[pvanabel]

Hello,
Does anyone have a list or know where I might find one on tests to be run on child when returning home? We have her doctor appt. this coming Thursday - thank you.
Kristie

[shelbydog]

Our ped's list was HUGE. She had to have a ton of bloodwork - just a warning. He tested her for everything from HIV, Hep., iron levels, newborn screen (which is a ton of tests in itself...) In our case, he treated her as a newborn and an international adoption. It was alot of tests, including urine screen and stool sample screen. It was a pain getting it all done but now I am glad knowing she is completely healthy.

[becky]

I don't have a list but I know that when Bella came home her doctor did the following:
Normal blood and urine tests
Titers testing to see if all immunizations were accurate (they were)
Tests for intestinal parasites (we had to collect stool samples for two or three days in a row)
TB testing

I am sure there are probably some others...but these are the ones I recall.

[jennifr]

In addition to the physical assessment, all children should have a panel of laboratory work completed soon after arriving home. Based upon several very well done medical studies from international adoption clinics at the University of Minnesota and Boston Children’s Hospital, all children should have the following tests:

• Complete blood count
• Lead level
• Stool samples for parasites (even if the child has no symptoms) 3 samples collected every other day
• Hepatitis B panel B must include Hep B surface antibody, surface antigen, and core antibody
• HIV Elisa
• Test for Syphilis BRPR or VDRL
• Test for Rickets Bcalcium, phosphorus, and alkaline phosphatase
• Hepatitis C antibody test (still controversial, although most adoption medical specialists highly recommend it)
• Urinalysis
• PPD test for Tuberculosis exposure. This should be a Mantoux test, done with a small needle prick just under the surface of the skin on the forearm. The test should be read in the physician’s office 48-72 hours later.

[soon2bemom]

You know there are an awful lot of tests which children are routinely screened for at birth in this country. If a child is older and healthy in every way then your pediatrician may decide to skip some of them. However the absolute MINIMUM which I think ALL adopted Guatemalan children MUST be tested for on arrival are:

CBC (blood count for anemia)
Blood Chemistry (minimum would be ALT,AST, BUN, and Creatinine for liver and kidney function)
Ova and Parasites (screen for worms)
Stool Culture (screen for shigella and salmonella)
Giardia (screen for malabsorption)
Thyroid Function

It is worthwhile to note that most cases of Giardia are missed on a standard Ova and Parasite. If my child had any evidence of diarrhea, or incomplete digestion or absorption of food, I would demand repeats on the Giardia test. (It took us six months of treatment to clear out Giardia from my oldest son after we lived in Nicaragua)

In an older child I would recommend getting titers on all immunizations (some people have found unpleasant surprises- that there is no blood evidence the child got those immunizations written on the paper). In a baby this would not be necessary because immunizations are repeated so many times in infancy that you are sure to get coverage.

Finally a TB test. The skin test is okay, but if your child recently got BCG, or got several BCG then the new tests which are coming out would be better. (There are four different ones including the QFT-gold and they can distinguish between TB and BCG)

I might be wrong but I believe that all adopted children are screened for HIV, Hepatitis B and Syphilis prior to coming to this country but I suppose it depends on whether the results were given to you, and how much you trust the results you were given.

[Devora]

I believe that all of the tests people have mentioned are in the Physician's Desk Reference as recommended for internationally adopted children. So any physician -- even if they don't have prior experience with international adoption -- should know to run these. It's good for you to know, too, but as long as you have a good physician this isn't something you need to worry about too much.

[Shay]

http://www.immunize.org/nslt.d/n17/when1.htm

I didn't know if this info would be helpful.

[csw]

Hi

I think some of the testing is more for kids in orphanages..for a healthy 4-6 month old in private foster care on premium formula and seeing Dr. Montiel probably doesn't need the one for rickets etc..Ana's pediatrician (her first one here who made lots of mistakes) didn't test her for lead because I was fostering her at the end and she felt that Ana wasn't old enough to chew on a crib with lead paint and she wasn't crawling around to eat paint chips etc..but..what she forgot was alot of homes in Guatemala probably have the old lead pipes..so her water used for making bottles probably contained some lead..she wasn't showing any symptoms of high lead levels..but I still wish she would have had it done..though her hair analysis for heavy metals came out high for lead, mercury, arsenic and silver..she didn't show signs of heavy metal toxicity until after her 2nd dose of thimerosal last year..

Her titers were all perfect..I had to tell the pediatrician what tests to run..she had no idea at all..

I would also note that if they had BCG vaccine they may test positive and as soon2bemom said there are other tests you can do..the PPD reactivated Ana's vaccine and she had a fever and slurred speech after her PPD..never again is she ever getting another skin test..she just got the quantiFERON test drawn..