Laboratory Screening for Children Entering Foster Care

OBJECTIVES:To determine the prevalence of medical illness detected by laboratory screening in children entering foster care in a single, urban county. METHODS:All children entering foster care in a single county in Ohio were seen at a consultation foster care clinic and had laboratory screening, including testing for infectious diseases such as HIV, hepatitis B, hepatitis C, syphilis, and tuberculosis as well as for hemoglobin and lead levels. RESULTS:Over a 3-year period (2012-2015), laboratory screening was performed on 1977 subjects entering foster care in a consultative foster care clinic. The prevalence of hepatitis B, hepatitis C, syphilis, and tuberculosis were all found to be <1%. There were no cases of HIV. Seven percent of teenagers entering foster care tested positive for Chlamydia. A secondary finding was that 54% of subjects were hepatitis B surface antibody-negative, indicating an absence of detected immunity to the hepatitis B virus. CONCLUSIONS:Routine laboratory screening for children entering foster care resulted in a low yield. Targeted, rather than routine, laboratory screening may be a more clinically meaningful approach for children entering foster care.