Acceptability of the RTS, S malaria vaccine and associated factors among caregivers of children under 25 months in Soa Health District, Cameroon: a community-based cross-sectional study
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Background Malaria remains a major cause of morbidity and mortality in sub-Saharan Africa. In Cameroon, malaria accounts for 48% of all hospital admissions, 30% of morbidity and 67% of childhood mortality per year, despite ongoing control strategies. However, data on community acceptability of this vaccine remain limited. This study aimed to assess the acceptability of the malaria vaccine and identify factors associated among caregivers of children under 25 months in the Soa Health District, Cameroon. Methods A community-based cross-sectional descriptive and analytical study was conducted between March and November 2024. Caregivers of children under 25 months residing in the Soa Health District were recruited using a non-probability convenience sampling method. Data were collected using a structured, pre-tested questionnaire and analysed using R software. Associations between independent variables and vaccine acceptability were assessed using Pearson’s chi-square or Fisher’s exact tests. Multivariable logistic regression model was used to estimate adjusted odd ratio (aOR) at a 95% confidence level. A p-value < 0.05 was considered statistically significant. Results A total of 541 caregivers participated in the study. Overall, 73.4% of caregivers expressed willingness to vaccinate their children against malaria. Higher odds of vaccine acceptability were observed among caregivers residing in Ngali II (aOR = 12.20; 95% CI: 3.23-46.02; p <0.001 ), Koulou (aOR = 5.66; 95% CI: 1.74-18.35; p= 0.004 ), Soa (aOR = 4.23; 95% CI: 1.59-11.25; p= 0.004 ), and Ebang (aOR = 2.66; 95% CI: 1.16-6.14; p= 0.021 ), Female caregivers (aOR = 1.85; 95% CI: 1.06-3.22; p= 0.031 ), Catholics (aOR = 3.85; 95% CI: 1.18-12.51; p =0.025 ), caregivers who had prior awareness of the malaria vaccine (aOR = 2.06; 95% CI: 1.28-3.30; p=0.003 ), caregivers who sought treatment in hospitals (aOR = 2.02; 95% CI: 1.15-3.55; p =0.015 ) or used street medicine (aOR = 2.46; 95% CI: 1.09-5.55; p=0.03 ). Conclusion Acceptability of the malaria vaccine among caregivers in the Soa Health District was relatively high and was significantly influenced by geographic location, sex, religion, health-seeking behaviour, and awareness of the vaccine. Targeted health education and culturally sensitive community engagement strategies are essential to improve vaccine acceptability and support the successful scale-up of malaria vaccination programmes in Cameroon and other endemic settings.
