Table 1.

Details of all paediatric migrant hepatitis B studies

Study	Year	Country	Study Setting	Study Purpose	Study Type	Study Population & country/region of origin	Inclusion Age Range (years)	How identified	Sample size	Prevalence Chronic HBV (%)	Vaccination Coverage (%)	Susceptible (%)	Age of Sample/at diagnosisa	Gender Split of HBV + ve (%male)	Gender Split of Sample (% male)	Screening/care pathway information	Data on complications, late severe disease
Belhassen-Garcia et al.,	2015	Spain	Salamanca	Assess imported transmissible diseases in migrants from low income areas	Cross-sectional (medical records and physical exam)	Immigrant children and adolescents from E/W/S/C Africa, North Africa and Latin America	0–18	Screening in immigrants < 18 yrs	350	4.3	39.7	32	15	86.7	53.4		7/15 patients with CHB had detectable HBV viral loads
Bergevin et al.,	2021	France	Dedicated migrant medical consultation service in 1 hospital, Paris	Describe health issues of newly arrived UAMs managed in a dedicated paediatric consultation service	Cross-sectional (single-centre retrospective)	UAM from Africa or Afghanistan	0–18	Visiting dedicated consultation service	90	8.0					89.0	Average time to 1st consult =3 months. UMs have free healthcare until adulthood
Finnegan et al.,	2015	Ireland	Specialist clinic for children born to HBV infected mothers	Describe long-term follow up of children born to HBV infected mothers	Cross-sectional (retrospective)	Children with chronic HBV infection attending specialist clinic (from Africa, Central Asia, Eastern Europe)	0–18	Children born to HBV infected mothers are referred	57				6 m-17 yr	60	60	69% born in Ireland received adequate prophyl. 0% born outside received adequate prophy l. 19% received vaccine alone.	7% (n = 4) developed complication of CHB. n = 3 had fibrosis n = 3 received antivirals
Fougere et al.,	2018	Switzerland	Hospital reference centre for the children of asylum seekers in region. More than 90% of migrant children in Lausanne/surroundings followed in this setting.	Estimate HB vaccine protection (using post booster serology). Those with anti-HBs ≥ 100 post booster were assumed to be vaccinated.	Prospective single-centre cohort	Migrant children from Eritrea, Iraq, Syria	1–18	Research study	200	<1%	81		9 yr*/ 12 yr -one case		51	Migrants should have 2 visits (for first dose of vaccine and serology 4–6 weeks later)
Genton et al.,	2019	Switzerland	Migrant care facility clinic in canton of Vaud (service for asylum seekers)—but data across multiple healthcare structures primarily used by this cohort	Describe the overall clinical profile and the care pathways of unaccompanied minor asylum seekers	Cross-Sectional (retrospective study, information extracted from medical records)	UAM (asylum seekers). Afghanistan, Eritrea, Somalia, Syria	0–18	Routine screening of newly arrived children.	109	2.8					87.2	Screening of newly arrived UAMs takes place
Giordano et al.,	2018	Italy	University hospital of Palermo, Sicily	Examine immunisation status of IAC and compare it with vaccination certificates, focusing on measles, mumps, rubella (MMR) and hepatitis B (HBV)	Cross-sectional	Internationally adopted children (IAC). Country/region of origin not specified	0–18	Screening of internationally adopted children	79 (for HBV)	0.0	65.8	34	84 mon		62	Concordance between serology and vaccination records is 71%
Hahne et al.,	2012	Netherlands	Population study	Assess differences in prevalence of HBV infection in The Netherlands between 1996 and 2007, and identify risk factors for HBV infection in 2007	Cross-sectional (seroprevalence)	Representative sample of Dutch population (with oversampling or largest migrant groups from Suriname, Turkey, Morocco, Dutch Antilles, Aruba, Indonesia	0–79	Prevalence study (no data if already aware or not prior to study)	2007: 6246 (0–14 = 1476, 14–29 =1002)	2007 1st gen: 0–14: 2.3% 15–29: 22.3% 2nd gen 0–14: 1.7% 15–29: 2.4%
Hampel et al.,	2016	Germany	5 initial refugee reception centres in Northern Germany	Assess prevalence of hepatitis B and the vaccination status of refugee population	Cross-sectional (retrospective descriptive data analysis)	Refugees. Country/region or origin not reported	0–17	Every refugee (newly arrived) who sought medical treatment for acute complaints offered testing	62 (aged under 18 yrs)	1.6	50			0%	80.6	Initial screening is offered but loss to follow-up and lack of joined up care is common
Hourdet et al.,	2020	France	Health care access centre for vulnerable populations, Paris	Assess the health status of this population	Cross-sectional (retrospective, observational, monocentric)	Patients self-reporting as UAM but not recognised as such by the state from Guinea, Ivory Coast, Mali	0–18	Screening offered when visiting a dedicated consultation service	301 -total 1035 consultations	12.8			16		95	Jurisdictional framework around this status unclear. Precarious access to care
Hübschen et al.,	2012	Luxembourg	Unclear	Investigate prevalence of IgG antibodies against different vaccine-preventable diseases in newcomers to Luxembourg	Cross-sectional	Refugees or asylum seekers (newly arrived) from Albania, Montenegro, Bosnia and Herzegovina, Middle East, Asia, Africa, Russia	13–25	Vaccine coverage study	131 (age 13–25)		25					Majority of migrants lacked antibodies to one or more VPDs
Jablonka et al.,	2015	Germany	single reception centre	Determine seroprevalence of antibodies against hepatitis A–E in an unselected cohort of refugees and asylum seekers during Middle East crisis	Cross-sectional	Refugees and asylum seekers from Africa, East MediterraneanEurope, SE Asia	0–17	On arrival screening (mandatory)	91	0.0	40.7	32			74.7
Janda et al.,	2020	Germany	Single paediatric consultation service for UMs, Municipal area Southwest Germany	Understanding frequency and clinical presentation of IDs among minor refugees, evaluate the performance and practicability of screening recommendation	Cross-sectional	UAM (refugee) from Africa (93.6%), Asia and Southern Europe	0–18	On arrival screening	776 with HBV (of 890)	7.7			16*		94	Problems with follow-up and retention in HBV service. Unable to offer antivirals	75% of URMs with active HBV were HBeAg -ve and had low viral loads in blood (<10 IU/ml)
Kloning et al.,	2018	Germany	2 paediatric practices and one collective housing for refugees in region of Bavaria, Germany	Investigate the morbidity profile and the sociodemographic characteristics of unaccompanied refugee minors (URM)	Cross-sectional (retrospective data derived from medical data records of routine first medical exam)	UAM (refugee) from Afghanistan, Eritrea, Somalia, Syria	0–18	On arrival screening (mandatory)	113	8	3.2	58	16*		93.5	No standardised pathway. Follow-up challenges due to frequent relocations
Maasen et al.,	2017	Germany	On arrival screening	Describe microbiological screenings for infection control in unaccompanied minor refugees undertaken by the German Armed Forces Medical Service	Cross-sectional	UAM (refugee) from Afghanistan, Algeria, Benin, Egypt, Ghana, Guinea, Iran, Iraq, Libya, Morocco, Palestine, Pakistan	0–18	On arrival screening (mandatory)	190 (from total sample of 219)	1.6			13–18	100	100
Marquardt et al.,	2016	Germany	On arrival screening in a private outpatient clinic for internal and tropical medicine, Bielefeld	Investigate the physical and mental disease burden of unaccompanied asylum-seeking adolescents	Cross-sectional	UAM (asylum-seeking adolescents) from Africa, Asia (mostly Afghanistan, Guinea, Morocco)	12–18	On arrival screening	101 tested for HBV (of 102)	7.9	14.9		16	100	76.5	On arrival screening available	Two children required antivirals
Marrone et al.,	2020	Italy	Reception centres, Rome	Address prevalence of infectious diseases in a population of unaccompanied immigrant minors	Cross-sectional	UAM from Africa, SE Asia, Eastern Europe	0–18	On arrival screening	879	2.5	18.2	76	17	100	97.6	On arrival screening available
Mockenhaupt et al.,	2016	Germany	Berlin travel and tropical medicine clinic GeoSentinel site	Present results of screening a cohort of unaccompanied Syrian minors (UAMs)	Cross-sectional	UAM from Syrian	0–18	On arrival screening	488	0.0					94
Monpierre et al.,	2016	France	Regional system for isolated foreign minors in Gironde	Describe data on overall health status obtained from a systematic medical check-up offered to URMs	Cross-sectional (data descriptive)	UAM (refugee) from Africa, Asia, Eastern Europe	0–18	On arrival screening (systematic)	235	6.0			16		89.8	On arrival screening available
Norman et al.,	2021	Spain	Migrant referral centre, Madrid	Describe seroprevalence rates for potentially transmissible viral infections in migrants attended at a referral centre in a major European city	Cross-sectional	Migrants from Africa	0–20	Attended for the first time (symptomatic or asymptomatic referred for a health exam) Unclear if screening was standardised.	96	10.4	24	30
Olivan-Gonzalvo et al.,	2021	Spain	UAM protection centres	Examine the health status and infectious diseases in a cohort of unaccompanied immigrant minors from Africa to Spain	Cross-sectional (retrospective)	UAM (Male, from Africa)	0–18	On arrival screening	622	2.6			16	100	100	Screening on admission to residential care
Pauti et al.,	2016	France	Migrant clinics: Drs of the World Clinics in Lyon, Nice, Paris and Saint-Denis	Present degree of lack of knowledge of the HBV and HCV status of people encountered in 2014, identify socio-demographic factors related to this lack of knowledge. HBV vaccination coverage rate analysed.	Cross-sectional	Persons in precarious conditions for primary health care - 94.5% are migrants from Africa, non-EU European countries, Asia	<15	Attendance at clinic	Unclear		58.1				61.8	Lack of systematic checking of HBV serology/ vaccination status
Pavlopoulou et al.,	2017	Greece	Migrant outpatient clinic of a tertiary Children’s hospital, Athens	Describe demographic, clinical and laboratory characteristics and identify possible determinants among newly arriving immigrant and refugee children	Cross-sectional	Migrant and refugee children mainly from Asia (Afghanistan, Bangladesh), Africa, Europe	0–18	On arrival screening	300	0.0	57.7	42			58.7	Health evaluation for migrant children on arrival and refugees are often referred by NGOs or social services.
Pohl et al.,	2017	Switzerland	Tertiary health care facility in Switzerland in 2015	Describe epidemiology and spectrum of infections of admitted paediatric refugees and asylum seekers	Cross-sectional (retrospective analysis using electronic patient records)	Paediatric refugees and asylum seekers (UAMs = 19.4%) from Africa, Eastern Europe and Asia	0–18	Admitted to hospital	93 patients (105 admissions)				5.7		62	Missed opportunities to offer catch-up vaccinations during admission
Sollai et al.,	2017	Italy	Tertiary health care setting, Italy	Evaluate infectious diseases prevalence in a large cohort of IAC	Cross-sectional	IAC from Africa, Asia and Europe	0–18	On arrival screening	1612	0.8	64.9	35			60	IAC are screened on arrival
Theuring et al.,	2016	Germany	Institute of Tropical Medicine and International Health, Charité- Universitätsmediz Berlin 2014–2015	Screening for infectious diseases among unaccompanied minor refugees	Cross-sectional	UAM (refugees) from Africa, Middle East, Asia, Southern and Eastern Europe	0–18	On arrival screening	1248	1.7			16
Tiittala et al., 2018	2018	Finland	Finland asylum seeker population study	Evaluate public health response to a large influx of asylum seekers to Finland in 2015–2016 re: national guidelines on initial health services and infectious disease screening	Cross-sectional (retrospective register-based)	Asylum Seekers – (accompanied and UAM) from Africa and Asia	0–17	On arrival screening (voluntary)	9031 (3400 of which UAM)	0.8						Screening for Hep B, HIV, syphilis within should occur within 3 m after arrival (but 33% not reached)
Williams et al.,	2020	UK	2 paediatric infectious disease clinics, London	Evaluate a screening programme for infection in UAM children and young people against national guidance and describe rates of identified infection in cohort	Cross-sectional (retrospective, routinely collected healthcare data)	UAM (asylum seeking)	0–18	Voluntary screening (on the basis of an individual risk assessment)	252 attendees, 211 (84%) tested for hepatitis B	4.8			17*		88.6	All UAMs receive a statutory health check and are referred to infectious disease clinic for screening

^aAge is expressed as mean. * = denotes median age.

UAM, unaccompanied migrant.

VPD, vaccine preventable diseases.