Screening Tests

INITIAL SCREENING TESTS recommended for newly arrived internationally adopted children:

TB PPD Mantoux skin test: Internationally adopted children come from countries in which tuberculosis (TB) is a common disease.  Children should have a TB PPD skin test shortly after arrival.  However, this test should be postponed for children with fresh or healing BCG vaccine sites (usually seen on upper left or right arms).  Once the BCG site is healed and no longer appears to be pink or red, TB PPD skin testing should be performed. 

Stool Tests:
O & P – Stool study for ova and parasites
GSA – Stool study for Giardia Specific Antigen

NOTE: If child has watery diarrhea, add stool studies for Cryptosporidium, routine stool culture, and stool culture for Yersinia.  Also, children who test positive for any type of intestinal parasite should have a recheck of their stool 2-3 weeks after completing treatment to confirm that the parasite has been successfully treated.

Blood Tests:
CBC - Complete Blood Count and WBC Differential Count
Ferritin
Iron panel (iron, iron saturation, transferring, TIBC)
Lead level
TSH – Thyroid Stimulating Hormone
HAAB - Hepatitis A antibody (if positive, then Hepatitis A core IgM antibody)
HBsAg – Hepatitis B surface antigen
HBcAb – Hepatitis B core antibody
HBsAb – Hepatitis B surface antibody
HCV – Hepatitis C antibody (if positive, then Hepatitis C RNA by PCR)
HIV 1 & 2 – HIV Types 1 and 2 antibody
RPR or VDRL – syphilis test 

Immunization Antibody Titer Tests: In addition, children should either restart all immunizations or the validity of the immunizations received in country of origin should be checked by obtaining blood tests for immunization antibody titers.  The status of hepatitis A and B vaccine status can be confirmed with the antibody tests recommended in the above list.  We typically check the following immunization antibody titers:

• Diphtheria antibody
• Tetanus antibody
• Poliovirus antibodies Types I, II, and III
• Chicken pox, measles, mumps, and rubella immunization titers (for older children) 

RECOMMENDED FOLLOW-UP TESTS to be repeated approximately 6 months after your child’s arrival:

TB PPD Mantoux skin test
CBC
Hepatitis B panel (if child did not have immunity to hepatitis B at first visit)
Hepatitis C antibody
HIV 1 & 2 antibody