Recommended screening tests for all internationally adopted children after their arrival in United States, independent of medical history and physical exam, include:
- Complete Blood Count, with differential and indices
- Urinalysis with dipstick and microscopic
- Stool for ova and parasites (3 samples) – should include giardia antigen DFA and cryptosporidium DFA
- Stool for C & S (if symptomatic) – yersinia, campylobacter, salmonella and shigella
- Hemoglobin electrophoresis (Asian, Latino and African children)
- Glucose-6-phosphate dehydrogenase assay (Asian, Mediterranean and African children)
- Comprehensive metabolic panel (including AST, ALT, GGT, Bun, Cr, Ca, phosphorous, and alkaline phosphate)
- Hepatitis B surface antigen**
- Hepatitis B surface antibody**
- Hepatitis B core antibody**
- Hepatitis C antibody**
- Hepatitis A IgG, IgM
- HIV (1&2) antibody** (consider HIV PCR for children under 18 months)
- Syphilis serology – RPR and TP-PA
- Thyroid functions – TSH, Free T4
- Newborn metabolic screen (for infants and toddlers)
- Tuberculosis screening** – a PPD should be placed, independent of BCG status. Children 5 years and older can be tested with Quantiferon.
- Hearing and vision evaluations
- Dental evaluation (for children older than 18 months)
Other studies may be indicated based on child’s medical history or initial physical examination.
All immunizations should be repeated unless the child has appropriately documented immunizations and titres document immunity. (Titres for diphtheria, tetanus, measles, mumps, rubella, varicella. Neutralizing antibodies for polio subtypes 1, 2 and 3.) Children from Korea do not need titres.
**These studies should be repeated 6 months after arrival