A novel strategy to increase identification of African-bornpeople with chronic hepatitis B virus infection in the chicago metropolitan area, 2012-2014

Edwin Chandrasekar, Sharon Song, Matthew Johnson, Aaron M. Harris, Gary I. Kaufman, David Freedman, Michael T. Quinn, Karen E. Kim

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Introduction Most research on hepatitis B virus (HBV) infection in the United States is limited to Asian populations, despite an equally high prevalence among African immigrants. The purpose of this study was to determine testing and detection rates of HBV infection among African-bornpeople residing in the Chicago metropolitan area. Methods A hepatitis education and prevention program was developed in collaboration with academic, clinical, and community partners for immigrant and refugee populations at risk for HBV infection. Community health workers implemented chain referral sampling, a novel strategy for recruitinghard-to-reachparticipants, targeting African-bornparticipants. Participants were tested in both clinical and nonclinical settings. To assess infection status, blood samples were obtained for hepatitis B surface antigen (HBsAg), core antibody, and surface antibody testing. Demographic information was collected on age, sex, health insurance status, country of origin, and years residing in the United States. Participants were notified of testing results, andHBsAg-positiveparticipants were referred forfollow-upmedical care. Results Of 1,000African-bornpeople who received education, 445 (45%) agreed to participate in HBV screening. There were 386 (87%) participants tested in clinical and 59 (13%) tested in nonclinical sites. Compared with participants who were tested in clinical settings, participants tested in nonclinical settings were older, were less likely to have health insurance, and had lived in the United States longer (P < .005 for each). Of these, most were from the Democratic Republic of the Congo (14%), Nigeria (13%), Ghana (11%), Somalia (11%), or Ethiopia (10%). There were 35 (8%) HBsAg-positivepeople, 37% had evidence of past infection, and 29% were immune. Conclusions Chain referral sampling identified many at-risk African-born people with chronic HBV infection. The large proportion of HBsAg-positivepeople in this sample reinforces the need for health promotion programs that are culturally appropriate and community-driven.

Original languageEnglish (US)
Article number160162
JournalPreventing Chronic Disease
Issue number9
StatePublished - 2016

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Public Health, Environmental and Occupational Health

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