Coordinators who did not initially respond were contacted up to three additional times. Areas were asked to report data from the most recently available 12-month continuous period prior to August 2008. Across all areas, this resulted

in data collected from refugees who entered the United States between 2006 and 2008. We pooled information BGJ398 supplier from across jurisdictions about refugees from the same country of origin. Using these data, we estimated the prevalence of HBsAg among refugees from each country of origin by dividing the number of HBsAg-positive refugees by the total number tested. We also pooled data and estimated prevalence by continent. Several jurisdictions provided numerical count data regarding the total number of refugees screened combined with proportional data about the countries of origin and the HBsAg prevalence observed among refugees from each country of origin. For these jurisdictions, we estimated the number of refugees tested and the number of HBsAg-positive refugees from each country by multiplying the total number of refugees screened by the proportion screened from each country, then multiplied that number by the proportion screened from that country Z-VAD-FMK in vitro of origin who were HBsAg-positive. We present our results for countries

from which we estimate that 30 or more refugees were tested. We calculated 95% confidence intervals (CIs) for each prevalence rate using the Wilson procedure with a correction for continuity.6 Of the 47 jurisdictions we attempted to contact, 31 responded with at least some information and 16 states did not respond, for a 66% response rate. Of the 31 areas that responded, 28 reported that they systematically screened at least some groups of refugees for hepatitis B, whereas three areas reported that hepatitis B testing was not part of the refugee health screening process. Of these 28, 20 were able to provide a count of the total number of refugees selleck screening library screened, and 13 were able to provide an estimate of the overall prevalence among all refugees

screened; of these 13, nine areas were able to provide data by country of origin. The 20 areas that provided data on the number of refugees screened screened a total of 42,303 refugees in the preceding 12 months, which is approximately 55% of the total number of refugees arriving in the United States in 2008. The nine areas that provided data by country of origin screened 31,980 refugees, or approximately 42% of refugees arriving in the United States in 2008. Screened refugees with country of origin data originated from 44 countries and 11 continental subregions across four continents. Of the 31,980 refugees with complete country of origin data, 891 (2.8%; 95% CI 2.6%–3.0%) tested positive for HBsAg. This rate varied by continent, continental region, and country of origin (Table 1).