Chronic viral hepatitis B and C are the leading causes of liver cancer and cirrhosis. In Europe, it is estimated that about 14 million people are chronically infected with the hepatitis B virus and nine million people with the hepatitis C virus. Migrants from endemic areas are particularly at risk and the conditions represent a substantial health burden among nearly all migrant groups in Europe. For migrants, transmission of hepatitis B is primarily from mother to child at birth and in early childhood, and primarily through blood transfusions in the past and unsafe injections for hepatitis C. Both conditions are mostly asymptomatic and remain undetected for many years. Awareness among those at risk and the general public is low, making case detection a challenge. Antiviral treatment exists for both hepatitis B and C, slowing progression, delaying the onset of cirrhosis and reducing the risk of liver cancer. However, awareness among professionals about treatment options is generally low. Treatment of eligible patients can prevent a considerable part of the hepatitis-related burden of disease and death and reduce inequalities in health. Systematic prevention and control among these often underserved migrant groups has long been neglected. Aim: To assess, describe and communicate to public health professionals the tools and conditions necessary for implementing successful screening programmes for hepatitis B and C in migrants in the European Union.
PO Box 70032
3000 LP Rotterdam
+31 10 4339205
Erasmus University Medical Center Rotterdam
Municipal Public Health Service Rotterdam (NL), Hamburg University of Applied Sciences (DE), Public Health Agency Barcelona (ES), Queen Mary’s University London (UK), National Health Service Grampian (UK), National Centre for Epidemiology (HU), National Institute of Public Health (NL), The Hepatitis C Trust (UK), University of Florence (IT), University of Las Palmas de Gran Canaria (ES)
- Collect, assess and share the evidence on screening, counselling, treatment and patient management for hepatitis B and C in migrants in the EU. - Collate information on effective communication strategies and materials aimed at migrant groups. - Pilot a range of approaches for case detection screening programmes. - To bring together a broad range of stakeholders to build a network and gather consensus on best practice. - Using the findings, develop a tool kit for public health professionals and a short policy document for public health authorities and other health policy oriented parties.
Expected results: Through the achievement of the objectives, the project will lay the foundation for the expansion of screening and prevention programmes for hepatitis B and C among migrants in countries of the European Union.
Health Protection Scotland
Duration of Project:
October 2011 - September 2014
Central in the project are four pilot studies using different screening strategies: 1) information and outreaching, combined with testing through local general practitioners; 2) combined information and testing on location; 3) opportunistic and systematic case finding in general practice; and 4) case finding through existing screening programs. Depending on the contents of the respective work packages, different methods and means will be used to achieve the general objective. Methods include literature review and surveys with structured questionnaires to obtain additional information from experts. Communication materials will be collected and a web based module will be developed to facilitate information and communication exchange with health care professionals.
Output / Materials produced:
The main product of the project will be a tool kit for policy makers and public health professionals containing recommendations, information and materials on implementing a screening program.