The hidden burden of viral hepatitis: a comparative study of KAP and infections among rohingya refugees and host communities in Bangladesh
摘要
Bangladesh has an intermediate endemicity of hepatitis B virus (HBV), with prevalence exceeding the global average. In border areas like Teknaf, where more than a million Forcibly Displaced Myanmar Nationals (FDMNs), as well as the Local Community Bangladeshi Nationals (host community), may be at increased risk of HBV and hepatitis C virus (HCV). We aimed to explore the knowledge, attitudes, and practices (KAP) regarding HBV and HCV in these populations.
MethodsThis was a cross-sectional study among adults who reported to the Severe Acute Respiratory Infection (SARI) Hospital in Teknaf, Cox’s Bazar, between April 2021 and March 2022. A structured questionnaire was developed to assess the participants’ knowledge, attitudes, and practices on HBV or HCV. Simultaneously, blood specimens from the participants were analysed to explore their infection status. KAP scores were calculated by assigning one point for each correct response, and participants were classified as satisfactory or unsatisfactory based on a midpoint cut-off of the total possible score. A p-value of < 0.05 was considered significant.
ResultsA total of 654 participants were enrolled; 58 (8.86%) were FDMNs and 596 (91.14%) were host community. Overall, 23 (3.52%) tested positive for either HBV or HCV, including 11 (18.97%) FDMNs and 12 (2.01%) host community (p < 0.001). HBV positivity was comparable between FDMNs and host community (1.72% vs. 1.01%; p = 0.480). HCV positivity was higher among FDMNs than host community (17.24% vs. 1.01%; p < 0.001). Satisfactory knowledge was observed in 5.17% of FDMNs and 12.25% of host community; satisfactory attitude in 71.70% and 81.12%, respectively; and satisfactory practice in 37.93% and 50.00%. FDMNs had poorer awareness of HBV vaccination (0.00% vs. 9.73%) and vertical transmission (6.90% vs. 19.33%).
ConclusionKAP regarding HBV and HCV was low in both populations, particularly among FDMNs, who also had a substantially higher infection burden. Targeted health education, culturally appropriate awareness programmes, and improved access to screening and care may help reduce future viral hepatitis transmission in both communities.