[Children of foreign origin adopted in France. Analysis of 68 cases during l2 years at the University Hospital Center of Tours]. / L'enfant adopté d'origine étrangère en France. Analyse de 68 observations sur 12 ans au CHU de Tours.

BACKGROUND: The number of children of foreign origin adopted in France has increased in the past 15 years. The aim of this study was to analyse distinctive features and medical problems associated with international adoption. PATIENTS AND METHODS: The files of 68 foreign-origin adopted children who attended or were admitted to the Medical and Nutrition Unit of the Pediatric Hospital in Tours between January 1st 1986 and December 31st 1997, were studied retrospectively. Various parameters were analysed: age at first consultation, age at adoption, country of origin and health problems, especially nutritional status, infectious diseases, growth and development. RESULTS: In the majority of cases, children were adopted before 12 months of age (61.2%), particularly before six months of age (49.3%). The children came mainly from Africa and countries in the Indian Ocean (48.5%), and from Southeastern Asia (33.9%). Malnutrition was frequent in children from Africa. Twenty-one children (30.9%) presented with severe malnutrition characterized by weight less than the mean-2SD for height and required hospitalization. No children had congenital hypothyroidism, hyperphenylalaninemia, nor were HIV positive. Some patients had infectious diseases: 11 Hepatitis B, four congenital syphilis and six tuberculosis, with favorable outcomes after treatment. The other most frequent diseases were acute diarrhea, chronic diarrhea, intestinal parasites, and scabies, varying according to countries. Three girls adopted from southern Asia developed precocious puberty. Growth and psychomotor development were satisfactory overall, but abnormalities were observed in 15 children (22.1%), which is higher than in the general population. CONCLUSION: The expansion of international adoption with distinctive diseases proves the importance of a checkup as soon as possible after the arrival of these children in France. This checkup has to include nutritional and general evaluation and supplementary tests, especially for specific serology and vaccination status. Following this, it would be possible to propose a suitable follow-up to the adoptive parents.

[Morbidity and mortality in the pediatric service of Banqui (Central African Republic) during the year 1990. Implications for public health]. / Morbidité et mortalité dans le service de pédiatrie de Bangui (Centrafrique) au cours de l'année 1990. Implications en matière de santé publique.

Hospitalizations in the department of pediatrics of the Bangui Hospital (Central Africa) during the year 1990 were evaluated in terms of mortality and morbidity. During the study year, 8,052 children were admitted. Overall in-hospital mortality rate was 11.6%. Most deaths occurred shortly after admission (60% within 24 hours), in patients less than one year of age. Analysis of morbid conditions highlighted the growing severity of malaria and anemia in the youngest patients. Since no other facilities for inpatient treatment of children exist in the area, the data presented here can be considered as reflecting local medical problems and, therefore, can be used to guide public health decisions.

Morbidite et mortalite dans le service de pediatrie de Bangui (Centrafrique) au cours de l'annee 1990 : implications en matiere de sante publique

Le bilan d'une annee d'hospitalisations (morbidite-mortalite) dans le Service de Pediatrie de Bangui en Republique Centrafricaine est presente. 8052 enfants ont ete hospitalises dans l'annee 1990 et le taux de mortalite hospitaliere globale est de 11;6 pour cent. Les deces sont precoces et frappent surtout les enfants de moins d'un an. Parmi les pathologies recensees les auteurs insistent particulierement sur l'importance et la gravite croissante du paludisme et des anemies severes dans le jeune age. Le service concerne est la seule structure hospitalisant des enfants dans la region; ainsi les statistiques presentees peuvent constituer un reflet de la pathologie locale et etre utilisees pour l'orientation des decisions en matiere de sante publique