International adoption from Ethiopia; an overview of the health status at arrival in Belgium

Background: Ethiopia is a densely populated country with a fast growing economy. Still socioeconomic and health issues render many children parentless. One thousand and twenty eight Ethiopian children have been adopted in Belgium from September 2005 to September 2015. Little has been published about their health status at arrival.

Methods: Three hundred and fifteen children adopted from Ethiopia were clinically evaluated at the Institute of Tropical Medicine in Antwerp from 1 January 2008 until 31 December 2014. Epidemiological and medical data were collected and analysed retrospectively.

Results: Data about 164 boys and 151 girls with a mean age of three years were analysed. Twenty per cent was adequately vaccinated, for 66.7% of children these data were absent. About 8.6% of the children were wasted/thin, 28.9% stunted. Skin abnormalities were seen in 40.3%, especially Tinea capitis. No children tested positive for HIV, syphilis or hepatitis C. Four children had an acute or chronic hepatitis B (HBV) infection, eight children had a cured HBV infection. Two children tested positive for malaria. Active pulmonary tuberculosis was found in six children. Sixty-two per cent had one or more intestinal parasite. Giardia lamblia (41.9%) and Blastocystis hominis (27.0%) were most frequently isolated. There is a statistically relevant association between the number of intestinal parasites and age at presentation. In this group eosinophilia had a sensitivity of 30.2%, a specificity of 79.1% for intestinal parasites and a positive likelihood ratio of 1.44 with a negative likelihood ratio of 0.88.

Conclusion: Apart from the high prevalence of stunting and intestinal parasites important medical problems were infrequent. A systematic clinical examination and screening for infectious diseases remain important to ensure a healthy start of a new life in Belgium.