82 和-2.13）和标准化体重（-0.32 比-0.57 和-1.57）更大。
来自海地的收养儿童面临着复杂的医疗挑战，这无疑与该国的低社会经济地位（SES）以及反复发生的自然灾害和政府对公共卫生基础设施的忽视对公共卫生基础设施的影响有关。适当的护理对于预防和避免传染病在收养儿童及其家庭成员中的传播至关重要。贫血和铅含量升高的高发率可能进一步加剧早期机构剥夺对发育的影响。
