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Hernanz Lobo A, Berzosa Sánchez A, Escolano L, Pérez Muñoz S, Gerig N, Sainz T, Mellado Peña MJ, García López Hortelano M. International Adoption of Children with Special Needs in Spain. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040690. [PMID: 37189939 DOI: 10.3390/children10040690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 05/17/2023]
Abstract
International adoption has declined in recent years, although the adoption of children with special needs has arisen. We aim to describe our experience in the international adoption of children with special needs and to analyze the concordance between the pathologies included in pre-adoption reports and the diagnosis made upon arrival. We conducted a retrospective descriptive study including internationally adopted children with special needs evaluated at a reference Spanish unit between 2016 and 2019. Epidemiological and clinical variables were collected from medical records, and pre-adoption reports were compared to established diagnoses following their evaluation and complementary tests. Fifty-seven children were included: 36.8% females, a median age of 27 months [IQR:17-39], mostly coming from China (63.2%) and Vietnam (31.6%). The main pathologies described in the pre-adoption reports were congenital surgical malformations (40.3%), hematological (22.6%), and neurological (24.6%). The initial diagnosis that motivated the international adoption via special needs was confirmed in 79% of the children. After evaluation, 14% were diagnosed with weight and growth delay, and 17.5% with microcephaly, not previously reported. Infectious diseases were also prevalent (29.8%). According to our series, the pre-adoption reports of children with special needs appear accurate, with a low rate of new diagnoses. Pre-existing conditions were confirmed in almost 80% of cases.
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Affiliation(s)
- Alicia Hernanz Lobo
- Pediatric Infectious Diseases Department, Gregorio Marañón University Hospital, 28007 Madrid, Spain
- Gregorio Marañón Research Health Institute (IiSGM), Translational Research in Pediatric Infectious Diseases (RITIP), 28007 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, 28040 Madrid, Spain
| | - Arantxa Berzosa Sánchez
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Pediatrics, Clínico San Carlos Hospital, Clínico San Carlos Research Health Institute (IdISSC), 28040 Madrid, Spain
| | - Lucía Escolano
- Department of Pediatrics, La Paz University Hospital, 28046 Madrid, Spain
| | - Sara Pérez Muñoz
- Department of Pediatrics, Torrejon Hospital, 28850 Madrid, Spain
| | - Nathalia Gerig
- Department of Pediatrics, La Paz University Hospital, 28046 Madrid, Spain
| | - Talía Sainz
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Pediatrics, Infectious and Tropical Diseases, Paediatrics, La Paz University Hospital, Paseo de la Castellana, 261, 28046 Madrid, Spain
- La Paz Hospital and La Paz Research Institute (IdiPAZ), Translational Research in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Medicine Faculty, Autónoma University of Madrid, 28049 Madrid, Spain
| | - María Jose Mellado Peña
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Pediatrics, Infectious and Tropical Diseases, Paediatrics, La Paz University Hospital, Paseo de la Castellana, 261, 28046 Madrid, Spain
- La Paz Hospital and La Paz Research Institute (IdiPAZ), Translational Research in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Medicine Faculty, Autónoma University of Madrid, 28049 Madrid, Spain
| | - Milagros García López Hortelano
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Pediatrics, Infectious and Tropical Diseases, Paediatrics, La Paz University Hospital, Paseo de la Castellana, 261, 28046 Madrid, Spain
- La Paz Hospital and La Paz Research Institute (IdiPAZ), Translational Research in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Medicine Faculty, Autónoma University of Madrid, 28049 Madrid, Spain
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Šmigová J, Šnábel V, Cavallero S, Šmiga Ľ, Šoltys J, Papaj J, Papajová I. Neglected Diseases—Parasitic Infections among Slovakian Children from Different Populations and Genotypes of Giardia duodenalis. Microorganisms 2022; 10:microorganisms10020381. [PMID: 35208836 PMCID: PMC8880538 DOI: 10.3390/microorganisms10020381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 12/10/2022] Open
Abstract
Children are most prone to parasitic infections. The objectives of the study were to examine the occurrence of parasitic infections in children from different populations and to perform molecular characterization of human Giardia duodenalis isolates. We examined 631 stool samples from Roma and non-Roma children for the presence of parasitic developmental stages. Samples were collected from three eastern Slovakia districts. The ages of the children ranged from 1 months to 17 years. Subsequently, the molecular characterization of human G. duodenalis isolates by PCR detected triosephosphate isomerase (tpi) and beta-giardin (bg) genes was performed. The overall prevalence of parasitic infection was 19.8%. Ascaris lumbricoides eggs were the most frequent, with an occurrence of about 13.8%. G. duodenalis cysts were present in 6.3% of samples. G. duodenalis isolates obtained from 13 children were subjected to DNA sequencing with tpi and bg genes. Five isolates were categorized as bearing subassemblage BIII, the three isolates as subassemblage BIV, one person was infected with a mixture of subassemblages BIII and BIV, four children had subassemblage AII, and one isolate revealed a structure corresponding with subassemblage AI. Our work is proof that poverty and poor hygiene contribute the most to public health problems associated with neglected parasitic diseases.
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Affiliation(s)
- Júlia Šmigová
- Institute of Parasitology, Slovak Academy of Sciences, Hlinkova 3, 040 01 Košice, Slovakia; (J.Š.); (V.Š.); (J.Š.)
| | - Viliam Šnábel
- Institute of Parasitology, Slovak Academy of Sciences, Hlinkova 3, 040 01 Košice, Slovakia; (J.Š.); (V.Š.); (J.Š.)
| | - Serena Cavallero
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy;
| | - Ľubomír Šmiga
- Department of Breeding and Diseases of Game, Fish and Bees, Ecology and Cynology, University of Veterinary Medicine and Pharmacy in Košice, Komenského 73, 041 81 Košice, Slovakia;
| | - Jindřich Šoltys
- Institute of Parasitology, Slovak Academy of Sciences, Hlinkova 3, 040 01 Košice, Slovakia; (J.Š.); (V.Š.); (J.Š.)
| | - Ján Papaj
- Faculty of Electrical Engineering and Informatics, Technical University in Košice, Letná 1/9, 042 00 Košice, Slovakia;
| | - Ingrid Papajová
- Institute of Parasitology, Slovak Academy of Sciences, Hlinkova 3, 040 01 Košice, Slovakia; (J.Š.); (V.Š.); (J.Š.)
- Correspondence: ; Tel.: +421-55-6331411
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Intestinal parasites may be associated with later behavioral problems in internationally adopted children. PLoS One 2021; 16:e0245786. [PMID: 33493225 PMCID: PMC7833226 DOI: 10.1371/journal.pone.0245786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 12/29/2020] [Indexed: 01/09/2023] Open
Abstract
Aim At arrival in new home country, internationally adopted children often have intestinal parasites. International adoptees also exhibit more behavioral problems than their biological peers. We examined whether intestinal parasite infections in international adoptees on arrival in Finland are associated with their later behavioral and emotional problems. Methods Data for this study were sourced from the Finnish Adoption Study (FinAdo) based on parental questionnaires for all internationally adopted children under 18 years (n = 1450) who arrived in Finland from 1985 to 2007. A total of 1293 families provided sufficient information on the adoptee’s background, parasitic status on arrival, and behavioral symptoms at the median time of 5 years after arrival (mean age = 7.8 years). Behavioral and emotional disorders were evaluated with the Child Behavior Checklist (CBCL). Statistical analyses were conducted using linear regression. Results Of the 1293 families, parents of 206 adoptive children reported intestinal parasites in their adopted children on arrival. Parasite-infected children had subsequently higher CBCL problem scores than the children without parasites (p < 0.001). The association between intestinal parasites and later behavioral problems was stronger than that between intestinal parasites and any other factors measured in this study, except disability. Limitations The control group was naturally provided by the adopted children without parasite infections, but we could not compare the adopted children to non-adopted children without a defined parasite infection. We were unable to specify the effects associated with a specific parasite type. It was not possible either to include multiple environmental factors that could have been associated with behavioral problems in the models, which indicated only modest explanatory values. Conclusions In this study, intestinal parasite infections in early childhood may be associated with children’s later psychological wellbeing, even in children who move to a country with a low prevalence of parasites. Our findings may support further developments pertaining to the gut-brain theory.
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Discrepancies between Vaccine Documentation and Serologic Status for Diphtheria, Tetanus, and Hepatitis B in Internationally Adopted Children. Vaccines (Basel) 2020; 8:vaccines8030489. [PMID: 32872676 PMCID: PMC7563378 DOI: 10.3390/vaccines8030489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 12/04/2022] Open
Abstract
Internationally Adopted Children (IAC) often show suboptimal immunisation coverage, but available data are discordant. Data at the first evaluation of 2073 IAC (median age: 6 years) referred to the Meyer Children’s University Hospital (Florence, Italy) in 2009–2019 were analysed in order to evaluate their immunisation status against diphtheria, tetanus, and hepatitis B. Negative antibody titres were observed in 11.5% of the IAC for diphtheria, 18.6% for tetanus, and 39.0% for hepatitis B. At multivariate analysis, originating from Africa was an independent risk factor for seronegativity for the three diseases (p < 0.001), while age below four years was an independent factor associated with protective immunity, only considering hepatitis B (p < 0.001). Vaccine documentation was an additional factor independently associated with protective immunity. However, a discrepancy between documentation (indicating previous vaccinations) and serology (showing negative antibody titres) was evidenced in 3.8% of the children for diphtheria, 12.6% for tetanus, and 29.6% for hepatitis B. This finding suggests that although vaccine documentation may reflect the presence of protective antibody titres, it should not be accepted as absolute evidence of protective immunity, underlining the importance of a complete assessment of immunisation status in IAC, particularly in those originating from Africa and aged over four years.
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