Timing of chronic hepatitis B diagnosis after migration and its determinants among Sub-Saharan African migrants living in France

In European countries, chronic hepatitis B (CHB) disproportionately affects migrants from medium- and high-endemic areas and is largely underdiagnosed. To inform policy and improve screening strategies, we measured the timing of CHB diagnosis after migration and its determinants among sub-Saharan mi...

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Published in:PloS one 2017-12, Vol.12 (12), p.e0189196-e0189196
Main Authors: Pannetier, Julie, Gigonzac, Virginie, Lydié, Nathalie, Desgrées du Loû, Annabel, Dray Spira, Rosemary
Format: Article
Language:English
Subjects:
Africans
Analysis
Care and treatment
Determinants
Diagnosis
Economic conditions
Employment
Epidemiology
Health aspects
Health care
Hepatitis
Hepatitis B
Hepatitis B virus
HIV
Human immunodeficiency virus
Human migration
Immunization
Life Sciences
Medical diagnosis
Medical records
Medical screening
Medical tests
Medicine and health sciences
Metropolitan areas
Migrants
Migration
Patients
People and places
Population
Pregnancy
Public health
Regression analysis
Regression models
Santé publique et épidémiologie
Social Sciences
Statistical analysis
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Gigonzac, Virginie
Lydié, Nathalie
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Dray Spira, Rosemary
description In European countries, chronic hepatitis B (CHB) disproportionately affects migrants from medium- and high-endemic areas and is largely underdiagnosed. To inform policy and improve screening strategies, we measured the timing of CHB diagnosis after migration and its determinants among sub-Saharan migrants living in the Paris metropolitan area (France). The PARCOURS study is a retrospective life-event history survey conducted in health care services in 2012-2013 among 779 migrants from sub-Saharan Africa who were receiving care for CHB. We investigated the timing of CHB diagnosis from the time of arrival in France using the Kaplan-Meier method and characteristics associated with CHB diagnosis since the time of arrival in France using discrete-time multivariate logistic regression models. The median CHB diagnosis occurred during the fourth year spent in France for men and during the second year spent in France for women. Among men, the probability of CHB diagnosis increased during years with (versus without) a temporary resident permit (aOR: 1.6, 95%CI: 1.1-2.2), a precarious accommodation (aOR: 1.7, 95%CI: 1.1-2.6), and hospitalization (aOR: 7.7, 95%CI: 3.4-15.1). Among women, CHB diagnosis was more likely to occur during years with unemployment (aOR: 1.9, 95%CI: 1.1-3.94), pregnancy (aOR: 6.6, 95%CI: 3.5-12.5) and hospitalization (aOR: 9.0, 95%CI: 2.95-32.3). For both sexes, the probability of CHB diagnosis was higher among those who migrated to France because they were threatened in their country. This study shows that social hardships (residential, economic, administrative) and contact with the health care system after arrival in France hasten access to a CHB diagnosis.
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Among men, the probability of CHB diagnosis increased during years with (versus without) a temporary resident permit (aOR: 1.6, 95%CI: 1.1-2.2), a precarious accommodation (aOR: 1.7, 95%CI: 1.1-2.6), and hospitalization (aOR: 7.7, 95%CI: 3.4-15.1). Among women, CHB diagnosis was more likely to occur during years with unemployment (aOR: 1.9, 95%CI: 1.1-3.94), pregnancy (aOR: 6.6, 95%CI: 3.5-12.5) and hospitalization (aOR: 9.0, 95%CI: 2.95-32.3). For both sexes, the probability of CHB diagnosis was higher among those who migrated to France because they were threatened in their country. This study shows that social hardships (residential, economic, administrative) and contact with the health care system after arrival in France hasten access to a CHB diagnosis.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29283994</pmid><doi>10.1371/journal.pone.0189196</doi><tpages>e0189196</tpages><orcidid>https://orcid.org/0000-0003-0913-9650</orcidid><oa>free_for_read</oa></addata></record>
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source Open Access: PubMed Central; Publicly Available Content Database (Proquest) (PQ_SDU_P3)
subjects Africans
Analysis
Care and treatment
Determinants
Diagnosis
Economic conditions
Employment
Epidemiology
Health aspects
Health care
Hepatitis
Hepatitis B
Hepatitis B virus
HIV
Human immunodeficiency virus
Human migration
Immunization
Life Sciences
Medical diagnosis
Medical records
Medical screening
Medical tests
Medicine and health sciences
Metropolitan areas
Migrants
Migration
Patients
People and places
Population
Pregnancy
Public health
Regression analysis
Regression models
Santé publique et épidémiologie
Social Sciences
Statistical analysis
title Timing of chronic hepatitis B diagnosis after migration and its determinants among Sub-Saharan African migrants living in France
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