Correlates of hepatitis B virus awareness and disease specific knowledge in Uganda: a meta-analysis and meta-regression of studies published between 2018 and 2025.

backgroundHepatitis B virus (HBV) remains a major public health challenge in Uganda, where prevalence varies by region and population group despite national vaccination and screening initiatives. Understanding awareness and knowledge levels is essential for guiding HBV prevention and control strategies. This study synthesized available evidence on the correlates of HBV awareness and disease specific knowledge among different Ugandan populations.

methodsWe systematically searched PubMed, African Journals Online (AJOL), and Google Scholar for cross-sectional studies reporting on HBV awareness or disease-specific knowledge in Uganda, published between January 2018 and December 2025. Study selection, data extraction, and quality appraisal were conducted independently by two reviewers using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Eighteen studies meeting the eligibility criteria were included in the final synthesis. Pooled estimates of HBV awareness and correlates of disease-specific knowledge were computed using a random-effects model in MedCalc software (version 10.10), with heterogeneity quantified using the I² statistic. Sources of heterogeneity were explored through subgroup analysis and sensitivity analysis. Meta-regression was performed to examine trends in HBV awareness by region, year of publication, and study population. Publication bias was assessed using Begg's and Egger's tests. Statistical significance was set at p < 0.05, and all estimates are reported with 95% confidence intervals.

resultsEighteen studies met the inclusion criteria. The pooled prevalence of HBV awareness was 75.3% (95% CI: 61.5%-86.9%), with substantial heterogeneity observed across regions and population groups (I²=99.24%). Subgroup analysis revealed that awareness was significantly higher in Central Uganda compared to the northern, eastern, and western regions (p < 0.05), and among healthcare workers compared to the general population and antenatal care attendees (p < 0.05). Knowledge of specific HBV domains varied considerably: awareness of the causative agent, screening services, and vaccination availability was significantly higher among knowledgeable participants compared to those with no prior HBV knowledge (p < 0.05), whereas awareness of post-exposure prophylaxis and completion of the full HBV vaccination schedule remained low compared to those who had received at least partial vaccination (p < 0.05). Awareness of key transmission routes including sexual contact, needle sharing, and mother-to-child transmission was moderate, though knowledge of transmission through infected body fluids remained poor. Participants who were of higher education level were more likely to take up vaccination compared to lower education level (p < 0.05), and participants with a positive attitude toward vaccine effectiveness were significantly more likely to be vaccinated compared to those with a negative attitude (p < 0.05). The meta-regression analysis further revealed a paradoxical overall decline in HBV awareness over the study period.

conclusionCritical gaps still persist in HBV awareness and key knowledge areas highlighting the need for alternative strategies tailored to the social dynamics of the current generation during the delivery of health messages. CLINICAL TRIAL NUMBER: Not applicable.