Hepatitis B and C among Northeast African Refugees in the United States: The Need for Screening, Immunization, and Follow-Up

By Ahmed YoussefAgha, Wasantha Jayawardene and David Lohrmann.

Published by The International Journal of Health, Wellness and Society

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Article: Print $US10.00
Article: Electronic $US5.00

The World Health Organization estimates that, worldwide, 2 billion people have been infected with hepatitis B and about 180 million people have been infected with hepatitis C. Middle Eastern and North African regions have a high prevalence of hepatitis B and C. These regions also serve as one of the major origins for refugees. The United States is a country of resettlement for a significant proportion of them. Refugees make up a small sector of the U.S. population; yet, they carry a higher burden of disease from hepatitis B and C. Although overall incidence of hepatitis B in the US has decreased and incidence of hepatitis C has almost leveled off during the past decade, the trend may be different for the refugee populations. The objective of this literature review was to explore the aspects that contributed to the high prevalence of hepatitis B and C among refugees in the US. Screenings of hepatitis B and C are not performed before departure or after arrival in the country. Hepatitis C, especially, is often asymptomatic and can become chronic. The barriers to health care that refugees face, including lack of screening, are most commonly associated with the cultural gap between their own beliefs and education and the culture and beliefs of the US. The implications of this review indicate a need for viral hepatitis screening and HBV immunization followed by more comprehensive treatment and follow-up care for infected refugees in order to decrease the risk of transmission and reduce mortality rates.

Keywords: Hepatitis B, Hepatitis C, Refugees, Screening

The International Journal of Health, Wellness and Society, Volume 2, Issue 3, pp.101-110. Article: Print (Spiral Bound). Article: Electronic (PDF File; 299.662KB).

Prof. Ahmed YoussefAgha

Assistant Professor, Department of Applied Health Science, Indiana University Bloomington, Bloomington, Indiana, USA

I have worked as a Biostatistician for Oncology Department of Novartis Pharmaceutical, a Biostatistician for Health Outcome Innovations in Humana Health Insurance, an Adjunct Faculty in Computer Sciences Department of Spalding University, KY, a Research Assistant in School of Public Health, University of Louisville, KY, an instructor in computer studies in the American University in Cairo, Egypt, and a Management Information System Specialist of US-Aid Programs for Development in Egypt. I'm interested in the integration of Biostatistics, Decision Analysis Techniques, and Computer Sciences for researches in Public Health. My research works include: Abuse of Prescription and Non-Prescription Drugs among Indiana Adolescents; an Extension of Stochastic Tree Model Utilizing WAFT Model; Multiobjective Simulation-Based Methodologies for Disease/Injury Treatment; Adjuvant Chemotherapy for Breast Cancer: How Presentation of Recurrence Risk Influences Decision-Making; Redesigning UofL Occupational Health Surveillance Program Databases; The Egyptian Industries' Needs for Entering the International Markets; Old Cairo Tanneries Relocation Project; and The Implications of Business Regulations on Small Enterprises in Egypt.

Dr. Wasantha Jayawardene

Doctoral Student, Department of Applied Health Science, Indiana University Bloomington, Bloomington, IN, USA

I obtained my medical degree in Moscow and completed medical internship in Sri Lanka followed by working as a Regional Epidemiologist in Sri Lanka for three years. During this period, I had also been conducting rehabilitation following South-Asia Tsunami, post-war rehabilitation, and attended three WHO workshops on management of epidemics in South-East Asia. I have conducted a research on “Psychological Distress Among Nurses Caring for War-Victims in Sri Lanka”, which was accepted by Journal of Disaster Medicine and Public Health Preparedness for publication. One of my other researches is “Prevention of Dengue fever: an exploratory school-community intervention involving students empowered as change agents”, which was accepted by Journal of School Health for publication. Few researches/reviews are also completed: Dimensions of HIV/AIDS in Africa; Characteristics of Diabetes Epidemic across Global Regions; Abuse of Prescription and Non-Prescription Drugs among Indiana Adolescents; Socio-Economic Factors Affecting Violence and Bullying among Adolescents across Global Regions.

Prof. David Lohrmann

Interim Chair, Professor, Applied Health Science, Indiana University, Bloomington, Indiana, USA