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对难民群体中乙型肝炎和丙型肝炎的预防、检测和治疗干预措施:系统评价结果。

Prevention, testing, and treatment interventions for hepatitis B and C in refugee populations: results of a scoping review.

机构信息

Coalition for Global Hepatitis Elimination, 330 W Ponce de Leon Ave, Decatur, GA 30030, USA.

Partners in Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.

出版信息

BMC Infect Dis. 2023 Dec 9;23(1):866. doi: 10.1186/s12879-023-08861-1.

Abstract

BACKGROUND AND AIMS

Refugees are at higher risk for hepatitis B (HBV) and hepatitis C (HCV), but often face unique healthcare barriers to vaccination, testing, and treatment. This scoping review aimed to identify and characterize HBV and HCV prevention and care services serving refugee populations globally.

METHODS

A literature search was conducted on Embase, Cochrane, and PubMed databases. Research studies published in English between January 2010 to July 2022 describing an HBV or HCV prevention, testing, or treatment intervention for refugees were included.

RESULTS

There were a total of 69 articles reporting viral hepatitis prevalence, implementation of services, or economic modelling. Of the 38 implementation studies, 14 were stand-alone HBV and/or HCV interventions, while 24 studies included HBV and/or HCV in an intervention targeting multiple infectious diseases and/or parasitic infections. Interventions commonly included a testing (n = 30) or referral (n = 24) component. Frequently reported features to promote program accessibility included bilingual services (n = 25), community partnerships (n = 21), and multidisciplinary staff members (n = 18), such as cultural and/or linguistic mediators, community health workers, community health leaders, lay health workers, local health staff, members of the refugee community, and social workers. The most commonly reported challenge was the transience of refugees (n = 5). Twenty studies noted funding sources, of which twelve reported governmental funding (not including national health insurance) and eight reported that refugees received national health insurance.

CONCLUSIONS

This is the first scoping review to characterize the types of hepatitis prevention, screening, and treatment interventions serving refugee populations globally. Published experiences of HBV and HCV services for refugee populations remain limited. Additional efforts are needed to disseminate models of hepatitis interventions for refugees to ensure access to care for this key population. To achieve hepatitis elimination globally, best practices must be identified and shared to expand access to hepatitis services for refugee populations.

摘要

背景和目的

难民感染乙型肝炎(HBV)和丙型肝炎(HCV)的风险较高,但他们在接种疫苗、检测和治疗方面往往面临独特的医疗保健障碍。本范围综述旨在确定和描述为全球难民人口提供的 HBV 和 HCV 预防和护理服务,并对其进行特征描述。

方法

在 Embase、Cochrane 和 PubMed 数据库中进行了文献检索。纳入了发表于 2010 年 1 月至 2022 年 7 月间、用英语描述针对难民的 HBV 或 HCV 预防、检测或治疗干预的研究。

结果

共有 69 篇文章报告了病毒性肝炎的流行率、服务实施情况或经济建模情况。在 38 项实施研究中,14 项是单独的 HBV 和/或 HCV 干预措施,而 24 项研究将 HBV 和/或 HCV 纳入针对多种传染病和/或寄生虫感染的干预措施中。干预措施通常包括检测(n=30)或转介(n=24)。促进项目可及性的常见特征包括双语服务(n=25)、社区伙伴关系(n=21)和多学科工作人员(n=18),如文化和/或语言调解员、社区卫生工作者、社区卫生领袖、非专业卫生工作者、当地卫生工作人员、难民社区成员和社会工作者。报道最多的挑战是难民的流动性(n=5)。20 项研究提到了资金来源,其中 12 项报告了政府资金(不包括国家健康保险),8 项报告难民获得了国家健康保险。

结论

这是首次对全球范围内为难民人口提供的肝炎预防、筛查和治疗干预措施的类型进行特征描述的范围综述。发表的针对难民的 HBV 和 HCV 服务经验仍然有限。需要进一步努力传播针对难民的肝炎干预模式,以确保这一关键人群获得护理。为了在全球范围内实现消除肝炎,必须确定和分享最佳实践,以扩大为难民人口提供的肝炎服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0309/10709891/7a460bfd7264/12879_2023_8861_Fig1_HTML.jpg

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