British Journal of General Practice
Volume 66, Issue 647, 2016, Pages e382-e391

Low hepatitis B testing among migrants: A cross-sectional study in a UK city (Article) (Open Access)

Evlampidou I.* , Hickman M. , Irish C. , Young N. , Oliver I. , Gillett S. , Cochrane A.
  • a Field Epidemiology Service, Public Health England, 2 Rivergate, Temple Quay, Bristol, BS1 6EH, United Kingdom, European Programme for Intervention Epidemiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden
  • b School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom, NIHR Health Protection Unit on Evaluation of Interventions, University of Bristol, Bristol, United Kingdom
  • c Public Health Laboratory Bristol, Bristol, United Kingdom
  • d South West Centre, Public Health England, Exeter, United Kingdom
  • e NIHR Health Protection Unit on Evaluation of Interventions, University of Bristol, Bristol, United Kingdom, South West Health Protection Team, Public Health England, Bristol, United Kingdom
  • f Public Health Laboratory Bristol, Bristol, United Kingdom
  • g School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom

Abstract

Background In 2012, hepatitis B virus (HBV) testing of people born in a country with a prevalence of ≥2% was recommended in the UK. Implementation of this recommendation requires an understanding of prior HBV testing practice and coverage, for which there are limited data. Aim To estimate the proportion of migrants tested for HBV and explore GP testing practices and barriers to testing. Design and setting A cross-sectional study of (a) migrants for whom testing was recommended under English national guidance, living in Bristol, and registered with a GP in 2006-2013, and (b) GPS practising in Bristol. Method NHS patient demographic data and HBV laboratory surveillance data were linked. A person was defined as 'HBV- Tested' if a laboratory result was available. An online GP survey was undertaken, using a structured questionnaire. Results Among 82 561 migrants for whom HBV testing was recommended, 9627 (12%) were 'HBVtested'. The HBV testing coverage was: Eastern Africa 20%; Western Africa 15%; South Eastern Asia 9%; Eastern Asia 5%. Of 19 GPS, the majority did not use guidelines to inform HBV testing in migrants and did not believe routine testing of migrants was indicated; 12/17 GPS stated that workload and lack of human, and financial resources were the most significant barriers to increased testing. Conclusion The majority of migrants to a multicultural UK city from medium-/high-prevalence regions have no evidence of HBV testing. Much greater support for primary care in the UK and increased GP awareness of national guidance are required to achieve adherence to current testing guidance.

Author Keywords

Transients and migrants UK Cross-sectional studies Diagnosis Hepatitis B General practice

Index Keywords

mass screening Pregnancy Complications, Infectious human middle aged Practice Guidelines as Topic protocol compliance health service Ethnic Groups statistics and numerical data State Medicine Guideline Adherence ethnic group Aged screening test Urban Health Services Hepatitis B virus hepatitis B testing national health service Cross-Sectional Studies blood donor Young Adult cross-sectional study migrant Humans Adolescent male female preventive health service Cities pregnancy prevalence isolation and purification Health Knowledge, Attitudes, Practice Article organization and management city major clinical study adult migration United Kingdom patient attitude chronic hepatitis B hepatitis B surface antigen Patient Acceptance of Health Care Immunization Programs Transients and Migrants hepatitis B practice guideline attitude to health Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84982144093&doi=10.3399%2fbjgp16X684817&partnerID=40&md5=c0c419366c6a439a6acc2d5057fc1404
DOI: 10.3399/bjgp16X684817
ISSN: 09601643
Cited by: 8
Original Language: English