# Assessment of self-reported prevalence, vaccination status, knowledge and behavioral determinants of hepatitis B and D in Pakistan: a cross-sectional study

## TL;DR

This study in Pakistan finds low awareness and vaccination rates for hepatitis B and D, with risky behaviors and stigma affecting disease management.

## Contribution

The study provides new insights into self-reported prevalence, vaccination status, and behavioral determinants of hepatitis B and D in Pakistan.

## Key findings

- Only 7.3% of respondents reported a hepatitis B or D diagnosis, with 21.3% having a family history.
- Low vaccination coverage (26.4%) and risky medical practices were significant risk factors.
- Stigma and limited public awareness were identified as major barriers to disease management.

## Abstract

In Pakistan, hepatitis B virus (HBV) and hepatitis D virus (HDV) infections remain a major concern. This study assessed the self-reported prevalence, vaccination status, knowledge, risk factors, attitude, and behavioral practices related to both viruses in Pakistan, along with the impact of stigma and cultural norms on disease perception and management. A cross-sectional study was conducted using an online survey, and the data was collected from 980 general Pakistani public (mostly 18–34 age) from January 15 to March 15, 2025. Among respondents, 79.2% were male and 20.8% female, while 58.5% did not know hepatitis (p > 0.05). Only 7.3% reported HBV/HDV self-reported diagnosis, lower than previous studies (16.6%), but 21.3% had a family history, indicating higher self-reported prevalence (p < 0.05). Key risk factors included low vaccination coverage (26.4%, χ2 = 41.17, p < 0.001), chronic infection (χ2 = 16.57, p < 0.001), needle-sharing (9.2%), unlicensed dental (10.6%) and medical (19.3%) procedures, and poor glove usage (14.8%) (p < 0.05). Limited public awareness (35.1%) was noted as the major barrier, while 38.4% of respondents acknowledged the presence of stigma. Participants lack adequate knowledge, gaps in vaccination, risky practices, and stigma persist. A comprehensive public health approach is essential to curb HBV/HDV in Pakistan.