Introduction: Viral hepatitis, particularly hepatitis B (HBV), remains a major public health issue, especially in low- and middle-income countries. In Burkina Faso, HBV prevalence was estimated at 9.1% based on 2010 Demographic and Health Survey (DHS) data. This study aimed to update the national estimate of HBV surface antigen (HBsAg) prevalence and evaluate sociodemographic and regional disparities, fifteen years after the vaccine’s introduction in the expanded immunization Program. Methodology: We conducted a secondary analysis of serum samples from a 2021 national household survey on COVID- 19 seroepidemiology across Burkina Faso’s 13 regions. HBsAg was detected using the Determine HBsAg 2 rapid diagnostic test (Abbott Diagnostics) (Ab- bott Diagnostics). Results: Among 6,115 participants, the overall prevalence of HBsAg was 9.3% (95% CI: 7.29 - 11.86). Prevalence was slightly higher in men (9.8%) than in women (8.9%), though not statistically significant (p = 0.503). No significant differences were observed by age group, education level, marital status, or urban/rural setting. However, regional disparities were marked, with the highest prevalence in Boucle du Mouhoun (15.1%), while the lowest rates were observed in the Sahel (4.2%) and Centre-Ouest (6.5%) regions. Conclusions: Our findings demonstrate that despite national vaccination efforts, HBV remains highly prevalent in Burkina Faso. These results underscore the urgent need for targeted public health strategies to address regional disparities and reduce the disease burden.

HBV, HBsAg, Prevalence, Disparities, Burkina Faso