Community perceptions of a malaria vaccine in the Kintampo districts of Ghana

Abstract

BackgroundMalaria remains the leading cause of morbidity and mortality in sub-Saharan Africa despite tools currently available for its control. Making malaria vaccine available for routine use will be a major hallmark, but its acceptance by community members and health professionals within the health system could pose considerable challenge as has been found with the introduction of polio vaccinations in parts of West Africa. Some of these challenges may not be expected since decisions people make are many a time driven by a complex myriad of perceptions. This paper reports knowledge and perceptions of community members in the Kintampo area of Ghana where malaria vaccine trials have been ongoing as part of the drive for the first-ever licensed malaria vaccine in the near future.MethodsBoth qualitative and quantitative methods were used in the data collection processes. Women and men whose children were or were not involved in the malaria vaccine trial were invited to participate in focus group discussions (FGDs). Respondents, made up of heads of religious groupings in the study area, health care providers, traditional healers and traditional birth attendants, were also invited to participate in in-depth interviews (IDIs). A cross-sectional survey was conducted in communities where the malaria vaccine trial (Mal 047RTS,S) was carried out. In total, 12 FGDs, 15 IDIs and 466 household head interviews were conducted.ResultsKnowledge about vaccines was widespread among participants. Respondents would like their children to be vaccinated against all childhood illnesses including malaria. Knowledge of the long existing routine vaccines was relatively high among respondents compared to hepatitis B and Haemophilus influenza type B vaccines that were introduced more recently in 2002. There was no clear religious belief or sociocultural practice that will serve as a possible barrier to the acceptance of a malaria vaccine.ConclusionWith the assumption that a malaria vaccine will be as efficacious as other EPI vaccines, community members in Central Ghana will accept and prefer malaria vaccine to malaria drugs as a malaria control tool. Beliefs and cultural practices as barriers to the acceptance of malaria vaccine were virtually unknown in the communities surveyed.

Factors Likely to Affect Community Acceptance of a Malaria Vaccine in Two Districts of Ghana: A Qualitative Study

“…The findings suggest that communities placed a high value on vaccines in general and were positive about the idea of a malaria vaccine. This positive attitude is the general trend seen in other studies conducted in other districts in Ghana [13] and in other African countries [9] – [12] . Community members acknowledged that malaria was one of the most common and serious diseases, especially among children, and they showed a positive attitude toward new interventions that might help in the control of the disease, as had been previously reported for IPTi in Ghana and other African countries [30] and IPTc [31] .…”

“…Data on community perceptions would also inform the development of a communications strategy to help ensure that the introduction of a partially efficacious malaria vaccine [8] does not jeopardize continued use of current malaria control measures or reduce confidence in vaccines for other diseases currently in use. Other qualitative studies on community perceptions of malaria and vaccines have been conducted, including in Kenya [9] , [10] , Mozambique [11] , Burkina Faso [12] , and in a malaria vaccine trial setting in Ghana, Kintampo [13] . This article provides further data from two non-trial settings in different provinces of Ghana.…”

RTS,S malaria vaccine development: progress and considerations for postapproval introduction

“…However, the burden of malaria is very well known to the community members and there is a critical community demand for a malaria vaccine. 67,68 This demand for a vaccine is likely to make community acceptance of a new vaccine easier. On the other hand, the high demand for a malaria vaccine may make community members perceive a partially efficacious malaria vaccine as a magic bullet for malaria control that could lead to a reduction in the use of other malaria control interventions such as bednets.…”

Stakeholder Views of Clinical Trials in Low- and Middle-Income Countries: A Systematic Review

“…Some studies were conducted in local languages, and transcripts were translated into English, which could be a potential limitation if linguistic and cultural nuances were not fully conveyed in the primary study. 14 In addition, some of the interviews in the primary studies were conducted by the research institute or trial staff, rather than by the independent interviewers, which may have limited the full range of issues and experiences that stakeholders were willing to share. Studies not published in English were excluded to avoid misinterpretation of results.…”

“…(Religious leader) 14 16, 22, 29, 31, 33, 37, 63, 70, 74 "...I was uncomfortable discussing topics like reproductive organs because according to our Shona culture it's taboo." (Teacher) 50 This was illustrated in the breastfeeding study regarding the issue of random assignment of mother-infant dyads to breast-or bottle-feeding groups.…”