{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T12:33:42Z","timestamp":1775910822733,"version":"3.50.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:00:00Z","timestamp":1663200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:00:00Z","timestamp":1663200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100019833","name":"World Health Organization Centre for Health Development","doi-asserted-by":"publisher","award":["AP21-00151"],"award-info":[{"award-number":["AP21-00151"]}],"id":[{"id":"10.13039\/100019833","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009827","name":"Alexandria University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009827","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Epidemiol Glob Health"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Estimating the prevalence of infectious diseases, including viral hepatitis, among refugees is important for evaluating their health needs and predicting the burden on the health system of the host country. This study aimed at estimating the seroprevalence of viral hepatitis among refugees in Egypt.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross-sectional study involved a heterogeneous group of 501 refugees. Enzyme-linked immunosorbent assays were used to detect IgG antibodies against hepatitis A virus (HAV), B virus (HBV) surface antigen (anti-HBsAg), C virus (HCV), and HBV surface antigen (HBsAg).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Anti-HAV was the most prevalent marker (<jats:italic>n<\/jats:italic>\u2009=\u2009482, 96.2%), followed by anti-HBs (<jats:italic>n<\/jats:italic>\u2009=\u2009142, 28.3%) and HBsAg (<jats:italic>n<\/jats:italic>\u2009=\u200921, 4.2%), while only four refugees (0.8%) had positive anti-HCV IgG. Anti-HBs was higher in males (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Older refugees and non-working subjects had significantly higher seropositive rates of anti-HAV (<jats:italic>p<\/jats:italic>\u2009=\u20090.051 and<jats:italic>p<\/jats:italic>\u2009=\u20090.023, respectively), while students and those below 15\u00a0years of age had higher rates of anti-HBs (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Positive HBsAg results were associated with history of hepatitis (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Obese participants were more likely to be positive for HBsAg (<jats:italic>p<\/jats:italic>\u2009=\u20090.025) and anti-HBs (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Sudanese refugees had significantly higher rates of anti-HAV antibodies (p\u2009=\u20090.049), while Yemini refugees had significantly higher rates for HBsAg (<jats:italic>p<\/jats:italic>\u2009=\u20090.019) positivity. Residents of Dakahlia had significantly higher rates of anti-HAV (<jats:italic>p<\/jats:italic>\u2009=\u20090.008) and anti-HBs (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). None of the studied risk factors was significantly associated with anti-HCV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Refugees in Egypt have poor immunity against HBV with intermediate to high HBV and low HCV prevalence rates. Despite that 65% of\u00a0refugees received the HAV vaccine, almost all had IgG anti-HAV, denoting previous infection.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s44197-022-00060-6","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T05:02:51Z","timestamp":1663218171000},"page":"430-440","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Seroprevalence of Hepatitis A, B and C Among a Sample of Refugees in Egypt: An Exploratory Survey"],"prefix":"10.1007","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3157-1629","authenticated-orcid":false,"given":"Engy Mohamed","family":"El-Ghitany","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayat","family":"Ashour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwa M.","family":"Fekry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ehab","family":"Elrewany","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azza Galal","family":"Farghaly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eman A.","family":"Omran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,9,15]]},"reference":[{"key":"60_CR1","unstructured":"United Nations High Commissioner for Refugees (UNHCR) E. UNHCR Egypt Monthly Statistical Report 2022 [cited 2022. Available from: chrome-extension:\/\/efaidnbmnnnibpcajpcglclefindmkaj\/viewer.html?pdfurl=https%3A%2F%2F. www.unhcr.org"},{"key":"60_CR2","unstructured":"United Nations High Commissioner for Refugees (UNHCR) E. Egypt: 3RP Regional Refugee & Resilience Plan in Response to the Syria Crisis (2020\/2021) 2021 [Available from: https:\/\/www.unhcr.org\/eg\/wp-content\/uploads\/sites\/36\/2020\/10\/3RP2021EN.pdf"},{"issue":"12","key":"60_CR3","doi-asserted-by":"publisher","first-page":"129","DOI":"10.3390\/children6120129","volume":"6","author":"AK Shetty","year":"2019","unstructured":"Shetty AK. Infectious diseases among refugee children. Children. 2019;6(12):129.","journal-title":"Children"},{"issue":"12","key":"60_CR4","doi-asserted-by":"publisher","first-page":"1742","DOI":"10.1086\/421268","volume":"38","author":"BD Gushulak","year":"2004","unstructured":"Gushulak BD, MacPherson DW. Globalization of infectious diseases: the impact of migration. Clin Infect Dis. 2004;38(12):1742\u20138.","journal-title":"Clin Infect Dis"},{"issue":"10","key":"60_CR5","doi-asserted-by":"publisher","first-page":"11004","DOI":"10.3390\/ijerph111011004","volume":"11","author":"T K\u00e4rki","year":"2014","unstructured":"K\u00e4rki T, Napoli C, Riccardo F, Fabiani M, Dente MG, Carballo M, et al. Screening for infectious diseases among newly arrived migrants in EU\/EEA Countries\u2014varying practices but consensus on the utility of screening. Int J Environ Res Public Health. 2014;11(10):11004\u201314.","journal-title":"Int J Environ Res Public Health"},{"issue":"10049","key":"60_CR6","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1016\/S0140-6736(16)30579-7","volume":"388","author":"JD Stanaway","year":"2016","unstructured":"Stanaway JD, Flaxman AD, Naghavi M, Fitzmaurice C, Vos T, Abubakar I, et al. The global burden of viral hepatitis from 1990 to 2013: findings from the global burden of disease study 2013. Lancet. 2016;388(10049):1081\u20138.","journal-title":"Lancet"},{"key":"60_CR7","unstructured":"[Egypt] MoHaP. Egypt Health Issues Survey 2015. Cairo, Egypt and Rockville, Maryland, USA: Ministry of Health and Population and ICF International: El-Zanaty and Associates [Egypt] & and ICF International; 2015"},{"issue":"1","key":"60_CR8","first-page":"187","volume":"9","author":"A Hassanin","year":"2021","unstructured":"Hassanin A, Kamel S, Waked I, Fort M. Egypt\u2019s ambitious strategy to eliminate hepatitis c virus: a case study. Global Health: Sci Pract. 2021;9(1):187\u2013200.","journal-title":"Global Health: Sci Pract"},{"issue":"Suppl 1","key":"60_CR9","doi-asserted-by":"publisher","first-page":"S80","DOI":"10.4103\/sja.SJA_203_17","volume":"11","author":"S Tsang","year":"2017","unstructured":"Tsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth. 2017;11(Suppl 1):S80.","journal-title":"Saudi J Anaesth"},{"issue":"1","key":"60_CR10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.11648\/j.ijdm.20160201.11","volume":"2","author":"S Jain","year":"2016","unstructured":"Jain S, Dubey S, Jain S. Designing and validation of questionnaire. Int Dent Med J Adv Res. 2016;2(1):1\u20133.","journal-title":"Int Dent Med J Adv Res"},{"key":"60_CR11","unstructured":"Obesity: preventing and managing the global epidemic. WHO obesity technical report series 894 [Internet]. World Health Organization. 2000 [cited 18 March 2022]. Available from: https:\/\/apps.who.int\/iris\/handle\/10665\/42330"},{"issue":"4","key":"60_CR12","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1080\/14760584.2020.1745071","volume":"19","author":"G den Hartog","year":"2020","unstructured":"den Hartog G, van Binnendijk R, Buisman A-M, Berbers GA, van der Klis FR. Immune surveillance for vaccine-preventable diseases. Expert Rev Vaccines. 2020;19(4):327\u201339.","journal-title":"Expert Rev Vaccines"},{"issue":"4","key":"60_CR13","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1007\/s10096-017-3126-1","volume":"37","author":"A Chernet","year":"2018","unstructured":"Chernet A, Utzinger J, Sydow V, Probst-Hensch N, Paris D, Labhardt N, et al. Prevalence rates of six selected infectious diseases among African migrants and refugees: a systematic review and meta-analysis. Eur J Clin Microbiol Infect Dis. 2018;37(4):605\u201319.","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"2","key":"60_CR14","doi-asserted-by":"publisher","first-page":"8","DOI":"10.5812\/hepatmon.44695","volume":"17","author":"M Safiabadi","year":"2017","unstructured":"Safiabadi M, Rezaee-Zavareh MS, Alavian SM. Estimation of hepatitis a virus infection prevalence among eastern Mediterranean and Middle Eastern countries: a systematic review and pooled analysis. Hepat Mon. 2017;17(2):8.","journal-title":"Hepat Mon"},{"issue":"12","key":"60_CR15","doi-asserted-by":"publisher","first-page":"1664","DOI":"10.1016\/j.vaccine.2018.01.079","volume":"36","author":"GS Freidl","year":"2018","unstructured":"Freidl GS, Tostmann A, Curvers M, Ruijs WL, Smits G, Schepp R, et al. Immunity against measles, mumps, rubella, varicella, diphtheria, tetanus, polio, hepatitis A and hepatitis B among adult asylum seekers in the Netherlands, 2016. Vaccine. 2018;36(12):1664\u201372.","journal-title":"Vaccine"},{"issue":"9","key":"60_CR16","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1111\/1348-0421.12916","volume":"65","author":"A Elbahrawy","year":"2021","unstructured":"Elbahrawy A, Ibrahim MK, Eliwa A, Alboraie M, Madian A, Aly HH. Current situation of viral hepatitis in Egypt. Microbiol Immunol. 2021;65(9):352\u201372.","journal-title":"Microbiol Immunol"},{"issue":"2","key":"60_CR17","doi-asserted-by":"publisher","first-page":"369","DOI":"10.3201\/eid2602.190652","volume":"26","author":"M Kaddoura","year":"2020","unstructured":"Kaddoura M, Allaham R, Abubakar A, Ezzeddine A, Barakat A, Mala P, et al. Hepatitis A virus genotype IB outbreak among internally displaced persons, Syria. Emerg Infect Dis. 2020;26(2):369.","journal-title":"Emerg Infect Dis"},{"issue":"1","key":"60_CR18","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1128\/CMR.14.1.38-58.2001","volume":"14","author":"JA Cuthbert","year":"2001","unstructured":"Cuthbert JA. Hepatitis A: old and new. Clin Microbiol Rev. 2001;14(1):38\u201358.","journal-title":"Clin Microbiol Rev"},{"issue":"9959","key":"60_CR19","doi-asserted-by":"publisher","first-page":"2053","DOI":"10.1016\/S0140-6736(14)60220-8","volume":"384","author":"C Tr\u00e9po","year":"2014","unstructured":"Tr\u00e9po C, Chan HL, Lok A. Hepatitis B virus infection. The Lancet. 2014;384(9959):2053\u201363.","journal-title":"The Lancet"},{"key":"60_CR20","unstructured":"Hepatitis B [Internet]. WHO. 2021 [cited 28 March 2022]. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hepatitis-b"},{"key":"60_CR21","unstructured":"UNICEF. WHO and UNICEF estimates of national immunization coverage 6 July 2021 [Available from: https:\/\/data.unicef.org\/resources\/immunization-country-profiles\/"},{"issue":"8","key":"60_CR22","doi-asserted-by":"publisher","first-page":"1679","DOI":"10.4161\/hv.24844","volume":"9","author":"Y Poovorawan","year":"2013","unstructured":"Poovorawan Y, Chongsrisawat V, Theamboonlers A, Crasta PD, Messier M, Hardt K. Long-term anti-HBs antibody persistence following infant vaccination against hepatitis B and evaluation of anamnestic response: a 20-year follow-up study in Thailand. Hum Vaccin Immunother. 2013;9(8):1679\u201384.","journal-title":"Hum Vaccin Immunother"},{"issue":"8","key":"60_CR23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0202637","volume":"13","author":"N Posuwan","year":"2018","unstructured":"Posuwan N, Vorayingyong A, Jaroonvanichkul V, Wasitthankasem R, Wanlapakorn N, Vongpunsawad S, et al. Implementation of hepatitis B vaccine in high-risk young adults with waning immunity. PLoS ONE. 2018;13(8): e0202637.","journal-title":"PLoS ONE"},{"issue":"11","key":"60_CR24","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.1007\/s10096-011-1240-z","volume":"30","author":"R Pond\u00e9","year":"2011","unstructured":"Pond\u00e9 R. The underlying mechanisms for the \u201csimultaneous HBsAg and anti-HBs serological profile.\u201d Eur J Clin Microbiol Infect Dis. 2011;30(11):1325\u201340.","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"10003","key":"60_CR25","doi-asserted-by":"publisher","first-page":"1546","DOI":"10.1016\/S0140-6736(15)61412-X","volume":"386","author":"A Schweitzer","year":"2015","unstructured":"Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015;386(10003):1546\u201355.","journal-title":"Lancet"},{"issue":"5","key":"60_CR26","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1080\/21645515.2016.1274475","volume":"13","author":"F Liu","year":"2017","unstructured":"Liu F, Guo Z, Dong C. Influences of obesity on the immunogenicity of Hepatitis B vaccine. Hum Vaccin Immunother. 2017;13(5):1014\u20137.","journal-title":"Hum Vaccin Immunother"},{"issue":"8","key":"60_CR27","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2019.e02249","volume":"5","author":"EM El-Ghitany","year":"2019","unstructured":"El-Ghitany EM, Farghaly AG. Geospatial epidemiology of hepatitis C infection in Egypt 2017 by governorate. Heliyon. 2019;5(8): e02249.","journal-title":"Heliyon"},{"key":"60_CR28","unstructured":"UNHCR, WHO Commend Egypt\u2019s Inclusion of Refugees in \u201c100 Million Seha\u201d [Internet]. 2019 [cited 9 April 2019]. Available from: https:\/\/www.unhcr.org\/eg\/12727-unhcr-who-commend-egypts-inclusion-of-refugees-in-100-million-seha.html"},{"issue":"1","key":"60_CR29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12879-019-3806-9","volume":"19","author":"M Talaat","year":"2019","unstructured":"Talaat M, Afifi S, Reaves EJ, Elsood HA, El-Gohary A, Refaey S, et al. Evidence of sustained reductions in the relative risk of acute hepatitis B and C virus infections, and the increasing burden of hepatitis A virus infection in Egypt: comparison of sentinel acute viral hepatitis surveillance results, 2001\u201317. BMC Infect Dis. 2019;19(1):1\u201313.","journal-title":"BMC Infect Dis"}],"container-title":["Journal of Epidemiology and Global Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s44197-022-00060-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s44197-022-00060-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s44197-022-00060-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T22:14:54Z","timestamp":1727993694000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s44197-022-00060-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,15]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["60"],"URL":"https:\/\/doi.org\/10.1007\/s44197-022-00060-6","relation":{},"ISSN":["2210-6014"],"issn-type":[{"value":"2210-6014","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,15]]},"assertion":[{"value":"15 July 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 August 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 September 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was conducted in compliance with the Helsinki Declaration and was approved by the Ethics Committee of the Faculty of Medicine, Alexandria University, Egypt [IRB number:00012098]. Written informed consent was collected from all participants. Anonymity and confidentiality were confirmed.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"All authors consented to submission for publication.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}