Published in PLOS One on 2026-01-16, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Bashiru Garba, Amino Adan Mohamud, Fartuun Hassan Mohamed, Ayan Aden Moussa, Yusuf Yakubu, Najib Isse Dirie, Aya Muktar Abdulatif, Jamal Hassan Mohamoud, Abdirasak Sharif Ali, Abdurrahman Hassan Jibril
Source: PLOS One • DOI 10.1371/journal.pone.0340800
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Hepatitis B virus (HBV) remains a major public health challenge in sub-Saharan Africa. Somalia, with its fragile healthcare system and high-risk population, lacks up to date data on HBV epidemiology. This study assessed HBV prevalence, associated risk factors, and viral load among hospital patients in Mogadishu, Somalia.
A cross-sectional survey was conducted in four major hospitals in Mogadishu. Socio-demographic and clinical risk data were collected using structured questionnaires. Blood samples from 270 participants were screened for HBsAg using a rapid test, with positives confirmed and quantified for HBV DNA by real-time PCR. Bivariate and multivariate analyses identified independent risk factors.
HBsAg prevalence was 11.5% (n = 31), but only 2.2% of all participants (6/270; 19.4% of HBsAg-positives) had detectable HBV DNA. The strongest independent predictors were family history of HBV (AOR: 5.08, 95% CI 1.90–13.60) and history of tooth extraction (AOR: 3.18, 95% CI 1.24–8.12). Socio-economic factors, facility variations, and low vaccination were also observed. Classical behavioral risk factors were infrequent and not significant. Among PCR positive cases, only one presented with a high viral load (>20,000 IU/mL).
HBV poses a substantial, ongoing threat to the Somali population, especially in hospital-based settings. Household transmission and unsafe medical procedures are the most significant risk factors. Improving infection control, expanding vaccination, and prioritizing molecular diagnostics will be critical to effective HBV control in Somalia.
Introduction
Hepatitis B virus infection remains a major public health challenge and a leading cause of morbidity and mortality globally. Despite the availability of vaccines, the diseases have continued to persist particularly in low and middle-income countries [1,2]. Available reports indicate that an estimated 296 million people live with chronic hepatitis B infection, leading to an annual mortality rate of 820,000 mainly due to complications including liver cirrhosis and hepatocellular carcinoma [3,4]. The burden of HBV is disproportionately high in the WHO African Region, which has a high prevalence of chronic infection, with an estimated 81 million people affected [4]. The virus is transmitted through contact with infected blood or body fluids such as semen and vaginal secretions, with common routes including mother-to-child transmission, unsafe medical injections, unprotected sexual contact, and other percutaneous exposures [5].
In contrast to many other African nations, comprehensive and recent data on the sero-prevalence of HBV in Somalia is severely limited. The country has faced decades of conflict and fragility, which have significantly disrupted its healthcare system, including routine immunization programs, disease surveillance, and blood safety protocols [6,7]. Conflict and humanitarian crises as experienced in Somalia create conditions, like displacement, disrupted healthcare, unsafe medical practices, and exposure to sexual violence that significantly increase vulnerability to blood-borne and sexually transmitted infections [8]. While some older studies and regional models suggest a high-intermediate endemicity for HBV in Somalia, there is a critical lack of robust studies that employ modern diagnostic techniques to quantify the current burden and transmissibility of the virus. Understanding the local epidemiology is further hampered by a general lack of information on the knowledge, attitudes, and practices of both the population and healthcare workers regarding HBV prevention and transmission [7,9].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider technology & industry desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Bashiru Garba, Amino Adan Mohamud, Fartuun Hassan Mohamed, Ayan Aden Moussa, Yusuf Yakubu, Najib Isse Dirie, Aya Muktar Abdulatif, Jamal Hassan Mohamoud, Abdirasak Sharif Ali, Abdurrahman Hassan Jibril. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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