Knowledge, attitudes, practices, and vaccination gaps related to hepatitis B among adolescents in a hyperendemic, fragile setting: A cross-sectional study from Mogadishu, Somalia

Background Hepatitis B virus (HBV) infection remains a major public health problem in sub-Saharan Africa, yet evidence on adolescents’ knowledge, attitudes, and practices (KAP) toward HBV is limited in Somalia. This study assessed HBV-related KAP and associated factors among high school students in Mogadishu. Objectives To assess HBV-related knowledge, attitudes, practices, and vaccination status among high school students in Mogadishu, Somalia, and identify associated factors. Methods A cross-sectional study was conducted among 392 high school students using a structured questionnaire. Descriptive statistics summarized KAP levels. Associations between sociodemographic variables and KAP outcomes were examined using chi-square tests and logistic regression. Results Although 98.0% of students had heard of HBV, 63.0% of participants demonstrated good knowledge of hepatitis B, while 37.0% had poor knowledge. Positive attitudes toward HBV were reported by 27.0% of participants, whereas 73.0% had negative attitudes. Just over half of respondents (52.5%) reported good preventive practices, while 47.5% had poor practices. HBV vaccination coverage was 39.3%. In multivariable analysis, grade level was significantly associated with the KAP domains, although the pattern of association varied across knowledge, attitudes, and practices. Conclusion High school students in Mogadishu exhibited substantial gaps in HBV knowledge, negative attitudes, and low vaccination uptake. Educational grade level was a key determinant of HBV-related KAP, highlighting the need for targeted, school-based interventions to strengthen adolescent HBV prevention.