Chronic Hepatitis B Health Literacy Lagging in Immigrant Patients

Chronic Hepatitis B Health Literacy Lagging in Immigrant Patients

HBVAn evaluation study on transmission and consequences of chronic hepatitis B infection entitled “Health literacy in patients with chronic hepatitis B attending a tertiary hospital in Melbourne: a questionnaire based survey” was published in the BMC Infectious Diseases journal by Dr. Tanya FM Dahl, part of Dr. Caroline Marshall’s group from the Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Victoria, Australia, and colleagues.

Hepatitis B virus (HBV) infections cause 1 million deaths across the globe each year. Presently in Australia, it is estimated that more than 218,000 people are chronically infected with the hepatitis B virus, mostly comprised of migrants and refugees from endemic countries for hepatitis B who have limited levels of education, health, and English knowledge. All of these factors were found to be an obstacle for HBV patients to gain full access to the Australian healthcare system and benefit from better management of the infection.

In this study, the researchers evaluated the knowledge of transmission and consequences in 55 patients with chronic hepatitis B enrolled from three Royal Melbourne Hospital outpatient clinics. They attributed a knowledge score out of 12 for each subject. The researchers performed two questionnaires during an observation of a prospective participants’ consultation given to the patient by their clinician; and after the consultation, to evaluate patient demographics and their general knowledge of the effect, transmission, and treatment of hepatitis B.

From the 55 patients recruited, 93% of them were born in a foreign country, 17% needed an interpreter, and all had a mean time after diagnosis of 9.7 years. The researchers concluded from the first questionnaire that the clinician hardly ever discussed many concepts about chronic hepatitis B, and from the second questionnaire, patients were found to have considerable gaps in hepatitis B knowledge, and few patients reported a risk of cirrhosis (11%) or liver cancer (18%).

There was high knowledge of the various transmission routes, with 89% identifying sexual transmission, 93% infected blood, and 85% perinatal transmission. Still, 25% of patients thought that hepatitis B could be transmitted by sharing food, and more than 50% by kissing and via mosquitoes. The average knowledge score of the subjects was 7.5. But there were higher knowledge scores among the patients with a family member also diagnosed with chronic hepatitis B and patients regularly seeing the same clinician.

Overall, the main findings of this study emphasize the existence of gaps concerning the knowledge and erroneous beliefs about chronic hepatitis B from the patients and stresses the need to increase education and support initiatives. Notably, this is the biggest Australian study evaluating knowledge and understanding of the effect, transmission, and treatment of hepatitis B among chronically infected individuals.

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