Background: There are limited studies evaluating the impact of COVID-19-related interruptions on hepatitis B virus (HBV) screening in endemic countries in Sub-Saharan Africa. Methods: We conducted a retrospective study of HBV testing in a community pharmacy in Freetown, Sierra Leone, from October 1, 2019, through September 30, 2022. We compared participant characteristics using Pearson's chi-square test. We evaluated trends in HBV screening and diagnosis using one-way ANOVA with Tukey's or Dunnett's post-test. Results: Of 920 individuals screened, 161 had detectable HBsAg (seroprevalence 17.5% [95% CI 14.9-20.4]). There was a 100% decrease in HBV screening during January-June of 2020; however, screening increased by 27% and 23% in the first and second year after COVID-19, respectively. Mean quarterly tests showed a significant upward trend: 55 − 6 tests during January-March (baseline), 74 − 16 tests during April-June, 101 − 3 tests during July-September, and 107 − 17 tests during October-December (one-way ANOVA test for trend, F = 7.7, p = 0.0254) but not the mean quarterly number of people diagnosed with HBV (F = 0.34, p = 0.7992). Conclusion: Community-based HBV screening dramatically improved following temporary disruptions related to COVID-19. Seasonal variation in HBV screening, but not HBV diagnosis, may have implications for HBV elimination efforts in Sierra Leone and other West African countries.

The authors have declared no competing interest.

This research was funded by KnowHep Foundation Sierra Leone and CitiGlobe Pharmacies Ltd (MG) and grants supporting GAY from the National Institutes of Health (NIH)/AIDS Clinical Trials Group (ACTG) under Award Numbers 5UM1AI068636-15 and AI068636 (1560GYD212), the Roe Green Center for Travel Medicine and Global Health/University Hospitals Cleveland Medical Center Award Number J0713 and the University Hospitals Minority Faculty Career Development Award/University Hospitals Cleveland Medical Center Award Number P0603. AMM was supported by the National Institute for Allergy and Infectious Diseases (NIAID) at NIH (grant K01AI166126) and the Harvard University Center for AIDS Research (grant P30AI060354). The funders had no role in the design or authorship of this publication. The article contents are solely the responsibility of the authors and do not necessarily represent the official views of the funders.

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Ethical approval to perform the study was obtained from the Njala University Institutional Review Board at Njala University, Bo Campus, Sierra Leone (approval date 23 January 2023). Informed consent was not required as this study involved a retrospective analysis of secondary data.

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