Published in PLOS One on 2026-06-02, 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: Linda Mercy Akello, Jimmy Osuret, Jovan Galiwango, Amos Deogratius Mwaka, Christopher Garimoi Orach, Madhavi Yennapu
Source: PLOS One • DOI 10.1371/journal.pone.0350568
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Hepatitis B virus (HBV) infection is a global public health concern. Uganda has a high prevalence of HBV infection among pregnant mothers. This study aimed to determine HBV vaccine uptake and associated factors among pregnant women attending Antenatal Care (ANC) at Gulu Regional Referral Hospital (GRRH).
This was a cross-sectional study. Data were collected from 430 participants who were selected by systematic sampling. Data were collected using an electronic questionnaire built on the Kobo Collect server and analyzed using STATA version 16.0. Prevalence ratios (PR) were calculated using a modified Poisson regression analysis to determine the association between HBV vaccine uptake and the predictors.
More than half (53%:229/430) of the pregnant mothers had received at least a dose of the HBV vaccine. Factors statistically significantly associated with HBV vaccine uptake included age (APR = 1.10, 95% CI: 1.02–1.18), knowledge about HBV (APR = 1.06, 95% CI: 1.01–1.10), and healthcare worker communication (APR = 1.17, 95% CI: 1.04–1.32).
More than half of pregnant mothers had received at least a dose of the HBV vaccination. Age, knowledge, and healthcare communication influenced vaccine uptake. There is a need to provide adequate health education regarding the importance of completing the HBV vaccine to pregnant women and community members to improve vaccine outcomes.
Introduction
Globally, Hepatitis B (HBV) infection poses a significant health threat, particularly due to its increased risk of liver cancer and death [1]. In 2022, the World Health Organization (WHO) estimated that 254 million people were living with chronic HBV infection, with more than 1.2 million new cases reported annually. This led to over 1.1 million deaths in the same year, primarily due to cirrhosis and hepatocellular carcinoma [2]. About 65 million people in the WHO African region live with chronic HBV infection, with over 60 million of them residing in Sub-Saharan Africa (SSA) [2,3]. The majority of individuals with chronic HBV infections acquired the infection during the perinatal period [4]. Individuals who get infected during the perinatal period are 95% likely to become chronic carriers compared to those who acquire the infection during adulthood [5]. Pregnant mothers who test positive for both Hepatitis B surface antigen (HBsAg) and Hepatitis B e antigen (HBeAg) have a high risk (70–90%) of transmitting the infection to their newborns [6,7]. Therefore, pregnant women should be screened for HBsAg and Hepatitis B e-antigens during antenatal care, and mothers who are positive for both tests need to have their infants vaccinated for HBV at birth. [8,9]. In 2022, an estimated 1,250 Ugandans died of HBV-related complications, while approximately 6% of Uganda’s population remained chronically infected [10]. According to the Uganda population-based HIV impact (UPHIA) assessment, the prevalence of HBV infection among adults aged 15–64 years was 4.1%, with the northern region having the highest prevalence rate of 4.6% [11]. A community-based study in Gulu City (formerly a Municipality) found that the prevalence of HBV in the general population was 17.6% [12]. A study among pregnant women in Gulu revealed a prevalence of HBV infection of 12% [13]. Data from the Gulu Cancer Registry (established in 2014) showed that the incidence and burden of liver cancer in the catchment area of the registry were 12.8 per 100,000, which was much higher than the liver cancer incidence and burden in the Kampala region of 10.0 per 100,000, where the incidence and burden of HBV infection are lower. The northern region has a higher prevalence of HBV (5.4%) compared to the central region, which is the catchment area of the Kampala Cancer Registry, with an HBV prevalence of approximately 2.3% [14,15].
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 hospital systems 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 Linda Mercy Akello, Jimmy Osuret, Jovan Galiwango, Amos Deogratius Mwaka, Christopher Garimoi Orach, Madhavi Yennapu. 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.
Explore connected evidence
- Evidence brief: Towards hepatitis B elimination in Ghana: vaccination coverage and its predictors among informal sector workers in Kejetia, Kumasi, Ghana
- Evidence brief: Strengthened HPV vaccination among adolescents living with HIV, – Findings of a Pilot QI project in Kampala Metropolitan, Uganda
- Evidence brief: Hepatitis B immunity and vaccine completion among adults at increased risk for hepatitis B infection in Zambia
