title: Hepatitis B infection prevalence by country of birth in migrant populations in a large UK city.
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.
  
  
  OBJECTIVE
  To estimate HBV infection prevalence by region of birth in migrant populations in a large UK city.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.affiliation: 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.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Cochrane
authors.affiliation: Field Epidemiology Service, Public Health England, UK; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
authors.forename: Iro
authors.initials: I
authors.lastname: Evlampidou
authors.affiliation: Public Health Laboratory Bristol, Bristol, UK; Avon, Gloucestershire and Wiltshire Health Protection Team, Public Health England, Bristol, UK.
authors.forename: Charles
authors.initials: C
authors.lastname: Irish
authors.affiliation: NIHR Health Protection Research Unit in Evaluation of Interventions, School of Social and Community Medicine, University of Bristol, UK.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Ingle
authors.affiliation: School of Social and Community Medicine, University of Bristol, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hickman
mesh_terms: D002947:Cities / Q000453:epidemiology; D054242:Emigrants and Immigrants; D005006:Ethnicity; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology*; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology
keywords: Global; Hepatitis B; Migrant; Prevalence; Screening; Testing