חומר רקע

FKC J K O Z V G BKK O C BK P GW-KN EK O CKQ- B Z XK KFGE F S R X YK1,2, BGZK ZGCKR [ JKKQ3, DZK EKB PGRE 1,2, E C T RC Z 1,2, 1F P MGQ N F \ V \ IG\ GN [KYGO FKNE, P ZMH [ RKKEZ NZVGB \ KNEKO, V \ I-\ YGGF, 2F V YGN J F NZVGB F S B Y NZ, BGRKCZ SKJ \ \ N-B CKC, 3F P I' NZVGB \ KNEKO GFKI' N P I NG\ HKFGPKG\, CK\-F IGNKO NRKBEG,R\RKF \ Y X K Z FKX T E N [ N KN EKO PGT P EKO N BKPGW C TGN O F P T Z CK GD O CK [ Z B N DZ O N T NKKF Z C F C BKPGW KN EKO CKQ-B Z XK M EK N P XGB V \ ZGQ N P [ V IG \ Z CG \ [ FKG T E M F I [ GMG \ KN EKO. C E C C E T O F T NKKF C P S V Z F BKPGXKO F I NG Z [ GKG \ F C ZKBG \ N F \ PGEE T O P I NG \ Y [ G \ F R VGXG \ C P EKRG \ P FQ FGC BG FKN EKO, B L REKZG \ KG \ Z C TGN O F P T Z CK. C EGP F N P EKRG \ RGS VG \, F I NG CK [ Z B N N \ \ B \ F E T \ N C TKG \ F Z VGBKG \ F M ZGMG \ C F C B \ KN EKO P P EKRG \ R I [ NG \,GP [ ZE F C ZKBG \ FGXKB FGZ BG \ GF P N XG \, T N- P R \ N [ PGZ T N C ZKBG \ F XKCGZ P V RK P I NG \ P E C YG \ GN P RGT TGD P \ -R V [ P F P [ V IG \ F P B P XG \. ZGC ZGV BK FKN EKO C Y FKN F I S ZK RKSKGQ GKE T C FKC JKO F Z VGBKKO [ N BKPGW KN EKO CKQ-B Z XK.KN EKO B NG P FGGKO Y CGX F F EGZ [ \ F \KKI SG \ PKGI E \,GC Z I CK F TGN O K [ ZGV BKO [ HFG TKSGY O FKIKE BG F TKY ZK. C S YKZ F HG REGQ C FKC JKO F Z VGBKKO F M ZGMKO C BKPGW KN EKO P IG"N. \ YRG\ I E [ G\, F P S EKZG\ BKPGW KNEKO P IG"N, V \ IG XGF Z [ N \ YGGF C VRK P [ V IG\ GKIKEKO CK[ Z B N, [ P [ B \ RV [ O FKB N B P W KNE. FKX T EN [ N KNEKO [ RGNEG CK[ Z B N GFGT P EG N BKPGW, DZ O N F P \RF P PG [ M \ GN SKMGK Y NG [ NHMG\ CKNE. \GZ F F P \RF F B ZGL GP EEKO RGY [KO, N T \KO Y [KO PR [ GB, DZ PG MN F [ RKO N IKVG [ EZMKO TGY VG\ GYKXGZK-EZL, [ N B \ PKE F \RF NG C P SDZ \ F IGY. F XGZL N F S EKZ B \ F BKPGW F CKQ-B Z XK F CKB N I YKY F, F P B V [ Z \ F C B \ \KRGYG\ GKNEKO P IG"N EZL T PG\G\ PGZ [ G\ GC VKYGI P P [ N \K ~1|. F VKYGI P \ C X T T N-KEK F Z [ G\ F P ZMHK\ N BKPGW CKQ-B Z XK [ N P [ ZE F T CGE F GF ZGGI F. P BH BK[ GZ F IGY C- 1998 FGC BG NK[ Z B N 644 KNEKO P-8 P EKRG\: ZGPRKF, BGY Z BKRF, ZGSKF, C NZGSKF, DGB J P N F, CGNDZKF, PGNE C F GYHI S JQ ~RI P F J N, P V Y I \ B Z XK\ N BKPGW CKQ-B Z XK, " F BKPGW F CKQ-B Z XK N B I Z I P [ [ RKO N \KYGQ IGY F BKPGW " { MRS CRG [ B BKPGW CKQ-B Z XK, KZG [ NKO, 2001 |. C B Z F " C, [ FKB F P EKRF F PGCKN F C TGN O C BKPGW KNEKO P IG"N, DEN GFGNL P [ RF N [ RF P S V Z F BKPGXKO: C [ R\ 1998 BGP XG 774 , 15 KNEKO, M P I XK\ O P SKQ GFK\ Z P- 15 P EKRG\ ~2|. C T Y CG\ F IGY FGX TG "MNNKO GFRIKG\ P Y XGTKG\ N V TGN \ T PG\ F PGMZ \ ",GC S TKU )2( 6 RB P Z MK"KC EGY ZGV B P J T O F T PG\ F B \ FKNE BG, B O F E C Z BKRG B V [ ZK, B \ IGG\-F E T \ BGEG\ P X CG F Z VGBK [ N FKNE, [ P S Z F F Z [ G\ F PGS P M \ [ N P EKR\ F IGW, GKB [ Z [ N VK E T \G BKQ XGZL C C EKYG\ Z VGBKG\ RGS VG\ " ~3|. C E C C E T O BK[ GZ F IGY F XKT F P IGY Y N C X T [ GZ F [ N C EKYG\ Z VGBKG\ NKNEKO F PGT P EKO N BKPGW; C EKYG\ B N F FGP N XG T N-KEK GT E F [ PGR\ F N [ O ML C P [ ZE F C ZKBG\. T O V Z SGO F P N XG\KF F EDK[ F FGGT E F: " BKRRG P P NKXKO T N PKDC NG\ IGYKG\ T N BKPGW. P C IKRF C ZKBG\K\, F F I N J F NDCK F BKPGW X ZKM F N FKG\ R\GRF N F I N J \ F FGZKO F P B P XKO ~ ... | BKRRG P P NKXKO N Y C N B \ F S M P \ P [ ZE F C ZKBG\ N BKPGW ~ ... |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~4=7|. RP X B MK T E % 60 P FKNEKO F P BGP XKO NGYKO C P I NG\ HKFGPKG\ C FQ RE C YG C P EKR\ PGX B O ~8,9|. P MKGGQ [ I N Y P FKNEKO RP X BKO C [ N C [ N EDKZ \ F P I N F, PGP N W N IHGZ T N F C EKYG\ F [ GRG\ PKE T O FDKT O N P [ V I F F P B P X \ GN F [ BKZ O C P T Y C DO N B I Z P MQ. PQ F XGZL N F \ ZKT T N ML [ C EKY F DGVRK\ C N C E NN B C EKYG\ P T C E F \DN F Z Y % 50 P F P I NG\ FHKFGPKG\ F [ MKIG\ ~8|. M PG- MQ K[ NHMGZ MK [KTGZ F \ I NGB F P [ \RF T O F [ RKO. NEGDP F, Key words: international adoption; HIV; hepatitis B; hepatitis C; tuberculosis; synphilis. F G Z G \ F Z V G B F M ZL 141 , IGC' F' ) P BK 2002 ( 483 F \ C ZZ [ I N F T NKKF C [KTGZ IGNK [ I V \ GIGNKO C J VKNK P TKKO P SGD G. lamblia C Y Z C KNEKO P BGP XKO F PDKTKO N B Z F " C C F [ GGB F NEKGGIKO P [ RKO YGE PG\ ~ 10 |. NZGC ZGV BK FKNEKO GZGV BK F P [ V I F C Y FKN F BKQ RKSKGQ C FKC JKO F Z VGBKKO [ N BKPGW KNEKO P IG"N.KNEKO B N F P FGGKO Y CGX F F EGZ [ \ F \KKI SG\ PKGI E \, GK[ ZGV BKO C B Z F " C [ HFG TKSGY O FKIKE BG F TKY ZK ~ 11 |. FKNEKO F PGT P EKO N BKPGW NGYKO DO C C TKG\ F \ V \ IG\ GC I S L \HGR\K C EZDG\ IGP Z F [ GRG\, HB \ M \GX B F P FHRI F C P [ V I \ O F CKGNGDK\ BG C P SDZ \ [ JKV N F C F O T E FDKT O N P [ V I F F P B P X \. C S YKZ F FRGM IK\ R\ P Y E B L GZ Y C C TKG\ F Z VGBKG\, GN B RT SGY C C TKG\ F \ V \ IG\, X PKI F G\HGRF. FGGT E F P J T O P [ ZE F C ZKBG\ N C EKY \ F FKC JKO F Z VGBKKO C BKPGW KNEKO CKQ-B Z XK F P NKX F T N C EKY \ F P I NG\ FHKFGPKG\ F C BG\: P I N \ F M [ N F IKSGRK FRZM [ ) AIDS ( (HIV1, HIV2) , X F C \ P SGD B, [ I V \, TDC \ GIKVG [ J VKNKO C P T ZM \ F TKMGN. CRGS U N C EKYG\ B N F F P NKX F FGGT E F T N CKXGT CKZGZ Z VGBKRGS U )J C N F 1(. F I C Z F F B P ZKY BK\ NZ VGB \ KNEKO P P NKX F CRGS U N C EGY X F C \ P SGD C CKNEKO F PDKTKO P B SKF, SKQ, PHZ I-BKZGV F GZGSKF, CKNEKO [ YKC NG TKZGK-E O GCKNEKO N B P FG\ F XGZMG\ S PKO. C P Y ZKO PKGI EKO P P NKX F F I C Z F F B P ZKY BK\ N F Z IKC B \ Z [KP \ F C EKYG\ [K[ N C X T C Y Z C KNEKO C BKPGW CKQ-B Z XK,GHB \ C F \ B O N P EKR\ F PGX B BG N \ S PKRKO Y NKRKKO P \ BKPKO ~ 12 , 13 |. ML NEGDP F K[ N C EGY B \ Z P \ F TGV Z \ C E O CKNEKO F PDKTKO P SKQ. P C EKY F [ RT ZM F C B Z F " C P S \ C Z, [ Z P \ F TGV Z \ C E O B X N KNEKO B N F FKB N T \KO DCGF F, M \GX B F P I [KV F N TGV Z \ [ P YGZ F C \ T [KKF, C MNK-I Z S, C \ ZGVG\ P SGZ \KG\ GTGE ~ 14 , 15 |. C P EKRG\ Z CG\ I N Y P F C EKYG\ [ FGHMZG N TKN BKRQ P \ C X TG\ MNN, GC I N Y P F P EKRG\ [ C FQ YKKP \ F \RDEG\ N CKXGT C EKYG\ Z VGBKG\, GB NG P CGX TG\ C BGVQ I N YK BG Z Y C \GO F F NKL F IGYK [ N F BKPGW, M [ FKNE M C Z FDKT NK[ Z B N. B \ F CKZGZ GF P T Y C F Z VGBK B I Z KNE P BGP W K[ N C X T C [ NG [ F [ N CKO: F CKZGZ F Z VGBK N VRK F BKPGW, CKZGZ Z VGBK PKE N B I Z F BKPGW [ N FKNE GFDT \G P IG"N, GP T Y C Z VGBK ~ 16 , 17 |. PGC B \ N F NQ S YKZ \ F P I NG\ FHKFGPKG\ F [ MKIG\ C P EKRG\ F PGX B [ N FKNEKO F P BGP XKO. P I N \ F M [ N F IKSGRK F RZ M [ ) Human Immunodeficiency Syndrome ± AIDS ( HKFGO PRDKVK HIV-1 G- HIV-2 FGB BRE PK C MN F TGN O, GF SKMGQ N F E C Y \ KNEKO P BGP XKO \ NGK C P EKR\ PGX B O GCDGZ PK SKMGQ BK[KKO ~ 18 |. C C EKYG\ [ CGX TG CKNEKO RJG [KO F [ GFKO C PGS EG\ C ZGPRKF, F \ C ZZ [ -2 % 0 P F O F O R [ BK RDKU F M [ N F IKSGRK FRZM [ ) HIV (. F IGY ZKO P X BG [ [KPG [ C N \K FGN O C P I JKO GC PHZ YKO FKGGF B \ FDGZ O F TKY ZK N \ I NGB F HG ~ 19 |. F B VKE PKGNGDKF [ N HIV P [ \RF C P FKZG\, GNMQ K[ XGZL C S YKZ \ F P I N F C MN FKNEKO F P BGP XKO. BKQ N S PGL B L GZ Y T N \GX BG\ F C EKYG\ C P EKR\ F PGX B; FGV T \ F P I N F CKNEKO KMGN F N FKG\ F EZD\K\, T O PKP X BKO M PG [ ZKTG\ YK[ ZKG\-NKP V F, [ ZKTG\ F M C E GF J IGN GF V Z TG\ C F \ V \ IG\. RGDERKO BKP FKKO, [ P YGZ O C P T C Z F \GL-Z I PK, T NGNKO N FKP X B CKNE T E DKN 18 IGE [KO, T N MQ BK\GZ RGDERKO N- HIV CDKN HF P IKKC P T Y C Y NKRK GC EKY \ BKPG\ RGS V \ M F \ YR\ \ Z CK\ BG PCR ~ 18 |. X F C \ RDKVK \ X F C \ A Z CKO P FKNEKO F P BGP XKO NGYKO C X F C \ A CDKN X TKZ NN B HKFGO RDKVK MZGRK. NMQ BKQ XGZL C C EKYG\ S Y Z [ N RGDERK IgG N X F C \ A , B L K[ N C EGY RGDERKO P SGD IgM N X F C \ A CKNEKO FRI [ EKO MNGYKO C EN Y \ M C E V TKN F ~6|. X F C \ B C EKY \ RGDERK X F C \ CKNEKO P BGP XKO P FGGF SGDKKF C T N \ I [KCG\ P EZDF Z B [ GRF, P B I Z [ YKKP \ F T C Z \ FRDKU N CRK-CK\ N B I SKRKO DO NN B I [KV F NE O BG N PDT PKRK ~ 20 |. R\GRK FGGT E F N P I NG\ HKFGPKG\ [ N F B Y E PKF F B P ZKY BK\ NZ VGB \ KNEKO P EDKPKO % 5= % 50 SKPRK X F C \ B C Y Z C KNEKO P BGP XKO ~ 13 |. PR\GRK BKZDGQ F C ZKBG\ F TGN PK TGN F, MK % 1= % 15 P FKNEKO R [ BK X F C \ B C Z I CK F TGN O PGX B O P P EKRG\ PHZ I-BKZGV F )ZGPRKF, ZGSKF, BGY Z BKRF(, B SKF GB V ZKY F ~ 24 |. P VKZ SGPKO Z CKO C TGN O TGN F [ F P X C CKNEKO P BGP XKO P FGGF Z BK P EGKY N P EK N PKE \ F \ V [ JG\ FHKFGO CRDKU X F C \ B J C N F 1: CEKYG\ Z VGBKG\ PGP N XG\ NKNEKO P IG"N F PGT P EKO N BKPGW CK[ Z B N . BKKE S: C EKY \ RGDERKO N- HIV1 , HIV2 . C P Y Z F [ N \GX B F F P VGZ [ \ M IKGCK\ C \KRGY P \ I \ NDKN 18 IGE [KO, K[ N C X T C EKY \ BKPG\ NRDKVK HIV BG C EKY \ PCR . . EN Y \ M C E RDKVK\: C EKY \ HbcAb ,HbsAb ,HbsAg . . [ I V \: C EKY \ PRJG C \GL F TGZ. . P T ZM \ F TKMGN: C EKY \ XGB F N J VKNKO GN B P CG\ NMN F \KRGYG\. C \KRGYG\ P [ N [ NKO { C EKY \ \ Z CK\ XGB F N S N PGRN F GN [KDN F. . TDC \: C EKY \ VDRL . F P JGNGDKF: RGS I \ \ BK E O P N B F. C BHGZKO BRE PKKO C EKYG\ S ZKY F NDKNGK BRPKF I Z P [K\, \ N S PKF GIGS Z G6PD . . MNKG\: C EKY \ [ \Q MNNK\. . TGV Z \: T N KNEKO P BGP XKO P SKQ N FKC E Y N F Z T N \ TGVZ \. . \KV YGE C NGJ \-F \ ZKS: C EKY \ TSH, T4 . . VRKN Y JGRGZKF: C EKY F N- PKU . PGPKO P NKE F: C EKY \ T N- [ P T NDKNGK PGPKO P NKE F, MGNN C EKY \ B YG-N C, GMQ C EKY \ T N- [ P T [ N F MNKG\, [ N VGIK\ F [ \Q GF PGI. . P I NG\ \GZ [ \KG\: C EKY \ MZGPGSGPKO N- X [ CKZ, C EKY \ S ZKY F NDKNGK NKKV \ MKS \K\ ) cystic fibrosis ± CF ( )C F \ B O N PGX B(. . F TZM F RKZG-F \ V \ IG\K\: C EKY F RKZG-F \ V \ IG\K\ MGNN \ T N-KEK ZGV B KNEKO C T N RKSKGQ PGM I [ N [ RF C P MGQ N F \ V \ IG\ FKNE BG ZGV B PGP I F NRKZGNGDK\ KNEKO. \ [ GP \ N C PKGI E \ K[ N F Y EK[ N F T ZM \ \KV YGEK Z BKKF G [ PKT F. F G Z G \ F Z V G B F M ZL 141 , IGC' F' ) P BK 2002 ( 484 C P EKRG\ PGX B O. TKY Z F F T C Z F FKB BRMK\ GN T \KO DO BGV YK\ ~ 11 , 20 |. NRGM I F I [KV F FDCGF F NRDKU, K[ N C X T NMN KNE P BGP W C EKYG\ S Y Z S ZGNGDKG\ N- HbcAb , HbsAb G- HbsAg . R\GRK F C EKYG\ KSKKTG C BK\GZ IGNKO F NGYKO C P I N F I E F, IGNKO [ N YG C P I N F C T C Z GIGNKO MZGRKKO. F EDKZ F F P PG [ M \ [ N F P I N F P IKKC \ N [ YGN C EKYG\ RK[ RG\ 6 IGE [KO N B I Z F BKPGW. HKFGO MZGRK CRDKU X F C \ B PGDEZ T N-VK FKP X BG\ HbsAg C P [ L KG\ Z P [K[ F IGE [KO. CKNEKO R [ BK X F C \ B K[ N [ NGN P I N F MZGRK\ GN J V N C F \ B O ~ 16 |. PGP N W N I SQ MN CQ-CK\ [ BKRG I SKQ N P I N F ~ 11 |. X F C \ C BKQ P S VKY R\GRKO T N X F C \ C CKNEKO P BGP XKO, BGN O C S YKZG\ [ GRG\ EGGI [ F I [KV F [ N KNEKO P BGP XKO NRDKU RPGM F,GNMQ BKQ F P N X F DGZ V \ N C EKY F [KDZ \K\ NMN KNE P BGP W. K[ N [ YGN CKXGT C EKY \ RGDERKO BG PCR NKNEKO [ YKC NG TKZGKK-E O, NKNEKO T O T ZMK J ZRS B PKRHG\ DCGFKO GKK\ MQ [ B U NKNEKO [ PGX B O P B Z XG\ BRE PKG\ M PHZ I-BKZGV F ~ 10 , 13 |. X F C \ D FRDKU N X F C \ D KIGNN P I N F Z Y CRGM IG\ HKFGO X F C \ B V TKN, C [ N C F \ Z CG\ FRDKU. [ MKIG\ F P I N F DCGF F KI SK\ C P EKRG\ PHZ I-BKZGV F, C B V ZKY F, C EZGO-B P ZKY F GC PHZ I-F \KMGQ. BGN O [ MKIG\ F P I N F RPGM F C F [ GGB F N X F C \ B, GNMQ BKQ XGZL C C EKYG\ S Y Z NMN KNE P BGP W ~ 13 , 22 |. [ I V \ [ MKIG\ P I N \ F [ I V \ CKNEKO P BGP XKO DCGF F C F Z C F P B [ Z CKNEKO P P EKRG\ P \GT [ G\ ~ 6|. F P I N F PGVKT F C EZL-MNN C [ RKO F Z B [ GRG\ N B I Z F BKPGW,GNMQRGE T \ I [KCG\ Z C F N CKXGT \ C IKQ PRJG ) PPD 5 TU ( NMN KNE P BGP W. FDKN F X TKZ GF P X C F \HGR\K [ N FKNEKO F P BGP XKO KMGNKO N T M C B \ F \DGC F F IKSGRK\, NMQ RK\Q N F S \KKT N P J Z \ C Y Z F C \ C IKRKO BRJKDRKKO, MDGQ YREKE F BG J JRGS. M PG-MQ, C I [ E N BRB ZDKF B X N FKNE K[ N [ YGN C EKY \ PRJG R [ RK\. M [ \ C IKQ F PRJG P VGZ [ M [ NKNK BKQ XGZL C XKNGO CK\-F IHF BG C F P [ L CKZGZ. K[ N F \KKI S N \ [ GC \ PRJG F P VGZ [ \ M IKGCK\ DO CKNEKO [ IGSRG C- BCG ~9|. BKC IGQ P I N \ F [ I V \ T [ GK N FKG\ P SGC L, GN T \KO T E BKC IGRF T NGNKO N FKE C Y P S V Z Z C [ N PDTKO. Y Z JKS GI C'~ 23 | EKGGIG T N KNE CQ 9 [ RKO [ N Y F C [ I V \, GP I N \G BGC IRF Z Y N B I Z [ F B O F P B P X \ N Y \ F C [ I V \ F T X O. I YKZ F [ N F PDTKO F Z B \ F [ P \GL 276 PDTKO, C- 50 P F O ) % 20 P F PDTKO( VGZ [ \ C IKQ JGC Z YGNKQ M IKGCK. T D C \ C P EKRG\ P \ V \ IG\ YKKO \ \-BKC IGQ [ N TDC \, C V Z J CHKFGO [ N P T ZM \ F T X CKO F P ZMHK\ ~ 13 |. C TKF P [ P TG\K\ FKB M [ F JKVGN BKRG P \ BKO N P JGV N BG N B FG [ N O T E \GPG ~ 20 |. T N MQ PGP N W N C X T NMN KNE P BGP W C EKY F S ZGNGDK\ N B SDGNK\ ) VDRL (,GB O F \GX B F P VGZ [ \ M IKGCK\ K[ N C X T B \ B I \ F C EKYG\ F SDGNKG\ )NEGDP F TPHA ( GN J V N C F \ B O. RDKU F XKJGP DNG) cytomegalovirus ± CMV ( M P I XK\ FKNEKO F P BGP XKO P V ZK[KO B \ RDKU F XKJGPDNG. C EZL MNN FHKFGO RZM [ S PGL NNKE F, NZGC NN B SKCGMKO. [ MKIG\ F V Z [ \ FRDKU C Y Z C FKNEKO F P BGP XKO EGP F NHG [ N KNEK P TGRG\-KGO [ C P EKRG\ F P \GT [ G\,GNMQ BKQ XGZL C S YKZ \ P T C E F [KDZ \K\ NMN KNE P BGP W. PGP N W N F EZKL B \ F FGZKO GF P J V NKO NDCK B P X TK FHFKZG\ [K[ NRYGJ, T N-PR\ N PRGT F E C Y F [ N R [KO X TKZG\ [ BKRQ P IGSRG\ F P TGRKRG\ C F ZKGQ T \KEK BG C F P [ L F ZKGQ. M PG-MQ K[ N F EDK[ B \ I [KCG\ Z IKX \ FKEKKO N B I Z PDT T O F V Z [ G\ FKNE ~8,9|. HKFGPKO C E Z MK-F TKMGN RK\Q N P XGB J VKNKO BG CKXK J VKNKO C- % 15 T E % 30 P FKNEKO F P BGP XKO ~ 10 |. F P IGNNKO F [ MKIKO CKG\ Z F O G lamblia , Ascaris lumbricoides G- Trichuris trichiura ~ 13 |. C EZL-MNN EDKP \ XGB F B I \ \ S VKY N C EKY \ F S ZKY F. CKNEKO P [ N [ NKO K[ N C EGY \ Z CKG\ XGB F N- Salmonella, Shigella, Yersinia, Campylobacter G- E. coli 0157: H7 . DGZ PK-F SKMGQ CKNEKO P BGP XKO N FKE C Y CHKFGO J VKNK MGNNKO KNEKO [ BGP XG N B I Z DKN [ RF, P [ Y N RPGL GP T Y C Z VGBK N YGK, M PG BK-F [ N P \ \GMRK\ F IKSGRKO ~9|. I [ GC N XKKQ [ JKVGN RDE J VKNKO P Y JKQ B \ TGP S F J VKNKO GP [ V Z B \ P X C F IGN F, B L N B \ PKE RK\Q N F [ PKE O,GNMQ FGV T F P IGE [ \ [ N \ S PKRKO C EZMK-F TKMGN IGE [KO BG B U [ RKO N B I Z F BKPGW, P IKKC \ N [ NGN HKFGO J VKNK. HKFGPKO C TGZ MKRP \, DZE \ G- molluscum contagiosum F O HKFGPK TGZ [ MKIKO P BGE.K[ N C X T C EKY F DGVRK\ P EGY E Y \ MEK N J V N CKNE GN PRGT B \ F E C Y \ CRK-F P [ V I F ~9|. HKFGPKO C E Z MK-F R [ KP F HKFGO C EZMK-FR [KP F P \ Z I [ N TK\KO Y ZGCG\ C IGE [ F Z B [ GQ N B I Z F BKPGW. C B I E F S Y ZKO FGEDO [KTGZ FKE C YG\ [ N % 40 ~ 24 |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{ 1981 , S TKU 28 B )\KYGQ \ [ R"G { 1996 ( " BKPGW CKQ-B Z XK", T P' 15 = .14 2. Immigrant visas issued to orphans coming to the USA available: http: //travel.state.gov/orphan-numbers.htm 3. IGY BKPGW KNEKO, KN YGJ F V Z SGPKO 4610 , F \ [ R" I, 1998 , T PGE .1580 4. Albers LH, Johanson DE, Hostetter MK & al, Health of children adopted from the former Soviet Union and Eastern Europe. JAMA, 1997; 278: 922-924. 5. Johnson DE, Miller LC, Iverson MS & al, The Health of children adopted from Romania. JAMA, 1992; 268: 3446-3451. 6. Hostetter MK, Infectious diseases in internationally adopted children: findings in children from China, Russia and Eastern Europe. Adv Pediatr Infect Dis, 1999; 14: 147-161. 7. Miller LC, Health of children adopted from China. Pediatrics, 2000; 105: E76. 8. Hostetter MK, Iverson S, Dole K & Johanson D, Unsuspected infectious diseases and other medical diagnosis in the evaluation of internationally adopted children. Pediatrics, 1989; 4: 559-564. 9. Hostetter MK, Iverson S, Thomas W & al, Medical evaluation of internationally adopted children. N Engl J Med, 1991; 325: 479- 485. 10. Saiman L, Aronson J, Zhou J & al, Prevalence of infectious diseases among internationally adopted children. Pediatrics, 2001; 108: 608-612. 11. Miller CM, Caring for international adopted children. N Engl J Med, 1999; 341: 1539-1540. 12. American Academy of Pediatrics Committee on Early Child- hood, Adoption and Dependent Care. Initial medical evaluation of an adopted child. Pediatrics, 1991; 88: 642-644. 13. American Academy of Pediatrics. Medical evaluation of internationally adopted children. In: Pickering LK, (ed). Red Book: Report of the Committee on Infectious Diseases. 25th ed. Elk Grove Village IL. 2000, pp 148-152. 14. Elevated blood lead levels among internationally adopted children United States, 1998. MMWR, 2000; 49: 97-10. 15. American Academy of Pediatrics. Screening for elevated blood lead levels. Pediatrics, 1998; 101: 1072-1078. 16. Sills Mitchell MA & Jenista JA, Health care of the internation- ally adopted child. Part 1: before and at arrival into the adoptive home. J Pediatr Health Care, 1997; 11: 51-60. 17. Sills Mitchell MA & Jenista JA, Part 2: chronic care and long- term medical Issues. J Pediatr Health Care, 1997; 11: 117-126. 18. Hostetter MK & Johanson D, Medical examination of the internationally adopted child. International Adoption, 1996; 99: 70-82. 19. Hersh BS, Popovici F, Jezek Z & al, Risk factors for HIV infection among abandoned Romanian children. AIDS, 1993; 7: 1617-1624. 20. Hosttetter MK, Infectious diseases in immigrant and interna- tionally adopted children. In: Long SS, Pickering LK & Prober CG, (eds). Principles and Practice of Pediatric Infectious Diseases, Churchill Livingstone Inc, 1997. I, pp 39-43. 21. Sobeslavsky O, Prevalence of markers of hepatitis B virus infection in various countries: a WHO collaborative study. Bull World Health Organ, 1980; 58: 621- 628. 22. Zwiener RJ, Fielman BA & Squires RH Jr, Chronic hepatitis B in adopted Romanian children. J Pediatr, 1992; 121: 572-574. 23. Curtis AB, Ridzon R, Vogel R & al, Extensive transmition of Mycobacterium tuberculosis from a child. N Engl J Med, 1999; 341: 1491-1495. 24. Jenista JA & Chapman D, Medical problems of foreign-born adopted children. Am J Dis Child, 1987; 141: 298-302. F G Z G \ F Z V G B F M ZL 141 , IGC' F' ) P BK 2002 (