Syrian Refugees at Risk of Hepatitis Diseases in Turkey, in Şanliurfa?

Aim: The aim of this study is to determine the prevalence of hepatitis B/C diseases among Syrian refugees living outside the temporary accommodation centers in Şanlıurfa city center, and individuals' levels of knowledge and risky behaviors related to these diseases. Methods: The research is cross-sectional. It was carried out with 473 Syrian refugees who were living in Şanlıurfa city center outside the temporary accommodation centers in April 2015 – 2016. Cluster sampling method was preferred in the selection of the sample. The questionnaire form, which was prepared by the researchers, was applied, and a venous blood sample was collected from the individuals during data collection. HBsAg, Anti-HBs, AntiHBc total and Anti-HCV levels of the blood samples were examined. Descriptive statistics, Chi-square, and MannWhitney U tests were used in the evaluation of the data. Statistical analyses were performed at 95% confidence level. p<0.05 value was accepted as statistically significant. Results: Of the Syrians, 62.2% were women and 37.8% men, with a median age of 34.0. 25.6% of participants had never attended school, and 82.2% of them were married. 57.3% of asylum seekers were Arabian, and 41.9% were Kurdish. 80.1% of them didn't know enough Turkish to communicate. Participants' average monthly income was 171$. An average of 8.6 individuals was living in the household, and the individual/room rate was 3.2. 60.3% of Syrian refugees had not heard of hepatitis B disease, and 69.1% of them had not heard of hepatitis C disease. Only 2.3% (n=11) of the individuals correctly answered all the questions about the transmission and prevention of hepatitis B/C diseases. 1.7% of Syrian refugees were HBsAg positive, 23.9% were AntiHBc total positive, and 0.4% of them were Anti-HCV positive. 25.2% of Syrian refugees were anti-HBS positive, while 7.1% were immunized with the hepatitis B vaccine. There was no statistically significant difference in the distribution of HBsAg and Anti-HCV antibody status of Syrian refugees according to socio-demographic characteristics and risky behaviors used in this study (p>0.05). Anti-HBc total antibody positivity was higher in males, in those over 50 years of age, in those who had never attended school and in those who had married at least once (p<0.05). Anti-HBc total positivity was higher in women, especially in those who had given birth at least once (p<0.05). Conclusions: The prevalence of hepatitis B/C in Syrian refugees was lower than in Turkey. This suggests that Syrian refugees are at more risk than individuals in our country. Low immunization rates also support this situation. It is believed that the risk of transmission of hepatitis B/C diseases can be reduced by giving information about the transmission and prevention ways of hepatitis B/C diseases to individuals at marriage age, by screening the group at risk and immunizing them against hepatitis B, increasing the rate of condom use in case of risky sexual intercourse, increasing education level, regular antenatal care of pregnant women and performing HBs Ag screening during this period. Improving socioeconomic status and living conditions of refugees is also crucial in terms of reducing disease transmission, early diagnosis, and treatment.