Assessment of monitoring practices for newly arrived refugees with chronic hepatitis b - Minnesota 2008-2017 [poster] Conference Poster uri icon

abstract

  • Over 250 million people worldwide are currently living with chronic Bhutan Congo hepatitis B (CHB) virus infection. The overall number of patients with hepatitis B infection in the United States is comparatively low (850,000-2 million), however the majority of new cases (95%) of CHB are diagnosed in immigrants and refugees. CHB is a risk factor for development of cirrhosis and hepatocellular carcinoma and therefore it is important for patients with CHB to have regular laboratory and ultrasound monitoring. Unfortunately studies have shown that among patients with chronic hepatitis B in the US only 20-42% are aware of their infection and 10-21% are currently receiving care. For immigrant and refugee patients with CHB, there are additional barriers to the care of including lack of insurance or under-insurance, low health literacy, difficulty navigating the US healthcare system, beliefs about seeking care when not feeling ill and fear of stigma or discrimination. Minnesota is home to a growing number of primary and secondary refugees. In 2016, there were a total of 3186 new primary refugee arrivals to Minnesota, with the majority coming from Somalia (44.7%) and Myanmar (20.7%). There were also an estimated 977 secondary refugees arriving from other states in the US. As a result of these recent migrations Minnesota now has the highest number of refugees per capita in the US. In an effort to improve CHB monitoring practices for newly arrived primary refugees in Minnesota, this project assessed whether refugees seen at HealthPartners (HP) Center for International Health (CIH) and diagnosed with CHB between 2008-2017 received hepatoma screening and recommended lab monitoring according to the American Association for the Study of Liver Diseases (AASLD) guidelines. For patients that did not receive appropriate CHB monitoring, we attempted to connect them with local providers that could offer appropriate CHB care.

publication date

  • 2018