Knowledge, attitude, and practice survey concerning hepatitis B and C and among migrant populations from sub-Saharan Africa
Main Article Content
Abstract
Background: Hepatitis B and C virus infections are serious blood borne diseases with global health concern particularly in developing countries. The association between survey participant’s knowledge, attitude, and practices (KAP) about HBV and HCV infection is rarely studied, particularly among migrants seeking resettlement. Libya is a main transit station for migrants northward toward Europe and the flow is increasing into Al Kufra from neighboring countries that have endemic intermediate and high HBV and HCV prevalence. The purpose of this exploratory descriptive study in Al Kufra was to assess the level of participating migrant's KAP, regarding cause, transmission, prevention, and treatment of viral hepatitis due to HBV and HCV.
Method: A cross-sectional study was conducted among 674 sub-Saharan African migrants in Al Kufra, Libya from January to October 2021. Migrant's KAP about HBV and HCV infection was assessed by interview questionnaire. Statistical and data analysis used SPSS version 25.
Results: Out of 700 questionnaires distributed, 674 were returned with a response rate of 96.3%. The study population included 580 (86.1%) males, mean age of 29.6 ± 7.2 SD years. A majority, 508 (75.4%) were illiterate or had basic education only. Positive significant linear correlations were found between knowledge-attitude (r = 0.524, p < 0.01) knowledge-practice (r = 0.123, p < 0.01) and attitude-practice (r = 0.278, p < 0.01). Ethnicity and education variables were significantly associated with mean KAP. Gender identity and marital status were both significantly associated with mean knowledge and attitude. Conclusion: The migrant population from the neighboring and sub-Saharan African countries have inadequate KAP about HBV and HCV to limit infection.
Keywords:
knowledge attitude practice (KAP),, hepatitis B (HBV), hepatitis C (HCV), migrants, sub-Saharan Africa
Article Details
How to Cite
M.A. SAEED, Frhat; ALI, Muna H.; ONGERTH, Jerry E..
Knowledge, attitude, and practice survey concerning hepatitis B and C and among migrant populations from sub-Saharan Africa.
Medical Research Archives, [S.l.], v. 14, n. 1, jan. 2026.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/7226>. Date accessed: 24 feb. 2026.
doi: https://doi.org/10.18103/mra.v14i1.7226.
Keywords
knowledge attitude practice (KAP), hepatitis B (HBV), hepatitis C (HCV), migrants, sub-Saharan Africa
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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2. Georgel P, Schuster C, Zeisel MB, Stoll-Keller F, Berg T, Bahram S. Virus-host interactions in hepatitis C virus infection: implications for molecular pathogenesis and antiviral strategies. Trends Mol Med. 2010;16(6):277–86. https://doi.org/10.1016/j.molmed.2010.04.003
3. Owiti JA, Greenhalgh T, Sweeney L, Foster GR, Bhui KS. Illness perceptions and explanatory models of viral hepatitis B & C among immigrants and refugees: a narrative systematic review. BMC Public Health. 2015; 15:151. https://doi.org/10.1186/s12889-015-1476-0 .
4. Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol. 2006;45(4):529–38. https://doi.org/10.1016/j.jhep.2006.05.013 .
5. World Health Organization: Advocacy, communication and social mobilization for TB control: A guide to developing knowledge, attitude and practice surveys. https://apps.who.int/iris/bitstream/handle/10665/43790/9789241596176_eng.pdf (Accessed Dec. 10, 2022)
6. Schilling T, Rauscher S, Menzel C, Reichenauer S, Müller-Schilling M, Schmid S, Selgrad M. Migrants and Refugees in Europe: Challenges, Experiences and Contributions. Visc Med. 2017 Aug;33(4):295-300. http://doi.org/10.1159/000478763
7. Gushulak BD, MacPherson DW. Globalization of infectious diseases: the impact of migration. Clin Infect Dis 2004 Jun 15; 38(12):1742e8. PMID: 15227621. https://doi.org/10.1086/421268
8. Frank C, Mohamed MK, Strickland GT, Lavanchy D, Arthur RR, Magder LS, et al. The role of parenteral antischistosomal therapy in the spread of hepatitis C virus in Egypt. Lancet 2000;355:887–891. https://doi.org/10.1016/s0140-6736(99)06527-7
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10. Goldstein ST, Zhou F, Hadler SC, Bell BP, Mast EE, Margolis HS. A mathematical model to estimate global hepatitis B disease burden and vaccination impact. Int J Epidemiol. (2005) 34:1329–39. https://doi.org/10.1093/ije/dyi206
11. Shalaby S, Kabbash I, El Saleet G, Mansour N, Omar A, El Nawawy A. Hepatitis B and C viral infection: prevalence, knowledge, attitude and practice among barbers and clients in Gharbia governorate, Egypt. East Mediterr Health J. 2010;16:10–7.
12. Taylor VM, Jackson JC, Pineda M, Pham P, Fischer M, Yasui Y. Hepatitis B knowledge among Vietnamese immigrants: implications for prevention of hepatocellular carcinoma. J Cancer Educ 2000;15:51–55. https://doi.org/10.1080/08858190009528654 .
13. Yang JD, Roberts LR. Hepatocellular carcinoma: a global view. Nat Rev Gastroenterol Hepatol. (2010) 7:448–58. https://doi.org/10.1038/nrgastro.2010.100 .
14. Yang JD, Gyedu A, Afihene MY, Duduyemi BM, Micah E, Kingham TP, et al. Hepatocellular carcinoma occurs at an earlier age in africans, particularly in association with chronic hepatitis B. Am J Gastroenterol. (2015) 110:1629–31. https://doi.org/10.1038/ajg.2015.289 .
15. Hauri AM, Armstrong GL, Hutin YJ. The global burden of disease attributable to contaminated injections given in health care settings. Int J STD AIDS. 2004;15(1):7–16. https://doi.org/10.1258/095646204322637182
16. WHO. Fact Sheet: Hepatitis C. 2022 https://www.who.int/news-room/fact-sheets/detail/hepatitis-c. (Accessed Dec. 10, 2022).
17. Badawi M, Atif M, Mustafa Y. Systematic review and meta-analysis of HIV, HBV & HCV infection prevalence in Sudan. Virol J. 2018;15(1):1-16. https://doi.org/10.1186/s12985-018-1060-1
18. Hauri AM, Armstrong GL, Hutin YJ. The global burden of disease attributable to contaminated injections given in health care settings. Int J STD AIDS. 2004;15(1):7–16. https://doi.org/10.1258/095646204322637182
19. Nelson PK, Mathers BM, Cowie B, Hagan H, Des Jarlais D, Horyniak D, et al. Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. Lancet. 2011;378(9791):571–83. https://doi.org/10.1016/s0140-6736(11)61097-0.
20. Saeed, FMA, Ongerth, JE, 2019. Giardia and Cryptosporidium in children with diarrhea, Kufra Libya, a North African migration route city. International Journal of Hygiene and Environmental Health. 222(5):840-846. https://doi.org/jijheh.2019.04.006.
21. OECD. World Migration in Figures.
22. Sharma S, Carballo M, Feld JJ, Janssen HLA. Immigration and viral hepatitis. Journal of Hepatology. 2015; 63: 515–522. https://doi.org/10.1016/j.jhep.2015.04.026.
23. Daw MA, et al. Hepatitis C Virus in North Africa: An Emerging Threat. The Scientific World Journal. Volume 2016, Article ID 7370524, 11 pages. http://dx.doi.org/10.1155/2016/7370524 .
24. Daw MA, El-Bouzedi A. In association with Libyan Study Group of Hepatitis & HIV. Prevalence of hepatitis B and hepatitis C infection in Libya: results from a national population-based survey. BMC Infect Dis 2014; 14: 17. http://doi.org/10.1186/1471-2334-14-17.
25. Nelson PK, Mathers BM, Cowie B, Hagan H, Des Jarlais D, Horyniak D, et al. Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. Lancet. 2011;378(9791):571–83. https://doi.org/10.1016/s0140-6736(11)61097-0.
26. Seeger C, Mason WS. Hepatitis B virus Biology. Micro Mol Biol Rev 2000; 64: 51-68. https://doi.org/10.1128/mmbr.64.1.51-68.2000.
27. Tugwell P, Pottie K, Welch V, Ueffing E, Chambers A, Feightner J, et al. Evaluation of evidence-based literature and formulation of recommendations for the clinical preventive guidelines for immigrants and refugees in Canada. CMAJ 2011;183:E933–E938. https://doi.org/10.1503/cmaj.090289.
28. Strong C, Hur K, Kim F, Pan J, Tran S, Juon H-S. Sociodemographic characteristics, knowledge and prevalence of viral hepatitis infection among vietnamese Americans at community screenings. J Immigr Minor Health 2015;17:298–301. https://doi.org/10.1007/s10903-014-0015-x.
29. Alam M, Tariq WUZ: Knowledge, Attitudes and Practices about Hepatitis B and C among young healthy males. Pak J Pathol 2006, 17:147–150.
30. Belyhun Y, Maier M, Mulu A, Diro E, Liebert UG. Hepatitis viruses in Ethiopia: a systematic review and meta-analysis. BMC Infect Dis. 2016;16(1):761. https://doi.org/10.1186/s12879-016-2090-1
31. World Health Organisation. Hepatitis: Fact sheets. Geneva: WHO. Available from: www. https://www.who.int/health-topics/hepatitis . Accessed on: Dec. 22, 2022.
32. Saaed, FMA, Ongerth, JE, 2023. Prevalence of hepatitis B and hepatitis C in migrants from sub-Saharan Africa newly arrived at Al Kufra in SE Libya in transit toward Europe. J Immigr Minor Health, 25(4): 882-888. https://doi.org/10.1007%2Fs10903-022-01448-z
33. Ayele A, Abera D, Hailu M, Birhanu M and Desta K. Prevalence and associated risk factors for Hepatitis B and C viruses among refugees in Gambella, Ethiopia. BMC Public Health (2020) 20:721. https://doi.org/10.1186/s12889-020-08893-1
34. Dwiartama A, Nirbayati WF, Giri-Rachman EA, Niloperbowo W, Tan MI, Anin A. Knowledge, Attitude, and Practice towards Hepatitis B Infection Prevention and Screening among Indonesians. Int J Environ Res Public Health. 2022 Apr 12;19(8):4644. http://doi.org/10.3390/ijerph19084644
35. ul Haq, N., Hassali, M.A., Shafie, A.A. et al. A cross sectional assessment of knowledge, attitude and practice towards Hepatitis B among healthy population of Quetta, Pakistan. BMC Public Health 12, 692 (2012). https://doi.org/10.1186/1471-2458-12-692
36. Shah HB, Dar MK, Jamil AA, Atif I, Ali RJ, Sindhu AS, Usmani AQ. Knowledge, attitudes and practices of hepatitis b and c among barbers of urban and rural areas of rawalpindi and islamabad. J Ayub Med Coll Abbottabad. 2015 Oct-Dec;27(4):832-6. PMID: 27004334.
37. Abere S, Oyan B, Alali DJ, Omunakwe H, Ejikem M. Viral Hepatitis B and C: Knowledge Gaps and Patterns of Preventive Practices Among Medical Doctors in Rivers State, Nigeria. Cureus. 2022 Mar 7;14(3):e22928. http://doi.org/10.7759/cureus.22928.
38. Khan N, Ahmed SM, Khalid MM, Siddiqui SH, Merchant AA. Effect of gender and age on the knowledge, attitude and practice regarding hepatitis B and C and vaccination status of hepatitis B among medical students of Karachi, Pakistan. J Pak Med Assoc. 2010 Jun;60(6):450-5. PMID: 20527642
39. Kochlamazashvili M, Butsashvili M, Kajaia M, Gulbiani L, Maglakelidze T, Kamkamidze G. Knowledge, attitude and practice survey among georgian health care workers towards blood borne infections. Georgian Med News. 2022 Jan;(322):21-25. PMID: 35134753.