To the Editor.
—The recent article by Johnson et al1 presented an excellent overview of the health of children adopted from Romania. As a physician who staffs a tuberculosis clinic that has treated a number of children from Romania, I would like to elaborate on the detection and treatment of tuberculosis discussed in the article.The authors report that 65 children participated in the study. While 61 (94%) were screened for parasites and 58 (89%) were screened for hepatitis B, only 41 (63%) were screened for tuberculosis with a purified protein derivative (PPD). In 1991, foreign-born persons accounted for 26% of the active tuberculosis cases in the United States.2 A majority of foreign-born persons who develop tuberculosis do so within the first 5 years after they enter the United States.3 Thus, screening of all these persons for tuberculosis on entry to the United States is important.In