Prevalence of hepatitis B virus amongst refugees, asylum seekers and internally displaced persons in low‐ and middle‐income countries: A systematic review

Lee, Caroline; Emeto, Theophilus I.; Walsh, Nick

doi:10.1111/jvh.13770

Cited by 9 publications

(6 citation statements)

References 51 publications

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“…Prevalence of CHB amongst refugees is generally higher than the overall population. Rates of CHB between refugees compared with the general population; Syria 1.1%–5.74% 19 compared with 3.1% 20 ; South Asia 4%–8.3% 19 compared with 2.8% 20 ; Middle East 5.5%–8.3% 19 compared with 2.9% 20 ; Africa 3.8%–15.9% 19 compared with 6.5% 20 respectively.…”

Section: Discussionmentioning

confidence: 93%

“…Despite the risk for refugee children, there is a paucity of literature surrounding the true prevalence of CHB amongst refugees. A recent review found HBV prevalence ranged between <1% and 60% in those with low‐middle incomes and on average 7.2% amongst those resettled in high income countries 19 . Prevalence of CHB amongst refugees is generally higher than the overall population.…”

Section: Discussionmentioning

confidence: 99%

“…A recent review found HBV prevalence ranged between <1% and 60% in those with low-middle incomes and on average 7.2% amongst those resettled in high income countries. 19 Prevalence of CHB amongst refugees is generally higher than the overall population. Rates of CHB between refugees compared with the general population; Syria 1.1%-5.74% 19 compared with 3.1% 20 ; South Asia 4%-8.3% 19 compared with 2.8% 20 ; Middle East 5.5%-8.3% 19 compared with 2.9% 20 ; Africa 3.8%-15.9% 19 compared with 6.5% 20 respectively.…”

Section: Demographic Factorsmentioning

confidence: 99%

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Epidemiology and assessment of Hepatitis B positive children in Western Australia

Bartley,

Turner,

Ford

et al. 2024

J Paediatrics Child Health

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AimTo describe the characteristics of patients with chronic hepatitis B (CHB) presenting to a tertiary paediatric hospital in Perth, Western Australia. Review of implementation of previous follow‐up recommendations for the cohort was also undertaken.MethodA retrospective data analysis of all individuals aged between 0 and 17 years presenting to the tertiary children's hospital who were hepatitis B surface antigen (HBsAg) positive over 8 years (2013–2020). Demographic features, clinical progress and follow up are described, including proportion transferred to adult services.ResultsSeventy‐four patients were identified to have CHB; mean age at diagnosis 11 years; standard deviation 4 years; 41 (55%) male. Cultural and ethnolinguistic diversity was high; 74% (n = 55) were from refugee‐like backgrounds. Many did not demonstrate English proficiency (23/40; 75%) and 7 (10%) Australian born including 4 patients who were Aboriginal. Most patients (58%) with CHB were in the hepatitis B e antigen‐positive chronic infection phase with no intervention provided. Seventeen children had undergone liver ultrasonography and one underwent liver biopsy; none received antiviral treatment. Follow up was concerning; 28 (38%) had at least one clinic non‐attendance, 24 (32%) lost to follow‐up and interpreter utilisation was poorly documented. Thirty‐nine (53%) were transferred to adult services with only 56% attending follow‐up.ConclusionCHB burden is higher in those from culturally and ethnolinguistically diverse backgrounds. There is a significant loss to follow‐up and suboptimal transfer to adult services. Improved recall, education and referral processes are necessary to overcome language, socioeconomic and cultural barriers. Although childhood complications are infrequent, longitudinal monitoring is crucial to prevent long‐term complications and adult morbidity.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Demographic Factorsmentioning

confidence: 99%

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Epidemiology and assessment of Hepatitis B positive children in Western Australia

Bartley,

Turner,

Ford

et al. 2024

J Paediatrics Child Health

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“…A meta-analysis assessing prevalence of hepatitis B throughout EMRO from 2000 to 2016 estimated the prevalence of antibodies against hepatitis B to be 2.84% [ 57 ]. Lee et al (2023), found that there is limited investigation into hepatitis B in refugee populations despite available information indicating high disease burden [ 58 ]. Hepatitis B, which has long-term disease sequalae, is a vaccine preventable disease.…”

Section: Discussionmentioning

confidence: 99%

Disease burden among refugees in camps on mainland Greece, 2016–2017: a retrospective cross-sectional study

Scales,

Park,

Nixon

et al. 2023

BMC Public Health

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Background Despite the importance of baseline health data for evidence-informed decision-making, these data are rarely available for displaced populations. At the height of the European refugee crisis, most of those seeking asylum in Europe were from regions with high prevalences of communicable and non-communicable diseases. To create an epidemiologic profile for refugees in camps on mainland Greece, this study assessed the prevalence of 11 communicable and non-communicable diseases among refugees utilizing Médecins du Monde (MdM) in-camp clinics. Methods The proportional morbidity of selected diseases among individuals utilizing MdM services were determined from data collected at refugee camp clinics on mainland Greece from April 2016 - July 2017. Overall and age-specific proportional morbidities were reported. Differences in disease burden among refugees from the largest sending countries - Afghanistan and Syria - were compared using proportional morbidity ratios and 95% confidence intervals. Patterns in results were compared with disease burden estimates in sending countries and with findings from comparable settings. Results Respiratory tract infections (RTIs) were the most prevalent outcome. Among RTIs, upper RTIs were most common, with a proportional morbidity of nearly 40%; throughout the study period, over 46% of children under 18 years had at least one upper RTI consultation. Musculoskeletal conditions (3.64%), were the most prevalent non-communicable outcome, followed by hypertension (2.21%) and asthma (1.28%). Afghans were 31.68% more likely than Syrians to have a consultation for at least one condition (PR: 1.32; 95% CI: 1.25, 1.39). The proportional morbidity of RTIs was comparable to sending countries, but there was a comparatively lower burden of other conditions among refugees than literature estimates from sending countries. Conclusion Refugees utilizing MdM clinics in camps had higher burdens of communicable diseases - predominantly RTIs - relative to non-communicable diseases. Non-communicable disease burdens were comparatively lower than reported prevalences from in-country populations. These findings can be attributed to a range of considerations including differences in demographic profiles between sending countries and refugee populations and missed opportunities for utilizing clinical care. Further investment is needed to capture the health profiles of displaced populations to support evidence-informed decision-making processes in humanitarian emergency responses.

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“…high prevalence of HBV and HCV in many settings. High HBV seroprevalence has been reported in at least eight settings: Syrian refugees in Turkey (1-5%); Myanmar refugees along the Thai-Myanmar border and in Thailand (6-10%); Afghan refugees and asylum seekers in Pakistan, Turkey, and Iran (8-61%); refugees in Gambella, Ethiopia (7%); refugees in Athens, Greece (15%); refugees at the Muzaffarabad refugee camp in Pakistan (7%); Burundian refugees at the Mahama camp in Rwanda (4%); and Rohingya refugees in Bangladesh (4%) [1][2][3][4][5][6]. Similarly, high HCV seroprevalence has been reported among refugees in Gambella, Ethiopia (2%), among refugees in Athens, Greece (2%), among refugees residing in the Muzaffarabad refugee camp in Pakistan (18%), and Rohingya refugees in Bangladesh (11%) [2][3][4][5][6].…”

mentioning

confidence: 99%

Prevention, testing, and treatment interventions for hepatitis B and C in refugee populations: results of a scoping review

Saseetharran,

Hiebert,

Gupta

et al. 2023

BMC Infect Dis

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Background and aims Refugees are at higher risk for hepatitis B (HBV) and hepatitis C (HCV), but often face unique healthcare barriers to vaccination, testing, and treatment. This scoping review aimed to identify and characterize HBV and HCV prevention and care services serving refugee populations globally. Methods A literature search was conducted on Embase, Cochrane, and PubMed databases. Research studies published in English between January 2010 to July 2022 describing an HBV or HCV prevention, testing, or treatment intervention for refugees were included. Results There were a total of 69 articles reporting viral hepatitis prevalence, implementation of services, or economic modelling. Of the 38 implementation studies, 14 were stand-alone HBV and/or HCV interventions, while 24 studies included HBV and/or HCV in an intervention targeting multiple infectious diseases and/or parasitic infections. Interventions commonly included a testing (n = 30) or referral (n = 24) component. Frequently reported features to promote program accessibility included bilingual services (n = 25), community partnerships (n = 21), and multidisciplinary staff members (n = 18), such as cultural and/or linguistic mediators, community health workers, community health leaders, lay health workers, local health staff, members of the refugee community, and social workers. The most commonly reported challenge was the transience of refugees (n = 5). Twenty studies noted funding sources, of which twelve reported governmental funding (not including national health insurance) and eight reported that refugees received national health insurance. Conclusions This is the first scoping review to characterize the types of hepatitis prevention, screening, and treatment interventions serving refugee populations globally. Published experiences of HBV and HCV services for refugee populations remain limited. Additional efforts are needed to disseminate models of hepatitis interventions for refugees to ensure access to care for this key population. To achieve hepatitis elimination globally, best practices must be identified and shared to expand access to hepatitis services for refugee populations.

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Prevalence of hepatitis B virus amongst refugees, asylum seekers and internally displaced persons in low‐ and middle‐income countries: A systematic review

Cited by 9 publications

References 51 publications

Epidemiology and assessment of Hepatitis B positive children in Western Australia

Epidemiology and assessment of Hepatitis B positive children in Western Australia

Disease burden among refugees in camps on mainland Greece, 2016–2017: a retrospective cross-sectional study

Prevention, testing, and treatment interventions for hepatitis B and C in refugee populations: results of a scoping review

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