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However, the extent of HBV vaccination and determinants of uptake in sub-Saharan Africa (SSA) have not been systematically examined. This systematic review aims to estimate HBV vaccination among pregnant women in SSA and identify the broader factors influencing uptake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This review will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines. A comprehensive literature search will be conducted in MEDLINE, Embase, Web of Science, Scopus, African Journals Online and Google Scholar in November 2025. We will include published observational studies that assess HBV vaccination among pregnant women in SSA countries from database inception to October 2025. A meta-analysis will be conducted using random-effects models to pool estimates of HBV vaccination and multivariable-adjusted ORs for vaccination-associated factors. Statistical heterogeneity will be assessed using the I\u00b2 statistic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval is not required as this review will not involve primary data collection. Findings will be published in a peer-reviewed journal, presented at regional and international public health conferences, and, where applicable, shared with policymakers and health authorities in SSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>This protocol is registered with the International Prospective Register of Systematic Reviews, registration number CRD420251120357.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-113229","type":"journal-article","created":{"date-parts":[[2026,1,4]],"date-time":"2026-01-04T08:15:19Z","timestamp":1767514519000},"page":"e113229","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Preventing vertical transmission of hepatitis B in sub-Saharan Africa: protocol for a systematic review and meta-analysis on vaccination uptake and determinants among pregnant women"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2814-3890","authenticated-orcid":false,"given":"Ismail Bamidele","family":"Afolabi","sequence":"first","affiliation":[{"name":"Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Craig","family":"Phillips","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8266-0242","authenticated-orcid":false,"given":"Darine","family":"El-Cha\u00e2r","sequence":"additional","affiliation":[{"name":"School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada"},{"name":"Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada"},{"name":"Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon A","family":"Bainbridge","sequence":"additional","affiliation":[{"name":"Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada"},{"name":"Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen P","family":"Phillips","sequence":"additional","affiliation":[{"name":"Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,1,3]]},"reference":[{"key":"2026062609050746000_16.1.e113229.1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0232653","article-title":"Prevalence of hepatitis B viruses and associated factors among pregnant women attending antenatal clinics in public hospitals of Wolaita Zone, South Ethiopia","volume":"15","author":"Bancha","year":"2020","journal-title":"PLoS One"},{"key":"2026062609050746000_16.1.e113229.2","unstructured":"World Health Organization, WHO . 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