Alexandra Cochrane1, Iro Evlampidou2, Charles Irish3, Suzanne M Ingle4, Matthew Hickman5. 1. School of Cellular and Molecular Medicine, Medical Sciences Building, University of Bristol, University Walk, Bristol BS8 1TD, UK. Electronic address: alex.cochrane@bristol.ac.uk. 2. Field Epidemiology Service, Public Health England, UK; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden. 3. Public Health Laboratory Bristol, Bristol, UK; Avon, Gloucestershire and Wiltshire Health Protection Team, Public Health England, Bristol, UK. 4. NIHR Health Protection Research Unit in Evaluation of Interventions, School of Social and Community Medicine, University of Bristol, UK. 5. School of Social and Community Medicine, University of Bristol, UK.
Abstract
BACKGROUND: Many countries with low prevalence of Hepatitis B Virus (HBV) infection recommend that migrants born in countries with higher prevalence are HBV tested. The cost effectiveness depends on the prevalence of HBV infection in the migrant population. In the UK the National Institute for Health and Care Excellence recommended HBV testing of migrants born in countries with HBV infection prevalence >2%, but the prevalence in migrant populations in the UK is not routinely measured. OBJECTIVES: To estimate HBV infection prevalence by region of birth in migrant populations in a large UK city. STUDY DESIGN: By retrospective data linkage HBV infection prevalence in migrant women tested in pregnancy was determined by UN region and sub-region of birth. RESULTS: Of 5840 migrant women born in regions with HBV infection prevalence >2%, 101 were infected (prevalence 1.7%; 95% CI 1.4-2.1). Sub-regions of birth with low (<2%), intermediate (2-8%) and high (>8%) prevalence in the study population were: low - Northern Africa, Southern Asia, Western Asia, Eastern Europe, South Europe, Central America, Latin America and The Caribbean; intermediate - Eastern Africa, Middle Africa, Western Africa, and South Eastern Asia; high - Eastern Asia. Prevalence in the study populations, was generally lower than published estimates for the region of origin. CONCLUSION: In a large ethnically diverse city in the UK the hepatitis B prevalence in migrant populations for whom HBV screening is recommended is below the estimated cost effectiveness threshold. We recommend more targeted screening based on measured prevalence in migrant populations.
BACKGROUND: Many countries with low prevalence of Hepatitis B Virus (HBV) infection recommend that migrants born in countries with higher prevalence are HBV tested. The cost effectiveness depends on the prevalence of HBV infection in the migrant population. In the UK the National Institute for Health and Care Excellence recommended HBV testing of migrants born in countries with HBV infection prevalence >2%, but the prevalence in migrant populations in the UK is not routinely measured. OBJECTIVES: To estimate HBV infection prevalence by region of birth in migrant populations in a large UK city. STUDY DESIGN: By retrospective data linkage HBV infection prevalence in migrant women tested in pregnancy was determined by UN region and sub-region of birth. RESULTS: Of 5840 migrant women born in regions with HBV infection prevalence >2%, 101 were infected (prevalence 1.7%; 95% CI 1.4-2.1). Sub-regions of birth with low (<2%), intermediate (2-8%) and high (>8%) prevalence in the study population were: low - Northern Africa, Southern Asia, Western Asia, Eastern Europe, South Europe, Central America, Latin America and The Caribbean; intermediate - Eastern Africa, Middle Africa, Western Africa, and South Eastern Asia; high - Eastern Asia. Prevalence in the study populations, was generally lower than published estimates for the region of origin. CONCLUSION: In a large ethnically diverse city in the UK the hepatitis B prevalence in migrant populations for whom HBV screening is recommended is below the estimated cost effectiveness threshold. We recommend more targeted screening based on measured prevalence in migrant populations.
Authors: Natasha K Martin; Peter Vickerman; Salim Khakoo; Anjan Ghosh; Mary Ramsay; M Hickman; Jack Williams; Alec Miners Journal: BMJ Open Date: 2019-06-28 Impact factor: 2.692
Authors: Iro Evlampidou; Matthew Hickman; Charles Irish; Nick Young; Isabel Oliver; Sophie Gillett; Alexandra Cochrane Journal: Br J Gen Pract Date: 2016-03-29 Impact factor: 5.386
Authors: Teresa Dalla Zuanna; Martina Del Manso; Cristina Giambi; Flavia Riccardo; Antonino Bella; Maria Grazia Caporali; Maria Grazia Dente; Silvia Declich Journal: Int J Environ Res Public Health Date: 2018-05-12 Impact factor: 3.390
Authors: Erwin Ho; Peter Michielsen; Pierre Van Damme; Margareta Ieven; Irene Veldhuijzen; Thomas Vanwolleghem Journal: Ann Glob Health Date: 2020-07-16 Impact factor: 2.462
Authors: Andreas Halgreen Eiset; Michaelangelo P Aoun; Ramzi S Haddad; Wadih J Naja; Kurt Fuursted; Henrik Vedel Nielsen; Christen Rune Stensvold; Monica Stougaard Nielsen; Annemarie Gottlieb; Morten Frydenberg; Christian Wejse Journal: BMJ Open Date: 2020-05-26 Impact factor: 2.692