Infectious diseases in internationally adopted children from Africa: a twelve-year retrospective study from Croatia

Aim: Infectious diseases are among the most commonly reported diseases in internationally adopted children. Pre-arrival medical evaluation is not mandatory for internationally adopted children arriving in Croatia, and post-arrival screening for infectious diseases is important to prevent complications and reduce the risk of transmission to the adoptive family and the community. This study aimed to assess the prevalence of infectious and vaccine-preventable diseases in internationally adopted children at the University Hospital for Infectious Diseases „Dr. Fran Mihaljević“ in Zagreb, Croatia. Methods: We retrospectively reviewed all medical data from hospital records of internationally adopted children from 2012 to 2024. We included asymptomatic internationally adopted children examined for post-arrival screening and internationally adopted children with post-arrival symptoms (e.g. fever, cough, haematuria, diarrhea) who have not done a screening for infectious diseases after arriving in Croatia. Results: All 54 included children were adopted from orphanages in the Democratic Republic of Congo. At least one infectious disease was diagnosed in 57 % of all included children and 45 % were asymptomatic upon presentation. The most prevalent were malaria and giardiasis. We observed high seroprevalence for measles and low for pertussis. Conclusions: With this study, we want to increase awareness about the importance of post-arrival screening (especially for malaria, giardiasis, and urinary schistosomiasis) and vaccination among healthcare professionals, to improve the healthcare of internationally adopted children from the Democratic Republic of Congo. Moreover, we suggest developing a national screening protocol for infectious diseases in all IAC arriving in Croatia.