Public Health Assessment of Hepatitis B in Ladakh

A team consisting of three CTA health department staffs, three health clinic staffs, and two public health researcCSC_0438hers conducted group and individual interviewed in Sonamling Tibetan camps in Leh and the Jhangtang areas at Sumdo and Samey including TCV School and Men Tsee Khang branch clinic from May 5 to 21, 2014. The goal of the project was to provide formative information to identify and better understand attitudes, practices, and public health challenges facing Tibetan refugee populations residing in Tibetan settlements (especially issues facing women and children), and, importantly, to help design a pilot project to address public health improvement, with a particular focus upon Hepatitis B reduction.

In total, 326 Tibetan refugees residing within the Sonamling Tibetan settlements in Ladakh, including 295 community members participated in group interviews (including those who disclosed positive hepatitis B status and were subsequently interviewed individually as well) and 31 additional community members (including hepatitis B positive and negative participants) were interviewed individually. Population, community, neighborhood, and individual consent were obtained prior to conducting interviews, which were led by health department staffs working with local health clinic providers. The team was also able to provide health education sessions around Hepatitis B along with distribution of Hepatitis B educational materials in both Tibetan and English following the group interviews, or individual counseling as requested.

Analysis of the data from the interviews is underway, and will culminate in recommendations to the Department of Health, CTA regarding development of an approach to Hepatitis B which is a complex disease, mostly asymptomatic, and can cause life threatening conditions like liver cancer and liver cirrhosis if left untreated in the long run. High cost of Hepatitis B medications continue to pose huge economic burden to the chronic Hepatitis B infected individuals in the Tibetan community.
This project is being implemented in collaboration primarily with University of Rochester Medical School and secondarily with University of Hawaii, USA.