EPSDT Care for Kids Newsletter

Health Screening for International Adoptees Winter 2005 For EVERY internationally adopted child, perform the following screenings:
Newborn metabolic panel for all infants Complete blood count (CBC) with red blood cell (RBC) indices	Blood lead level Hearing screen Vision screen	Thyroid function screen Urinalysis

*PARASITES*
	Giardia: Stool exam for ova and parasites, also serology screen for Giardia antigen (one specimen unless there are GI symptoms) Scabies: Visual exam of skin; microscopic exam of skin scrapings
*INFECTION*
	Hepatitis B: Hepatitis B panel, with surface antibody and surface antigen screens Hepatitis C: Serology, hepatitis C antibody HIV-1: Enzyme-linked immunosorbent assay (ELISA) with confirmatory Western blot; if positive, refer for further testing and evaluation HIV-2 - Some recommend ELISA and confirmatory Western blot screening for this as well Syphilis, screen via serology, Serology Tuberculosis: Purified protein derivative (PPD) skin test regardless of previous BCG immunization; if PPD is positive, obtain a chest radiograph

ADDITIONAL SCREENINGS
A child who:	May be at risk for:	To screen, use:
Is of African, American Indian, Asian or Latino descent	Lactose intolerance	Hydrogen breath test
Has a fever of unknown origin	Malaria	Peripheral blood smear
Has recurrent reflux, vomiting, irritability, failure to thrive, stomach pain	Reflux esophagitis due to helicobacter pylori infection	Endoscopy
A child born in:	May be at risk for:	To screen, use:
Africa, Mediterranean countries, Middle East, central India, Latin America	Red blood cell disorders such as sickle cell, thalassemia, hemoglobin C disease	Hemoglobin electrophoresis
Central Europe, Russia	Anemia	Glucose-6-phosphate dehydrogenase assay (G6PD)
China	Lead poisoning, rickets	Blood lead test, Radiograph
Eastern Europe	Giardia, other intestinal parasites	See above
Tropical or subtropical regions	Malaria	Peripheral blood smear