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Section 2. Recommendations for Care of Children in Special Circumstances
Medical Evaluation of Internationally Adopted Children for Infectious Diseases 78
Annually, more than 20 000 children from other countries are adopted by families in the United States. More than 90% of international adoptees are from Asian (China, South Korea, Philippines, Vietnam, and India), Central and South American (Guatemala and Colombia), and Eastern European (Russia, Belarus, Ukraine, Kazakhstan, and Bulgaria) countries. Africa and the Middle East are less common origins for international adoptees, but an increasing minority of children are adopted from Ethiopia, Sierra Leone, Liberia, and other African countries. The diverse birth countries of these children, their unknown medical histories before adoption, their previous living circumstances (eg, orphanages and/or foster care), and the limited availability of reliable health care in some economically developing countries make the medical evaluation of internationally adopted children a challenging but important task.
Internationally adopted children typically differ from refugee children in terms of their access to
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