Date of Conferral

4-8-2026

Degree

Ph.D.

School

Health Sciences

Advisor

Clarence Schumaker

Abstract

Hepatitis B virus (HBV) presents a significant public health burden in Sierra Leone. Although the estimated prevalence was 8.7% in 2021, comprehensive statistical data has been limited in general. Programmatic interventions for HBV control such as systematic screening and vaccination have remained limited as well. The purpose of this quantitative cross-sectional study was to examine the relationship between screening and vaccination practices and HBV prevalence in Sierra Leone while controlling for age, sex, education and health care access. The theoretical framework incorporated the Integrated Screening Action model, which highlights screening as a critical disease prevention strategy, and the Social Ecological Model, which conceptualizes health as influenced by multiple social and environmental determinants. Secondary data analysis was performed using logistic regression modeling on data collected by the Sierra Leone Ministry of Health and Sanitation on HBV prevalence, screening and vaccination practices. The results showed that individuals who observed screening practices were more likely (AOR=1.72, 95%CI=(1.39, 2.14), p<0.001), and those who observed vaccination practices were less likely (AOR=0.19, 95%CI=(0.17, 0.22), p<0.001) to report having HBV compared to those who do not observe such practices after adjusting for age, sex, education and health care access. Through identification of factors that contribute to HBV prevalence, the study can inform evidence-based strategies for improving screening uptake, enabling early diagnosis and linkage to care, and reducing transfusion-transmitted HBV infections in Sierra Leone.

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