Low hepatitis B testing among migrants: a cross-sectional study in a UK city

Iro Evlampidou, Matthew Hickman, Charles Irish, Nick Young, Isabel Oliver, Sophie Gillett, Alexandra Cochrane

Research output: Contribution to journalArticle (Academic Journal)peer-review

22 Citations (Scopus)
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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 'HBV-tested'. 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.

Original languageEnglish
Pages (from-to)e382-e391
Number of pages10
JournalBritish Journal of General Practice
Issue number647
Early online date26 May 2016
Publication statusPublished - Jun 2016


  • Cross-Sectional Studies
  • Hepatitis B
  • Transients and Migrants
  • Diagnosis
  • General Practice
  • United Kingdom


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