Understanding Caregiver Readiness and Awareness of Malaria Vaccination for Children under-Five in a High-Burden Region
Onu Stella N.
*
Department of Internal Medicine, Godfrey Okoye University Teaching Hospital, Enugu, Nigeria.
Oiku Marcellus O.
Department of Family Medicine, Godfrey Okoye University Teaching Hospital, Enugu, Nigeria.
Ojeh F. Golden
Department of Internal Medicine, Godfrey Okoye University Teaching Hospital, Enugu, Nigeria.
Enya Victor
Department of Pediatrics, Alex Ekwueme Federal Teaching Hospital, Abakaliki, Nigeria.
Manoj Swetha
Department of Pediatrics, Government Medical College, Kannur, Kerala, India.
Uguru Precious O.
Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Nigeria.
Etomike Obianyo
Department of Internal Medicine, Institute of Human Virology Nigeria (IHVN), Abuja, Nigeria.
Tolulope Ajayi
Department of Internal Medicine, University of Lagos Teaching Hospital, Lagos, Nigeria.
Adediran F. Damilola
Department of Internal Medicine, Lagos State University Teaching Hospital, Nigeria.
Chikezi Ideyi
Department of Internal Medicine, Federal University Teaching Hospital, Owerri, Nigeria.
Eze Chibuike
Department of Internal Medicine Imo State University, Owerri, Nigeria.
Chioma M. Muotoh
College of Medicine, University of Ibadan, Ibadan, Nigeria.
Tamegnon Dévi M.
Services des Urgences, Centre Hospitalier de Kourou, Guyane, France.
Katerina Paraskevas
Department of Public Health, Columbia University, New York, USA.
Chinaza Ekwueme
Department of Internal Medicine Enugu State University Teaching Hospital, Enugu, Nigeria.
De-Nwigwe C. Blessing
Department of Family Medicine, Alex Ekwueme Federal Teaching Hospital, Abakaliki, Nigeria.
Elujekwute M. Chinedu
Department of Internal Medicine University of Nigeria Teaching Hospital, Nigeria.
Maduka Somtochi. M.
Department of Paediatrics, Babcock University Teaching Hospital, Ogun State, Nigeria.
Akhaine J. Precious
Department of Surgery, Edo Specialist Teaching Hospital, Benin City, Edo State. Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: The malaria vaccine has proven effective in preventing malaria alongside other preventive methods. This study aimed to assess caregiver knowledge, willingness, and barriers to malaria vaccination in a tertiary healthcare facility in southeast Nigeria. It also explored factors influencing willingness to vaccinate.
Methods: A cross-sectional descriptive study was conducted at the Institute of Child Health (ICH), UNTH, with 350 caregivers of children under five from a period of March to May 2025. Interviewer-administered questionnaires, developed by researchers and validated against WHO studies on the malaria vaccine, were used to collect data. Participants were selected through simple random sampling. Analysis was done using SPSS v26, with Chi-square tests and a significance level of p<0.05.
Results: The study involved 350 caregivers (mean age 35 ± 9 years); most were female (94.6%), urban residents (61.7%), and Igbo (95.7%). Awareness of malaria was high (97.4%), and 71.4% had heard of the malaria vaccine. However, only 44% knew about the RTS,S vaccine, and 60.3% were aware of the recommended age of administration. About 82.9% correctly identified the vaccine as preventive, and 61.5% had good overall understanding. While only 27.1% were willing to enroll their child in a vaccine study, 96% were willing to receive the malaria vaccine, with 82.3% willing to vaccinate their child and 84.3% encouraging others. Key barriers included cultural beliefs, misinformation, and cost. No significant associations were found between knowledge or willingness and sociodemographic factors (p>0.05), as a satisfactory number seemed to be accommodating of the vaccine.
Conclusion: Despite strong willingness to vaccinate, knowledge gaps and sociocultural challenges persist among caregivers. For the malaria vaccine rollout in Nigeria to succeed, efforts must focus on improving public education, building trust in health systems, and addressing financial and informational obstacles. These findings are crucial for health policymakers, educators, and program developers focused on malaria eradication through immunization.
Keywords: Malaria, awareness, willingness, barriers, caregivers, under-fives, malaria vaccine