Prevalence and associated risk factors for hepatitis B and C viruses among refugee populations living in Mahama, Rwanda: A cross-sectional study

The Burden and Risk Factors Associated with Infectious Diseases among Refugees in a Camp for Migrants in Porto Alegre: A Cross-Sectional Survey

Refugees usually face a disproportionate burden of infectious diseases. Recently, Brazil has experienced an influx of refugees which demands the need for scaling up public health efforts to address the challenges. The research sought to study the burden and risk factors associated with infectious diseases among refugees received in the city of Porto Alegre. This was a cross-sectional study of 261 newly arrived refugees. The study sample was predominantly composed of Venezuelans (50.6%) and Haitians (44%), male (146: 56.7%), single (30.7%), with an average age of 33.38 (± 7.30) years. The average schooling was 10.42 (± 2.09) years. Diseases with the highest prevalence were influenza, whooping cough, diphtheria, and tuberculosis. There was significant association between the country of origin and presence of symptoms for infectious and contagious diseases, which warrants targeted interventions for reducing the incidence of these diseases among refugees in Brazil.

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

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.

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

Hepatitis B, caused by the hepatitis B virus (HBV), is a global public health issue that affects 290 million people worldwide. Most people with hepatitis B are in low- and middle-income countries (LMIC), where health systems and resources are often constrained. Refugees, asylum seekers and internally displaced persons (IDPs) often face barriers in seeking health care and are a priority population at risk of hepatitis B. No systematic review to date has evaluated the prevalence of hepatitis B amongst refugees in in LMIC. We undertook a systematic review of the literature identifying 28 studies addressing this topic. Though few studies on this topic exist, the available evidence suggests a high prevalence amongst refugees in LMIC, with wide variation between and within countries. Possible risk factors contributing to hepatitis B include unsafe injections, low immunization coverage, low awareness, mother-to-child transmission, and limited health services. Further study is needed to better understand the prevalence and risk factors for hepatitis B amongst refugees in LMIC, to inform public health responses. Vulnerable populations such as refugees are an important group to consider in national and global efforts to eliminate hepatitis B.

A study of HBV infection and its risk factors in pregnant women in Zakho city, Iraq

Background

Despite vaccine and antiviral treatment availability, hepatitis B virus (HBV) continues to circulate among pregnant women in Iraq. HBV spread is due to many factors. This study evaluated HBV prevalence among pregnant women and Syrian refugees residing in Zakho city, Iraq, and identified risk factors associated with infection.

Materials and methods

Demographic data were collected from 2,054 pregnant women via a questionnaire assessing risk factors associated with HBV infection. Blood samples were collected for hepatitis B surface antigen (HBsAg) and were screened using an enzyme-linked immunosorbent assay.

Results

Tests revealed that 1.1% of pregnant women in Zakho and 11.3% of Syrian refugees (p = 0.001) were positive for HBsAg. The average age of HBsAg-positive patients was 31.4286 ± 6.6746 years (p = 0.002). Average rates of parity and abortion in HBV-infected subjects were 3.5 ± 2.6874 and 0.1785 ± 0.5479, respectively (p = 0.044 and 0.012, respectively). The following were identified as associated risk factors for HBV infection: nationality, (Zakho versus the city centre), tattoos, and polygamy (p = 0.001, 0.03, 0.007, and 0.001, respectively). No significant associations between HBV prevalence and blood transfusion, prior injection history, dental procedures, or surgical procedures were found.

Conclusion

The prevalence of HBV infection among Syrian refugees was higher than that of indigenous participants. Several risk factors were significantly associated with HBV positivity, which may facilitate effective preventive program implementation and decrease mother-to-child transmission risk. This will likely reduce infant and childhood HBV chronicity, and mortality rates.