Seroprevalence and associated factors of hepatitis B virus infection among pregnant women in Africa: an umbrella review and meta-analysis

Abstract Background Among pregnant women hepatitis B surface antigen serotype is one of the infections that remains a major public health concern in Africa, due to the high risk of mother-to-child transmission and subsequent chronic infection. Even though there are systematic reviews and meta-analysis, there are overlapping of researches and the results are inconsistent, and remain fragmented. Objective To summarize, critically appraise, and synthesize evidence on the seroprevalence and associated factors of hepatitis B surface antigen infection among pregnant women in Africa. Methods An umbrella review and meta-analysis were conducted in accordance with the PRIOR guidelines. A comprehensive literature search was performed across PubMed/MEDLINE, ScienceDirect, African Journals Online, PsycINFO, HINARI, and Google Scholar to identify studies published until February 1, 2026. Eligible high-quality systematic reviews and meta-analyses were selected following appraisal using the AMSTAR 2 quality assessment tool. A random-effects meta-analysis model was applied to estimate the pooled prevalence. Heterogeneity and publication bias were evaluated. The extent of overlap among the included primary studies was assessed using the corrected covered area method. Results Eleven published articles comprising 570,590 pregnant women were included. The pooled HBsAg seroprevalence among pregnant women in Africa was 5.66% (95% CI: 5.21%–6.13%), with heterogeneity (I² = 80.51%). associated factors of HBsAg infection were having multiple sexual partners, abortion, blood transfusion, tooth extraction, tattooing, and history of sharing sharp materials. Conclusion This umbrella review indicates that HBsAg infection remains a considerable concern among pregnant women in Africa, with a moderate-to-high prevalence across settings and due to the extreme heterogeneity (I2 = 80.51%) observed across regions and reviews, the single pooled continental prevalence estimate must be interpreted with caution. Keywords: Hepatitis B virus; HBsAg; Seroprevalence; Pregnancy; Africa; Umbrella review; Meta-analysis.