Global prevalence of hepatitis B among displaced populations (internally-displaced persons, refugees, and asylum seekers): a systematic review and meta-analysis

Displaced persons, including internally displaced persons (IDPs), refugees and asylum seekers, are vulnerable to several diseases, including hepatitis B. This systematic review and meta-analysis assessed the global prevalence of hepatitis B among displaced persons and their subgroups. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guideline was followed in this review. Relevant published studies were searched from eight academic databases from 2016 to 2026, with additional citation searching. After screening, relevant data were extracted from each included study and assessed using the Joanna Briggs Institute (JBI) checklist. Using Stata 15.0, the random-effects model of DerSimonian and Laird, with the Freeman-Tukey double arcsine transformation, was used to pool the estimates. Heterogeneity was assessed using I 2 and Cochran’s Q test, and the sources were traced using subgroup and meta-regression analyses. The leave-out-one sensitivity analysis was used to test study’s robustness. Publication bias was assessed using Egger regression test and funnel plot visualisation. The search strategy identified 4,673 records, and 117 were included. The pooled prevalence of hepatitis B was 3.86% (95% confidence interval [CI]: 3.45–4.29%). The prevalence was higher among males, 5.98% (CI: 4.61–7.50%), compared to females, 3.82% (CI: 2.96–4.78%), while children and adolescents recorded lower rates at 1.56% (CI: 1.01–2.20%). The prevalence was highest among those from Eastern Asia, 11.62% (CI: 7.61–16.32%), South-eastern Asia, 7.18% (CI: 5.70–8.80%), and Sub-Saharan Africa, 6.62% (CI: 5.44–7.90%). Subgroup analysis indicated significantly higher ( p ≤ 0.05) pooled prevalence among IDPs, 9.99% (CI: 6.82–13.67%), those hosted in Africa, 7.74% (CI: 5.02–10.97%), and in displacement camps, 7.19% (CI: 5.47–9.11%). Considerable heterogeneity remained after subgroup analyses and multivariate meta-regression linked the heterogeneity to displacement status, male percentage, temporal design and study settings. Sensitivity analysis demonstrated the robustness of findings, while Egger’s regression test and funnel plot asymmetry indicated small-study effect. In conclusion, displaced persons have a high burden of hepatitis B compared to the general population, with being male, an IDP, of Eastern Asian origin, residing in displacement camps, and being from Africa associated with higher risk. Hence, government and non-governmental organisations are encouraged to prioritise them in their hepatitis B control efforts. CRD420261361168.