Published in PLOS One on 2026-04-02, 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: Michael Agyemang Obeng, Daniel Kobina Okwan, Clinton Owusu Boateng, Godfred Yawson Scott, Joshua Kofi Attah, Senam Yawa Nunamey Ahadzie, Nathaniel Darko Antwi, Pius Takyi, De-Graft Kwaku Ofosu Boateng, Augustine Yeboah, Derrick Wedam, Emmanuella Asaamah Ofori, Richwonder Abla Ahiable, Ebenezer Oppong Gyamfi, Akwasi Amponsah Abrampah, Abu Abudu Rahamani
Source: PLOS One • DOI 10.1371/journal.pone.0334205
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Hepatitis B virus (HBV) infection remains major public health concern in Ghana, where prevalence is high despite the availability of an effective vaccine. Informal sector workers represent a large proportion of the national workforce but have limited access to preventive health services. This study assessed hepatitis B vaccination coverage and its predictors among informal sector workers in Kejetia market, Kumasi, Ghana. A cross-sectional analytical study was conducted among 809 market workers selected using stratified random sampling across different occupational groups. Data were collected using structured interviewer-administered questionnaires covering sociodemographic characteristics, HBV awareness and knowledge, and vaccination history. Vaccination uptake was categorized as at least one dose (≥1) and full coverage (≥3 doses). Logistic regression analyses were used to identify predictors of vaccination uptake. Overall, only 137 (16.9%) had completed the three-dose schedule, though 256 (31.6%) of participants reported having received at least one dose of HBV vaccine. While 718 (88.8%) of respondents had heard of HBV infection, 619 (76.5%) reported very little or no knowledge about the disease, and 402 (49.7%) did not know its routes of transmission. Vaccination uptake was significantly higher among those who had received HBV-related health education, 175 (62.7%) compared to those who had not 18 (15.3%, p < 0.001). In the multivariate logistic regression model, ≤ 30 years (aOR = 2.209, 95% CI [1.140–4.282], p = 0.019), secondary education (aOR = 2.426, 95% CI [1.220–4.824], p = 0.012), and tertiary education (aOR = 4.796, 95% CI [2.121–10.845], p < 0.001) were the independent predictors of vaccination status. HBV vaccination coverage among informal sector workers in Kejetia Market is alarmingly low despite high general awareness of the infection. Sociodemographic factors and receipt of HBV-related health education strongly influenced uptake. These findings underscore the urgent need for targeted health education and subsidized vaccination programs tailored to informal sector workers in Ghana to achieve national HBV elimination goals.
Introduction
Hepatitis B virus (HBV) infection remains a significant global public health concern, despite the availability of a safe and highly effective vaccine [1–4]. In 2019, an estimated 296 million people were living with chronic HBV infection worldwide, resulting in approximately 820,000 deaths, primarily due to cirrhosis and hepatocellular carcinoma [1,2,5,6]. The African region bears a disproportionately high burden, with prevalence rates of 6–8%, while Ghana is classified as hyperendemic with prevalence estimates ranging from 8% to 15% [1,7].
Vaccination is the cornerstone of HBV prevention. The World Health Organization (WHO) recommends timely infant vaccination, completion of the vaccine series, and catch-up vaccination for unvaccinated adolescents and adults at risk [8,9]. However, in Ghana, despite the integration of HBV vaccination into the Expanded Programme on Immunization (EPI) since 2002, adult coverage remains low, with barriers including limited awareness, high costs, access challenges, and poor vaccine completion rates [10–13].
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 research & evidence 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 Michael Agyemang Obeng, Daniel Kobina Okwan, Clinton Owusu Boateng, Godfred Yawson Scott, Joshua Kofi Attah, Senam Yawa Nunamey Ahadzie, Nathaniel Darko Antwi, Pius Takyi, De-Graft Kwaku Ofosu Boateng, Augustine Yeboah, Derrick Wedam, Emmanuella Asaamah Ofori, Richwonder Abla Ahiable, Ebenezer Oppong Gyamfi, Akwasi Amponsah Abrampah, Abu Abudu Rahamani. 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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