***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Vietnamese have higher liver cancer rates than any other racial/ethnic group in the United States . Approximately 80 % of liver cancers are etiologically associated with hepatitis B virus ( HBV ) infection , which is endemic in Southeast Asia . METHODS A  telephone survey of r and omly selected Vietnamese households ( n = 75 ) was conducted during 1998 to examine HBV knowledge among Seattle 's Vietnamese community . The question naire included items related to the transmission of HBV , the possible sequelae of infection , and disease prevention . RESULTS The response rate was 70 % among reachable and eligible households . Prior to being provided with a description of the disease , two thirds of our respondents had heard of HBV infection . Less than 60 % knew that asymptomatic individuals can transmit the disease to others . Most thought that HBV infection can cause liver cancer ( 63 % ) and death ( 80 % ) . However , only a minority knew that infection can be lifelong ( 38 % ) and incurable ( 22 % ) . Finally , 28 % had never heard of the HBV vaccine . There were significant associations between knowledge and educational level as well as home ownership . CONCLUSIONS The findings suggest that Vietnamese immigrants have low levels of knowledge about HBV infection , and indicate a need for targeted educational interventions aim ed at reducing HBV-related liver cancer mortality BACKGROUND & AIMS Little is known about the HCV prevalence in non-Western migrant population s. To determine whether targeted HCV screening and prevention programs for migrants are needed , we examined HCV prevalence and determinants among non-Western , Western migrants , and the native Dutch population in the Netherl and s. METHODS Data were obtained from four surveys : ( 1 ) 3895 heterosexual visitors recruited during biannual surveys at the STI-clinic Amsterdam , 2007 - 2009 ; ( 2 ) r and om sample of 4563 pregnant women in Amsterdam , 2003 ; ( 3 ) population -based r and om sample of 1309 inhabitants of Amsterdam , 2004 ; ( 4 ) population -based r and om sample of 4428 people living in the Netherl and s , 2006 - 2007 . Characteristics associated with HCV-positivity were examined and phylogenetic analysis was used to obtain insight in the geographical origin of HCV strains . RESULTS HCV seroprevalence in the four surveys was low ( 0.3 - 0.6 % ) . In total 4860/14,195 ( 34 % ) were non-Western and 9329/14,195 ( 66 % ) Western participants ( including Dutch ) . First-generation non-Western migrants were more likely to be HCV-positive ( 0.7 - 2.3 % ) than Western participants ( 0.1 - 0.4 % ) . Except for survey 3 , second-generation non-Western migrants had a lower HCV prevalence than first-generation migrants , comparable to Western migrants and the Dutch population . Phylogenetic analysis showed that the majority of the HCV-positive , first-generation non-Western non-European migrants were infected with endemic strains which are rarely observed in Europe . CONCLUSIONS First-generation non-Western migrants are at increased risk for HCV . Phylogenetic analysis suggests that transmission likely took place in the country of origin , causing introduction but no further transmission of endemic HCV strains in the Netherl and s. HCV screening and prevention programs should target first-generation , but not second-generation , non-Western migrants This study examines mortality patterns among Canadian immigrants , including both refugees and non-refugees , 1980–1998 . Records of a stratified r and om sample of Canadian immigrants l and ing between 1980–1990 ( N = 369,936 ) were probabilistically linked to mortality data ( 1980–1998 ) . Mortality rates among immigrants were compared to those of the general Canadian population , stratifying by age , sex , immigration category , region of birth and time in Canada . Multivariate analysis examined mortality risks for various immigrant subgroups . Although immigrants presented lower all-cause mortality than the general Canadian population ( SMR between 0.34 and 0.58 ) , some cause-specific mortality rates were elevated among immigrants , including mortality from stroke , diabetes , infectious diseases ( AIDS and hepatitis among certain subgroups ) , and certain cancers ( liver and nasopharynx ) . Mortality rates differed by region of birth , and were higher among refugees than other immigrants . These results support the need to consider the heterogeneity of immigrant population s and vulnerable subgroups when developing targeted interventions BACKGROUND Liver cancer , a significant health problem in Chinese , can be controlled through HBV blood testing , vaccination , and community education about HBV . The PRECEDE framework has been very helpful in identifying factors associated with health practice s. OBJECTIVES The objective was to identify factors associated with HBV testing in Chinese Canadians , using the PRECEDE framework . METHODS Five hundred and thirty-three r and omly selected Chinese Canadian adults were interviewed about  HBV blood testing practice  s. Factors were grouped as predisposing , reinforcing and enabling . RESULTS Fifty-five percent had received HBV blood testing . Several predisposing factors , all reinforcing factors and one enabling factor were associated with HBV testing in bivariate analysis . A physician 's recommendation for testing was the strongest factor associated with testing in multiple logistic regression analysis ( OR=4.4 , p<0.0001 ) . INTERPRETATION Many Chinese Canadian adults in Vancouver have not been tested for HBV . Continuing educational efforts are needed and the PRECEDE framework can inform the development of health education interventions Southeast Asians have higher liver cancer rates than any other racial/ethnic group in the US . Approximately 80 percent of liver cancers are etiologically associated with hepatitis B virus ( HBV ) infection which is endemic in Southeast Asia . An in-person survey of Cambodian women ( n = 320 ) was conducted in Seattle , Washington , during 1999 . The question naire included items about HBV knowledge , beliefs , and practice s. Prior to being provided with a description of the disease , only about one-half ( 56 percent ) of our respondents had heard of HBV infection . Less than one-quarter ( 23 percent ) of the study group thought that asymptomatic individuals can transmit the disease to others . Most thought that HBV infection can cause liver cancer ( 54 percent ) and death ( 72 percent ) . However , a minority thought that infection can be lifelong ( 24 percent ) and incurable ( 15 percent ) . Only 38 percent reported they had been serologically tested for HBV . Finally , of those who had been tested and thought they were susceptible , two-thirds ( 67 percent ) had not been vaccinated . Lower levels of education were associated with lower levels of HBV knowledge and serologic testing . Our findings suggest that Cambodian immigrants have low levels of HBV knowledge , serologic testing , and vaccination ; and demonstrate a need for targeted educational interventions aim ed at reducing  HBV-related liver cancer mortality among Southeast Asian communities 
    Output:
    
Many immigrants lacked adequate knowledge of aetiology , symptoms , transmission risk factors , prevention strategies , and treatment , of hepatitis HBV and HCV .
Ethnicity , gender , better education , higher income , and English proficiency influenced variations in levels and forms of knowledge .
Conclusion Immigrants are vulnerable to HBV and HCV , and risk life-threatening complications from these infections because of poor knowledge and help-seeking behaviour .