Medical Problems of Internationally Adopted Children from Nepal

Abstract

Background: Spain is one of the main countries in the world in international adoption, and Nepali children account for 0.8% of all adoptees. According to United Nations, Nepal is a poorly developed country. Due to the quality of medical care that Nepali children receive in orphanages, it has been reported that the diagnoses described in the pre-adoptive medical reports do not offer an absolute guarantee of accuracy, and sometimes these reports are not provided to adoptive families. The objective of this study was to describe epidemiological characteristics, pre-adoptive history, and medical problems observed in the post-adoption evaluation in a cohort of children adopted from Nepal. Material and Methods: Retrospective descriptive study on 11 Nepali adopted children from 2005 to 2011, examined according to a standardized protocol. Variables were collected from pre-adoption medical reports, interviews with the family, and post-adoption evaluation records. Results: Epidemiological characteristics and pre-adoptive history: females, 63.6%; all were abandoned and adopted from orphanages; mean age at institutionalization was 32 months, and at adoption was 55 months. 72.7% had a pre-adoptive medical report, and all were diagnosed as "healthy". 54.5% had a vaccination certificate. Medical problems most frequent diagnosed in post-adoption evaluation were iron deficiency anemia (72.7%), xerosis cutis (54.4%), neurodevelopmental delay (45.5%), underweight and stunting (36.4%), and acute bronchitis (36.4%). Only one child had a serious problem (cerebral palsy). The BCG vaccination scar was present in 81.8%. 72.7% showed vaccination immunity against hepatitis B virus. Conclusion: The pre-adoption medical information for the Nepali children was unreliable, and all showed more than one medical problem in the post-adoption evaluation. Adoptive families should seek pre-travel specialized medical advice regarding the medical reports and health of the child to be adopted, the updating of routine immunizations, and the destination-specific health problems.