Hepatitis

Hepatitis A is highly prevalent in the developing world. In general, by the age of 10, the vast majority of children have been exposed and have lifelong protective antibodies. Sometimes, child refugees, some incubating the disease, have caused limited outbreaks in persons having close contacts with them (Castelli et al., 1999). In Asia and Africa, the endemicity of hepatitis B is high, with over 5% carriers of hepatitis B surface antigen. Table 28.2 shows the seroprevalence of hepatitis B in asylum seekers screened in Switzerland at the time of arrival, according to their origin (Raeber et al., 1990). This illustrates its variability as the result of the level of endemicity in their country of origin; it is also related to some selection inherent in the migratory process. Counselling and providing medical care to those who are chronically infected, and immunising relatives to prevent intrafamilial infection, should be carried out by medical providers. Hepatitis C is also of concern, with high prevalence rates ( > 10%) in the developing world.

THE HEALTH OF MIGRANTS AND REFUGEES Table 28.2 Results of hepatitis B screening in asylum seekers

HBsAg Anti-HBs HBeAg

Country

n

Pos

%

n

Pos

%

n

Pos

Turkey

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