Investigation of fertility perception and antibody levels of tetanus and hepatitis b in women aged between 15-49 years old WHO live in tent camp in Diyarbakir

Wars and forced immigration are circumstances causing disability, death and sickness of millions of people, increasing mental and socioeconomic problems, and interrupting delivery of basic health services. Under such circumstances, women of childbearing age and children are the first to face the highest risk as in all extraordinary conditions. The aim of the present study is to evaluate reproductive features and factors affecting fertility in women from the Ezidi community, who fled to our country due to civil war and who are living in a tent city. The study also aims to detect the requirement for vaccination by evaluating Hepatitis B and Hepatitis C antibody levels. This descriptive cross-sectional study was conducted between July 2015 and February 2016 in a tent city established in Diyarbakir municipality. There are 580 married women aged between 15 and 49 years living in the tent city. The study targeted reaching 50% (290 women) of this population and 248 women were included in the study. A survey was conducted using a 54-item questionnaire and face-to-face interview technique after a written informed consent which was translated into Kurdish was obtained from each participant, as the mother language of this population is Kurdish. After the completion of the interview, blood samples were obtained from each participant for seroprevalence study. Of the participants, 72.8% were illiterate. The mean marriage age was 17.8 ± 3.4 years, the mean age at first labor was 19.4 ± 3.3 years, the mean parity was 4.6 ± 3.2, the mean number of living children was 4.1 ± 2.8, and the mean number of children that the women wished to have was 4.7 ± 2.2. Of these women, 83.9% were aware of birth control methods and 50% of the women were currently using any type of birth control method. Of the women, 10.1% delivered a baby after they fled to Turkey (25 women) and of these laboring women, 72% received prenatal health care services, while 40% received (10 women) postnatal healthcare services. The level of awareness on the use of birth control methods and the rate of women who used a birth control method was higher among those who did not complete primary school education, compared to primary school graduates and those who had higher education, indicating a statistically significant difference between the groups (p<0.05). Of the women, 4.5% had immunity against hepatitis B infection due to previous exposure, 15.5% had vaccine-induced immunity, and 80% were susceptible to hepatitis B infection. None of the women were infected with hepatitis C virus. In conclusion, the individuals fleeing to other countries should be considered of first priority as they are in the risk group and these individuals should be paid particular attention for the protection and improvement of health. Particularly, immigrant women taking refuge in other countries should be offered unpaid healthcare services and the services offered and access to these services should be provided in their native language. Of note, this population is particularly susceptible to hepatitis B virus and vaccination is of utmost importance for the protection of the well-being of both their spouses and their babies to be born.