Effectiveness and cost-effectiveness of screening for and vaccination against hepatitis B virus among migrants in the EU/EEA
Citation: Myran DT, Morton R, Biggs BA, et al. The effectiveness and cost-effectiveness of screening for and vaccination against hepatitis B virus among migrants in the EU/EEA: a systematic review. International Journal of Environmental Research and Public Health. 2018;15(9):1898.
Language: Abstract and full text available in EN.
Free to view: Yes.
Funding sources: European Centre for Disease Prevention and Control.
What is this? In this systematic review, the authors searched for publications reporting the effectiveness or the cost-effectiveness of Hepatitis B Virus (HBV) screening and vaccination programmes among migrants to the European Union (EU) or European Economic Area (EEA). They restricted their searches to articles published in English from 1 January 2010 to 31 December, 2016. They included 9 articles reporting effectiveness data, of which four were systematic reviews, three were guidelines, one technical report and one primary study. They also included 9 studies reporting the cost-effectiveness of screening and vaccination in Canada (2), China (1), The Netherlands (1), Italy (1), and the USA (4), of which six studies were specific to migrant communities in these countries.
What works: Childhood and adolescent HBV vaccination program were found to be effective at preventing chronic hepatitis B (CHB) in marginalised and high-risk populations. Screening for CHB infection may also be effective for high-risk individuals. Screening was found to be more cost-effective than no or voluntary screening. Additionally, screen-and-treat strategies were more cost-effective when compared with universal vaccination strategies.
What is uncertain: The relationship between the proportion of migrants with CHB and follow up or ongoing care was unclear. The effectiveness of vaccination programmes specifically in migrant populations also not identified.
Implications: The authors of the review stated that implementing screening programmes amongst migrants may present challenges such as limited access to health care, language barriers, and inability to navigate healthcare systems. A mix between vaccination and testing programs and improved access to care would have the highest impact.
Other considerations: The authors of the review discussed their findings in the context of place of residence, ethnicity, culture, and language.
This summary was prepared by Joly Ghanawi, checked by Sneha Bhadti and Grace Meng, and finalized by Helen Worthington.