{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T16:19:41Z","timestamp":1788970781179,"version":"build-2803163510"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>HBsAg prevalence was 11.5% (n\u2009=\u200931), 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\u201313.60) and history of tooth extraction (AOR: 3.18, 95% CI 1.24\u20138.12). 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 (&gt;20,000 IU\/mL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0340800","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T18:28:05Z","timestamp":1768588085000},"page":"e0340800","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence, risk factors, and viral load quantification of HBV infection among hospital patients: A cross-sectional investigation in Mogadishu, Somalia"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7295-9665","authenticated-orcid":true,"given":"Bashiru","family":"Garba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amino Adan","family":"Mohamud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fartuun Hassan","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayan Aden","family":"Moussa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuf","family":"Yakubu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najib Isse","family":"Dirie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya Muktar","family":"Abdulatif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamal Hassan","family":"Mohamoud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdirasak Sharif","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdurrahman Hassan","family":"Jibril","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"issue":"12","key":"pone.0340800.ref001","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1016\/S2468-1253(17)30295-9","article-title":"Hepatitis B in sub-Saharan Africa: Strategies to achieve the 2030 elimination targets","volume":"2","author":"CW Spearman","year":"2017","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"8","key":"pone.0340800.ref002","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1038\/s41575-023-00760-9","article-title":"Global burden of hepatitis B virus: Current status, missed opportunities and a call for action","volume":"20","author":"Y-C Hsu","year":"2023","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"7","key":"pone.0340800.ref003","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/S2468-1253(25)00069-X","article-title":"A 2024 global report on national policy, programmes, and progress towards hepatitis B elimination: Findings from 33 hepatitis elimination profiles","volume":"10","author":"L Hiebert-Suwondo","year":"2025","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"pone.0340800.ref004","unstructured":"WHO. Global hepatitis report 2024: action for access in low- and middle-income countries. https:\/\/WwwWhoInt\/Publications\/i\/Item\/9789240091672 2024."},{"key":"pone.0340800.ref005","unstructured":"Tripathi N, Mousa OY. Hepatitis B. 2023."},{"issue":"6","key":"pone.0340800.ref006","doi-asserted-by":"crossref","first-page":"2664","DOI":"10.4103\/jfmpc.jfmpc_119_20","article-title":"Barriers for full immunization coverage among under 5 years children in Mogadishu, Somalia","volume":"9","author":"TM Mohamud Hayir","year":"2020","journal-title":"J Family Med Prim Care"},{"key":"pone.0340800.ref007","first-page":"1555775","article-title":"Prevalence and risk factors associated with Hepatitis B and Hepatitis C infections among patients undergoing hemodialysis: A single-centre study in Somalia","volume":"2021","author":"MOO Jeele","year":"2021","journal-title":"Int J Nephrol"},{"issue":"1","key":"pone.0340800.ref008","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1017\/S0950268899003441","article-title":"Prevalence of serum antibodies against bloodborne and sexually transmitted agents in selected groups in Somalia","volume":"124","author":"YA Nur","year":"2000","journal-title":"Epidemiol Infect"},{"issue":"5","key":"pone.0340800.ref009","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1016\/0035-9203(87)90043-5","article-title":"Epidemiology of hepatitis B in Somalia: Inference from a cross-sectional survey of serological markers","volume":"81","author":"KM Bile","year":"1987","journal-title":"Transactions Royal Society Tropical Med Hygiene"},{"issue":"10","key":"pone.0340800.ref010","doi-asserted-by":"crossref","first-page":"577","DOI":"10.11622\/smedj.2021083","article-title":"Healthcare workers as a sentinel surveillance population in the early phase of the COVID-19 pandemic","volume":"63","author":"I Venkatachalam","year":"2022","journal-title":"Singapore Med J"},{"issue":"1","key":"pone.0340800.ref011","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.mayocp.2011.08.001","article-title":"Viral hepatitis among Somali immigrants in Minnesota: Association of hepatitis C with hepatocellular carcinoma","volume":"87","author":"AM Shire","year":"2012","journal-title":"Mayo Clin Proc"},{"key":"pone.0340800.ref012","article-title":"Risk of hepatocellular carcinoma in hepatitis B and prevention through treatment","author":"M Sherman","year":"2009","journal-title":"Cleve Clin J Med"},{"issue":"2","key":"pone.0340800.ref013","doi-asserted-by":"crossref","first-page":"95","DOI":"10.4103\/2141-9248.181835","article-title":"Viral load pattern among hepatitis B surface antigen-positive patients: Laboratory perspective and implications for therapy","volume":"6","author":"KC Iregbu","year":"2016","journal-title":"Ann Med Health Sci Res"},{"issue":"34","key":"pone.0340800.ref014","doi-asserted-by":"crossref","first-page":"12039","DOI":"10.3748\/wjg.v20.i34.12039","article-title":"Hepatitis B viral load affects prognosis of hepatocellular carcinoma","volume":"20","author":"SJ Yu","year":"2014","journal-title":"World J Gastroenterol"},{"issue":"4","key":"pone.0340800.ref015","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/S1665-2681(19)31747-8","article-title":"Patterns of viral load in chronic hepatitis B patients in Brazil and their association with ALT levels and HBeAg status","volume":"8","author":"M Eidi Nita","year":"2009","journal-title":"Annals of Hepatology"},{"issue":"34","key":"pone.0340800.ref016","doi-asserted-by":"crossref","first-page":"3927","DOI":"10.3748\/wjg.v24.i34.3927","article-title":"Epidemiology of viral hepatitis in Somalia: Systematic review and meta-analysis study","volume":"24","author":"MA Hassan-Kadle","year":"2018","journal-title":"World J Gastroenterol"},{"issue":"1","key":"pone.0340800.ref017","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1186\/s12889-024-18136-2","article-title":"Assessment of prevalence and risk factors associated with Hepatitis B virus infection among blood donors in Mogadishu Somalia","volume":"24","author":"AK Mohamud","year":"2024","journal-title":"BMC Public Health"},{"issue":"11","key":"pone.0340800.ref018","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.3855\/jidc.19982","article-title":"Human papillomavirus DNA detection in cervical samples from women of reproductive age in Mogadishu, Somalia","volume":"18","author":"B Garba","year":"2024","journal-title":"J Infect Dev Ctries"},{"issue":"1","key":"pone.0340800.ref019","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-025-93364-z","article-title":"Prevalence and intensity of intestinal and soil-transmitted helminths infection among children in internally displaced camps in Mogadishu Somalia","volume":"15","author":"B Garba","year":"2025","journal-title":"Sci Rep"},{"issue":"6","key":"pone.0340800.ref020","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1093\/inthealth\/ihaf034","article-title":"Assessment of the burden of Giardia infection and its associated risk factors among children resident in internally displaced persons camps in Mogadishu, Somalia: A cross-sectional study","volume":"17","author":"B Garba","year":"2025","journal-title":"International Health"},{"issue":"1","key":"pone.0340800.ref021","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-023-04723-x","article-title":"Prevalence of and factors associated with depression among adult patients living with HIV\/AIDs undergoing ART unit in Banadir hospital, Mogadishu Somalia","volume":"23","author":"AK Mohamud","year":"2023","journal-title":"BMC Psychiatry"},{"issue":"12","key":"pone.0340800.ref022","doi-asserted-by":"crossref","first-page":"2212","DOI":"10.1016\/j.vaccine.2011.12.116","article-title":"Global epidemiology of hepatitis B virus infection: New estimates of age-specific HBsAg seroprevalence and endemicity","volume":"30","author":"JJ Ott","year":"2012","journal-title":"Vaccine"},{"issue":"10003","key":"pone.0340800.ref023","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1016\/S0140-6736(15)61412-X","article-title":"Estimations of worldwide prevalence of chronic hepatitis B virus infection: A systematic review of data published between 1965 and 2013","volume":"386","author":"A Schweitzer","year":"2015","journal-title":"Lancet"},{"issue":"1","key":"pone.0340800.ref024","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1186\/s12879-025-11145-5","article-title":"Sero-prevalence of hepatitis B virus and associated risk factors among pregnant women attending Demartino hospital, Mogadishu, Somalia","volume":"25","author":"OM Mohamud","year":"2025","journal-title":"BMC Infect Dis"},{"key":"pone.0340800.ref025","doi-asserted-by":"crossref","first-page":"9","DOI":"10.2147\/CEG.S3887","article-title":"Epidemiology of viral hepatitis in Sudan","volume":"1","author":"HM Mudawi","year":"2008","journal-title":"Clin Exp Gastroenterol"},{"key":"pone.0340800.ref026","doi-asserted-by":"crossref","first-page":"163","DOI":"10.2147\/HMER.S381809","article-title":"Prevalence and factors associated with Hepatitis B infection among outpatient adults in South-Western Uganda","volume":"14","author":"E Rugaatwa Ndibarema","year":"2022","journal-title":"Hepat Med"},{"issue":"1","key":"pone.0340800.ref027","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s40249-024-01225-0","article-title":"Disparities in hepatitis B virus healthcare service access among marginalised poor populations: a mixed-method systematic review","volume":"13","author":"C Li","year":"2024","journal-title":"Infect Dis Poverty"},{"issue":"45","key":"pone.0340800.ref028","doi-asserted-by":"crossref","first-page":"6902","DOI":"10.3748\/wjg.14.6902","article-title":"Current treatment indications and strategies in chronic hepatitis B virus infection","volume":"14","author":"GV Papatheodoridis","year":"2008","journal-title":"World J Gastroenterol"},{"issue":"9","key":"pone.0340800.ref029","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.3390\/microorganisms8091416","article-title":"Recent advances in understanding, diagnosing, and treating Hepatitis B virus infection","volume":"8","author":"M Rybicka","year":"2020","journal-title":"Microorganisms"},{"issue":"1","key":"pone.0340800.ref030","doi-asserted-by":"crossref","first-page":"7425","DOI":"10.1038\/s41598-022-11535-8","article-title":"Hepatitis B virus (HBV) serological patterns among the HBsAg negative hospital attendees screened for immunization","volume":"12","author":"HM Kafeero","year":"2022","journal-title":"Sci Rep"},{"issue":"44","key":"pone.0340800.ref031","doi-asserted-by":"crossref","first-page":"9836","DOI":"10.3748\/wjg.v22.i44.9836","article-title":"Clinical features of HBsAg seroclearance in hepatitis B virus carriers in South Korea: A retrospective longitudinal study","volume":"22","author":"YM Park","year":"2016","journal-title":"WJG"},{"issue":"1","key":"pone.0340800.ref032","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12072-015-9675-4","article-title":"Asian-Pacific clinical practice guidelines on the management of hepatitis B: A 2015 update","volume":"10","author":"SK Sarin","year":"2016","journal-title":"Hepatol Int"},{"issue":"7","key":"pone.0340800.ref033","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1016\/j.jiph.2023.05.003","article-title":"Exploring risk factors and transmission dynamics of Hepatitis B infection among Indian families: Implications and perspective","volume":"16","author":"S Athalye","year":"2023","journal-title":"J Infect Public Health"},{"issue":"1","key":"pone.0340800.ref034","doi-asserted-by":"crossref","DOI":"10.1186\/s41182-025-00781-x","article-title":"Intra-familial transmission of Hepatitis B virus in a peri-urban community from the Democratic Republic of the Congo","volume":"53","author":"F Cindibu Kalonji","year":"2025","journal-title":"Trop Med Health"},{"issue":"6","key":"pone.0340800.ref035","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1080\/21645515.2020.1847951","article-title":"Prevalence and factors associated with hepatitis B virus infection among household members: A cross-sectional study in Beijing","volume":"17","author":"X Zhao","year":"2021","journal-title":"Hum Vaccin Immunother"},{"issue":"1","key":"pone.0340800.ref036","doi-asserted-by":"crossref","first-page":"12697","DOI":"10.1038\/s41598-025-93364-z","article-title":"Prevalence and intensity of intestinal and soil-transmitted helminths infection among children in internally displaced camps in Mogadishu Somalia","volume":"15","author":"B Garba","year":"2025","journal-title":"Sci Rep"},{"issue":"4","key":"pone.0340800.ref037","doi-asserted-by":"crossref","first-page":"321","DOI":"10.7150\/ijms.8.321","article-title":"Seroprevalence and risk factors for hepatitis B infection in an adult population in Northeast China","volume":"8","author":"H Zhang","year":"2011","journal-title":"Int J Med Sci"},{"issue":"31","key":"pone.0340800.ref038","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000029815","article-title":"Failure of sterilization in a dental outpatient facility: Investigation, risk assessment, and management","volume":"101","author":"N Chanchareonsook","year":"2022","journal-title":"Medicine (Baltimore)"},{"issue":"9","key":"pone.0340800.ref039","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.adaj.2016.03.020","article-title":"Transmission of blood-borne pathogens in US dental health care settings: 2016 update","volume":"147","author":"JL Cleveland","year":"2016","journal-title":"J Am Dent Assoc"},{"issue":"1","key":"pone.0340800.ref040","article-title":"Assessment of infection prevention and control in Somali Healthcare Facilities using the WHO infection prevention and control assessment framework","volume":"14","author":"AA Adam","year":"2025","journal-title":"Antimicrob Resist Infect Control"},{"issue":"1","key":"pone.0340800.ref041","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1186\/s13031-021-00428-8","article-title":"Challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings: A qualitative study","volume":"15","author":"H Lowe","year":"2021","journal-title":"Confl Health"},{"issue":"1","key":"pone.0340800.ref042","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1186\/s12889-023-15309-3","article-title":"Measuring social desirability bias in a multi-ethnic cohort sample: Its relationship with self-reported physical activity, dietary habits, and factor structure","volume":"23","author":"WL Teh","year":"2023","journal-title":"BMC Public Health"},{"key":"pone.0340800.ref043","doi-asserted-by":"crossref","first-page":"50","DOI":"10.7150\/ijms.2.50","article-title":"Epidemiology and Prevention of Hepatitis B Virus Infection","author":"J Hou","year":"2005","journal-title":"Int J Med Sci"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0340800","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T18:28:17Z","timestamp":1768588097000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0340800"}},"subtitle":[],"editor":[{"given":"Ashraf","family":"Elbahrawy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0340800","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,16]]}}}