Hepatitis B and Liver Cancer: Community Awareness, Knowledge and Beliefs of Middle Eastern Migrants in Sydney, Australia.

Monica C Robotin,Gisselle Gallego,Jacob George,Jack Wallace

doi:10.3390/ijerph18168534

Abstract

Chronic hepatitis B (CHB) is a significant global health challenge given an increasing morbidity and inadequate public health response, Migrant populations are primarily affected by CHB in industrialised countries, and while more than 7% of Australians with CHB were born in Africa or the Middle East, little is known of their awareness or knowledge of viral hepatitis and its impact. This qualitative study, using semi-structured interviews with Assyrian and Arabic community leaders and focus groups (FG) with 66 community members sought to identify hepatitis and liver cancer knowledge and awareness among local Arabic and Assyrian-speaking communities in Western Sydney. Interviews were thematically analysed, with findings framing the topics for the FGs which were analysed using a framework analysis. Themes identified across both methods included limited awareness or knowledge of viral hepatitis or liver cancer, stigma associated with both conditions, variable levels of health literacy and trust in medical practitioners, and fear that receiving “bad news” would deter people from seeking care. Preferred sources of health information were family doctors, family members, the internet and the ethnic media. The study gave valuable information for the design of an educational program and provided useful information for the planning of culturally appropriate hepatitis screening and treatment services for these communities.

Highlights

In the space of a generation, the incidence of and mortality from primary liver cancer in Australia increased significantly and from 1982 to 2020 liver cancer moved from the 15th to the 6th most common cause of cancer death [1], with approximately 80% of liver cancers attributable to chronic viral hepatitis, which affects more than 400,000 Australians [2]
People born in hepatitis B endemic countries carry a disproportionate burden of chronic hepatitis B (CHB) [3] and liver cancer [4], and understanding community awareness, knowledge and
Four focus groups (FG) were conducted in Arabic and involved 38 participants, of whom 58% were male with a median age range from 56 to 64, with countries of birth included Egypt, Lebanon, Syria, Palestine, Kuwait, Iran and Iraq

Summary

Introduction

In the space of a generation, the incidence of and mortality from primary liver cancer in Australia increased significantly and from 1982 to 2020 liver cancer moved from the 15th to the 6th most common cause of cancer death [1], with approximately 80% of liver cancers attributable to chronic viral hepatitis, which affects more than 400,000 Australians [2].A large proportion of people with chronic hepatitis B (CHB) remain unaware of their diagnosis: of the 227,000 estimated to be living with CHB in Australia in 2018 [3], only 68%were diagnosed and just 9.3% were receiving antiviral treatment [2]. In the space of a generation, the incidence of and mortality from primary liver cancer in Australia increased significantly and from 1982 to 2020 liver cancer moved from the 15th to the 6th most common cause of cancer death [1], with approximately 80% of liver cancers attributable to chronic viral hepatitis, which affects more than 400,000 Australians [2]. A large proportion of people with chronic hepatitis B (CHB) remain unaware of their diagnosis: of the 227,000 estimated to be living with CHB in Australia in 2018 [3], only 68%. 56% of Australians with CHB were born overseas, with the largest population groups comprising people born in the Asia Pacific region (38%), Europe (10%) and Africa or the Middle East (7%) [3].

Methods

Results

Discussion

Conclusion