title: Changing epidemiology of hepatitis B and migration--a comparison of six Northern and North-Western European countries.
abstract: BACKGROUND
  Increased migration volume and different Hepatitis B prevalence between immigration and emigration countries have changed the Hepatitis B virus (HBV) epidemiology considerably in Northern and North-Western European migrants-receiving countries. Due to the difference in migration status monitoring, the HBV infection data on migrants are not easily comparable among those countries. The study aims were: to compare the migration status indicators used by the national surveillance system in six Northern and North-Western European countries (the Netherlands, Germany, Finland, Denmark, Sweden and the UK); to determine the impact of the migration status on HBV infection by comparing the available data on prevalence and transmission routes of Hepatitis B in the migration and the general population in the six countries; to recommend sensible indicators and pertinent measures for HBV infection surveillance and control in the region.
  
  
  METHODS
  Literature review, statistical data analysis on migration and HBV infection in the six countries; expert interviews to identify migration status indicators used in national surveillance systems.
  
  
  RESULTS
  Evident differences were found between the migration and the general population in Hepatitis B prevalence and transmission routes in the six countries. Migration status is monitored differently in six surveillance systems; immigrants from high/intermediate Hepatitis B endemic countries constitute a substantial proportion of HBsAg(+) and chronic cases in all six countries.
  
  
  CONCLUSIONS
  International migration has an obvious impact on Hepatitis B prevalence in the six countries. It is important to include common migration status indicators and to collect comparable data for HBV infection surveillance in different notification systems.
authors.affiliation: Department Health Sciences, Faculty Life Sciences, Hamburg University of Applied Sciences, Germany. janet.chu@billwiese.de
authors.forename: Janet JunQing
authors.initials: JJ
authors.lastname: Chu
authors.forename: Tanja
authors.initials: T
authors.lastname: Wörmann
authors.forename: Johann
authors.initials: J
authors.lastname: Popp
authors.forename: Gunnar
authors.initials: G
authors.lastname: Pätzelt
authors.forename: Manas K
authors.initials: MK
authors.lastname: Akmatov
authors.forename: Alexander
authors.initials: A
authors.lastname: Krämer
authors.forename: Ralf
authors.initials: R
authors.lastname: Reintjes
mesh_terms: D003431:Cross-Cultural Comparison; D003718:Denmark / Q000453:epidemiology; D054242:Emigrants and Immigrants; D005387:Finland / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006509:Hepatitis B / Q000453:epidemiology* / Q000635:transmission* / Q000821:virology; D006515:Hepatitis B virus / Q000472:pathogenicity*; D006801:Humans; D007114:Immunization / Q000639:trends; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D013548:Sweden / Q000453:epidemiology / Q000208:ethnology; D006113:United Kingdom / Q000453:epidemiology