{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T10:42:13Z","timestamp":1772620933748,"version":"3.50.1"},"reference-count":41,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,7,1]]},"abstract":"<jats:p>OBJECTIVE. Because most internationally adopted children come from areas of high tuberculosis prevalence, an initial tuberculin skin test is recommended after arrival to the United States. We evaluated whether repeat testing of children \u22653 months after arrival to the United States would identify additional children with latent tuberculosis infection.<\/jats:p><jats:p>METHODS. Internationally adopted children who were seen at our International Adoption Center and had a tuberculin skin test within 2 months of arrival to the United States were eligible for the study. Children not diagnosed with tuberculosis with initial testing were retested at least 3 months later. The prevalence of tuberculosis on arrival and after repeat testing was determined, and potential risk factors for infection were examined.<\/jats:p><jats:p>RESULTS. Of the 527 internationally adopted children with an initial tuberculin skin test completed, 111 (21%) had evidence of latent tuberculosis infection. Repeat tuberculosis testing was complete for 191 internationally adopted children (46.9% of those who had an initially negative tuberculin skin test). Latent tuberculosis infection was found in 20% of those who were retested. No children were found to have active tuberculosis disease. Children with an initially positive tuberculin skin test result had slightly higher weight-for-age z scores at their initial clinic visit, whereas those whose tuberculin skin test result was positive after repeat testing had slightly lower weight-for-age z scores. A strong correlation between BCG immunization and tuberculin skin test result was observed.<\/jats:p><jats:p>CONCLUSIONS. Latent tuberculosis infection is common in internationally adopted children. A high proportion of internationally adopted children had an initially false-negative tuberculin skin test. Repeat tuberculosis testing of all internationally adopted children with an initially negative tuberculin skin test should be the standard of care for identifying tuberculosis infection and preventing tuberculosis disease in this high-risk population.<\/jats:p>","DOI":"10.1542\/peds.2007-1338","type":"journal-article","created":{"date-parts":[[2008,7,1]],"date-time":"2008-07-01T13:29:15Z","timestamp":1214918955000},"page":"e7-e14","source":"Crossref","is-referenced-by-count":34,"title":["Tuberculosis Screening in Internationally Adopted Children: The Need for Initial and Repeat Testing"],"prefix":"10.1542","volume":"122","author":[{"given":"Indi","family":"Trehan","sequence":"first","affiliation":[{"name":"Department of Pediatrics"},{"name":"Department of Pediatrics, Washington University and St Louis Children's Hospital, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jareen K.","family":"Meinzen-Derr","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Jamison","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Allen","family":"Staat","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"},{"name":"International Adoption Center, University of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2008,7,1]]},"reference":[{"key":"2021120905543886200_R1","unstructured":"US Department of State. Immigrant visas issues to orphans coming to U.S. Available at: http:\/\/travel.state.gov\/family\/adoption\/stats\/stats_451.html. Accessed December 19, 2007"},{"key":"2021120905543886200_R2","unstructured":"Pickering LK, Baker CJ, Long SS, McMillan JA, eds. Red Book: 2006 Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, IL: American Academy of Pediatrics;2006"},{"key":"2021120905543886200_R3","doi-asserted-by":"crossref","unstructured":"Nelson LJ, Schneider E, Wells CD, Moore M. Epidemiology of childhood tuberculosis in the United States, 1993\u20132001: the need for continued vigilance. Pediatrics.2004;114(2):333\u2013341","DOI":"10.1542\/peds.114.2.333"},{"key":"2021120905543886200_R4","unstructured":"Taylor Z, Nolan CM, Blumberg HM; American Thoracic Society; Centers for Disease Control and Prevention; Infectious Diseases Society of America. Controlling tuberculosis in the United States. Recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of America [published correction appears in MMWR Morb Mortal Wkly Rep. 2005;54(45):1161]. MMWR Recomm Rep.2005;54(RR-12):1\u201381"},{"key":"2021120905543886200_R5","doi-asserted-by":"crossref","unstructured":"Horsburgh CR Jr. Priorities for the treatment of latent tuberculosis infection in the United States. N Engl J Med.2004;350(20):2060\u20132067","DOI":"10.1056\/NEJMsa031667"},{"key":"2021120905543886200_R6","doi-asserted-by":"crossref","unstructured":"Phillips L, Carlile J, Smith D. Epidemiology of a tuberculosis outbreak in a rural Missouri high school. Pediatrics.2004;113(6). Available at: www.pediatrics.org\/cgi\/content\/full\/113\/6\/e514","DOI":"10.1542\/peds.113.6.e514"},{"key":"2021120905543886200_R7","doi-asserted-by":"crossref","unstructured":"Curtis AB, Ridzon R, Vogel R, et al. Extensive transmission of Mycobacterium tuberculosis from a child. N Engl J Med.1999;341(20):1491\u20131495","DOI":"10.1056\/NEJM199911113412002"},{"key":"2021120905543886200_R8","doi-asserted-by":"crossref","unstructured":"Bozaykut A, Ipek IO, Ozkars MY, Seren LP, Atay E, Atay Z. Effect of BCG vaccine on tuberculin skin tests in 1\u20136-year-old children. Acta Paediatr.2002;91(2):235\u2013238","DOI":"10.1111\/j.1651-2227.2002.tb01701.x"},{"key":"2021120905543886200_R9","doi-asserted-by":"crossref","unstructured":"American Thoracic Society, Centers for Disease Control and Prevention. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med.2000;161(4 pt 1):1376\u20131395","DOI":"10.1164\/ajrccm.161.4.16141"},{"key":"2021120905543886200_R10","unstructured":"American Thoracic Society. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR Recomm Rep.2000;49(RR-6):1\u201351"},{"key":"2021120905543886200_R11","doi-asserted-by":"crossref","unstructured":"Pediatric Tuberculosis Collaborative Group. Targeted tuberculin skin testing and treatment of latent tuberculosis infection in children and adolescents. Pediatrics.2004;114(4 suppl):1175\u20131201","DOI":"10.1542\/peds.2004-0809"},{"key":"2021120905543886200_R12","doi-asserted-by":"crossref","unstructured":"Sleiman R, Al-Tannir M, Dakdouki G, Ziade F, Assi NA, Rajab M. Interpretation of the tuberculin skin test in Bacille Calmette-Guerin vaccinated and nonvaccinated school children. Pediatr Infect Dis J.2007;26(2):134\u2013138","DOI":"10.1097\/01.inf.0000253058.48277.86"},{"key":"2021120905543886200_R13","doi-asserted-by":"crossref","unstructured":"Mandalakas AM, Kirchner HL, Iverson S, et al. Predictors of Mycobacterium tuberculosis infection in international adoptees. Pediatrics.2007;120(3). Available at: www.pediatrics.org\/cgi\/content\/full\/120\/3\/e610","DOI":"10.1542\/peds.2006-2817"},{"key":"2021120905543886200_R14","doi-asserted-by":"crossref","unstructured":"Menzies D. Interpretation of repeated tuberculin tests: boosting, conversion, and reversion. Am J Respir Crit Care Med.1999;159(1):15\u201321","DOI":"10.1164\/ajrccm.159.1.9801120"},{"key":"2021120905543886200_R15","doi-asserted-by":"crossref","unstructured":"Cauthen GM, Snider DE Jr, Onorato IM. Boosting of tuberculin sensitivity among Southeast Asian refugees. Am J Respir Crit Care Med.1994;149(6):1597\u20131600","DOI":"10.1164\/ajrccm.149.6.8004319"},{"key":"2021120905543886200_R16","unstructured":"Centers for Disease Control and Prevention, Division of Tuberculosis Elimination. Tuberculin skin testing. Available at: www.cdc.gov\/tb\/pubs\/corecurr\/Chapter4\/Chapter_4_Skin_Testing.htm. Accessed December 19, 2007"},{"key":"2021120905543886200_R17","doi-asserted-by":"crossref","unstructured":"Santiago EM, Lawson E, Gillenwater K, et al. A prospective study of bacillus Calmette-Guerin scar formation and tuberculin skin test reactivity in infants in Lima, Peru. Pediatrics.2003;112(4). Available at: www.pediatrics.org\/cgi\/content\/full\/112\/4\/e298","DOI":"10.1542\/peds.112.4.e298"},{"key":"2021120905543886200_R18","unstructured":"National Center for Health Statistics. NHANES: CDC growth charts: United States. Available at: www.cdc.gov\/nchs\/about\/major\/nhanes\/growthcharts\/datafiles.htm. Accessed December 19, 2007"},{"key":"2021120905543886200_R19","doi-asserted-by":"crossref","unstructured":"Miller LC, Hendrie NW. Health of children adopted from China. Pediatrics.2000;105(6). Available at: www.pediatrics.org\/cgi\/content\/full\/105\/6\/e76","DOI":"10.1542\/peds.105.6.e76"},{"key":"2021120905543886200_R20","doi-asserted-by":"crossref","unstructured":"Miller L, Chan W, Comfort K, Tirella L. Health of children adopted from Guatemala: comparison of orphanage and foster care. Pediatrics.2005;115(6). Available at: www.pediatrics.org\/cgi\/content\/full\/115\/6\/e710","DOI":"10.1542\/peds.2004-2359"},{"key":"2021120905543886200_R21","doi-asserted-by":"crossref","unstructured":"Miller LC, Tseng B, Tirella LG, Chan W, Feig E. Health of children adopted from Ethiopia. Matern Child Health J.2007; Aug 22","DOI":"10.1007\/s10995-007-0274-4"},{"key":"2021120905543886200_R22","unstructured":"World Health Organization. The WHO child growth standards. Available at: www.who.int\/childgrowth\/standards\/en\/index.html. Accessed December 19, 2007"},{"key":"2021120905543886200_R23","doi-asserted-by":"crossref","unstructured":"Nelson LJ, Wells CD. Tuberculosis in children: considerations for children from developing countries. Semin Pediatr Infect Dis.2004;15(3):150\u2013154","DOI":"10.1053\/j.spid.2004.05.007"},{"key":"2021120905543886200_R24","doi-asserted-by":"crossref","unstructured":"Lange WR, Warnock-Eckhart E, Bean ME. Mycobacterium tuberculosis infection in foreign born adoptees. Pediatr Infect Dis J.1989;8(9):625\u2013629","DOI":"10.1097\/00006454-198909000-00012"},{"key":"2021120905543886200_R25","doi-asserted-by":"crossref","unstructured":"Hostetter MK, Iverson S, Dole K, Johnson D. Unsuspected infectious diseases and other medical diagnoses in the evaluation of internationally adopted children. Pediatrics.1989;83(4):559\u2013564","DOI":"10.1542\/peds.83.4.559"},{"key":"2021120905543886200_R26","doi-asserted-by":"crossref","unstructured":"Hostetter MK, Iverson S, Thomas W, McKenzie D, Dole K, Johnson DE. Medical evaluation of internationally adopted children. N Engl J Med.1991;325(7):479\u2013485","DOI":"10.1056\/NEJM199108153250706"},{"key":"2021120905543886200_R27","doi-asserted-by":"crossref","unstructured":"Ozuah PO, Burton W, Lerro KA, Rosenstock J, Mulvihill M. Assessing the validity of tuberculin skin test readings by trained professionals and patients. Chest.1999;116(1):104\u2013106","DOI":"10.1378\/chest.116.1.104"},{"key":"2021120905543886200_R28","doi-asserted-by":"crossref","unstructured":"Carter ER, Lee CM. Interpretation of the tuberculin skin test reaction by pediatric providers. Pediatr Infect Dis J.2002;21(3):200\u2013203","DOI":"10.1097\/00006454-200203000-00008"},{"key":"2021120905543886200_R29","doi-asserted-by":"crossref","unstructured":"Saiman L, Aronson J, Zhou J, et al. Prevalence of infectious diseases among internationally adopted children. Pediatrics.2001;108(3):608\u2013612","DOI":"10.1542\/peds.108.3.608"},{"key":"2021120905543886200_R30","doi-asserted-by":"crossref","unstructured":"Soysal A, Millington KA, Bakir M, et al. Effect of BCG vaccination on risk of Mycobacterium tuberculosis infection in children with household tuberculosis contact: a prospective community-based study. Lancet.2005;366(9495):1443\u20131451","DOI":"10.1016\/S0140-6736(05)67534-4"},{"key":"2021120905543886200_R31","doi-asserted-by":"crossref","unstructured":"Trunz BB, Fine P, Dye C. Effect of BCG vaccination on childhood tuberculous meningitis and miliary tuberculosis worldwide: a meta-analysis and assessment of cost-effectiveness. Lancet.2006;367(9517):1173\u20131180","DOI":"10.1016\/S0140-6736(06)68507-3"},{"key":"2021120905543886200_R32","doi-asserted-by":"crossref","unstructured":"Young J, O'Connor ME. Risk factors associated with latent tuberculosis infection in Mexican American children. Pediatrics.2005;115(6). Available at: www.pediatrics.org\/cgi\/content\/full\/115\/6\/e647","DOI":"10.1542\/peds.2004-1685"},{"key":"2021120905543886200_R33","doi-asserted-by":"crossref","unstructured":"Karalliedde S, Katugaha LP, Uragoda CG. Tuberculin response of Sri Lankan children after BCG vaccination at birth. Tubercle.1987;68(1):33\u201338","DOI":"10.1016\/0041-3879(87)90005-5"},{"key":"2021120905543886200_R34","doi-asserted-by":"crossref","unstructured":"al-Kassimi FA, Abdullah AK, al-Orainey IO, et al. The significance of positive Mantoux reactions in BCG-vaccinated children. Tubercle.1991;72(2):101\u2013104","DOI":"10.1016\/0041-3879(91)90035-Q"},{"key":"2021120905543886200_R35","doi-asserted-by":"crossref","unstructured":"Young TK, Mirdad S. Determinants of tuberculin sensitivity in a child population covered by mass BCG vaccination. Tuber Lung Dis.1992;73(2):94\u2013100","DOI":"10.1016\/0962-8479(92)90062-O"},{"key":"2021120905543886200_R36","doi-asserted-by":"crossref","unstructured":"Morse DL, Hansen RE, Swalbach WG, Redmond SR, Grabau JC. High rate of tuberculin conversion in Indochinese refugees. JAMA.1982;248(22):2983\u20132986","DOI":"10.1001\/jama.248.22.2983"},{"key":"2021120905543886200_R37","doi-asserted-by":"crossref","unstructured":"Menzies R, Vissandjee B, Rocher I, St Germain Y. The booster effect in two-step tuberculin testing among young adults in Montreal. Ann Intern Med.1994;120(3):190\u2013198","DOI":"10.7326\/0003-4819-120-3-199402010-00003"},{"key":"2021120905543886200_R38","doi-asserted-by":"crossref","unstructured":"Hoft DF, Tennant JM. Persistence and boosting of Bacille Calmette-Guerin-induced delayed-type hypersensitivity. Ann Intern Med.1999;131(1):32\u201336","DOI":"10.7326\/0003-4819-131-1-199907060-00007"},{"key":"2021120905543886200_R39","doi-asserted-by":"crossref","unstructured":"Detjen AK, Keil T, Roll S, et al. Interferon-gamma release assays improve the diagnosis of tuberculosis and nontuberculous mycobacterial disease in children in a country with a low incidence of tuberculosis. Clin Infect Dis.2007;45(3):322\u2013328","DOI":"10.1086\/519266"},{"key":"2021120905543886200_R40","unstructured":"Centers for Disease Control and Prevention. Recommendations for prevention and control of tuberculosis among foreign-born persons: report of the Working Group on Tuberculosis among Foreign-Born Persons. MMWR Recomm Rep.1998;47(RR-16):1\u201329"},{"key":"2021120905543886200_R41","doi-asserted-by":"crossref","unstructured":"Barnett ED. Infectious disease screening for refugees resettled in the United States. Clin Infect Dis.2004;39(6):833\u2013841","DOI":"10.1086\/423179"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/122\/1\/e7\/1068652\/zpe007080000e7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/122\/1\/e7\/1068652\/zpe007080000e7.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T01:36:28Z","timestamp":1684460188000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/122\/1\/e7\/72957\/Tuberculosis-Screening-in-Internationally-Adopted"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,7,1]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2008,7,1]]},"published-print":{"date-parts":[[2008,7,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2007-1338","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,7,1]]}}}