Tanzania, a country deeply affected by malaria, faces a significant challenge in controlling the disease despite relying on proven prevention methods like insecticide-treated bed nets and indoor residual spraying. Malaria continues to be a serious health threat, exacerbated by growing resistance to these interventions. As a result, the global health community has turned its focus to innovative solutions, including malaria vaccines, to complement current control measures. However, concerns about vaccine efficacy and safety, fueled by misinformation, have led to vaccine hesitancy in various parts of the world. This article explores the findings of a study conducted in Dar es Salaam, Tanzania, investigating the knowledge and willingness of caregivers to adopt the new malaria vaccine.
The study, conducted between September 2022 and March 2023, was a health facility-based, cross-sectional survey. A total of 293 caregivers attending Ante-Natal Clinics (ANC) in selected health facilities across Dar es Salaam participated in the study. Data was collected through a semi-structured questionnaire, which covered caregivers’ demographics, their knowledge of malaria, their awareness of malaria vaccines, and their willingness to vaccinate their children.
The majority of the respondents were women (97.3%), aged between 18 and 52 years. A significant 87.4% of the caregivers demonstrated knowledge about malaria, although 14% of the respondents were unaware of how the disease is transmitted. More than 86% were familiar with malaria prevention and control measures, including the use of bed nets and indoor spraying. However, only 14.7% were aware of the malaria vaccine. Despite this low awareness, most respondents (92.8%) expressed their willingness to vaccinate their children under five years of age against malaria, highlighting a high degree of trust in vaccines among caregivers.
The study revealed that while malaria knowledge was widespread, awareness of the malaria vaccine was limited. Of those caregivers who had been exposed to vaccine-related messages, 67.4% understood that the vaccine targets children under five years old, and 53.5% knew that it could be administered to pregnant women as well. Despite the lack of widespread awareness, the results indicated a strong willingness to accept the malaria vaccine, with nearly 93% of caregivers agreeing to vaccinate their children if given the opportunity.
Tanzania is one of the African countries heavily impacted by malaria, with a prevalence rate of 8% among children under five years as of 2022. The country has been grappling with the dual challenge of increased resistance to malaria drugs and insecticide-treated nets. While these control measures have been successful in reducing malaria prevalence in the past, their effectiveness has diminished over time. This shift in the malaria landscape necessitates the introduction of additional tools, such as vaccines, to bolster existing strategies.
Malaria vaccines have shown promising results in clinical trials. For instance, the RTS, S/AS01 and R21/Matrix-M vaccines, developed from the circumsporozoites protein, have demonstrated substantial efficacy in preventing malaria in children under five years. The R21/Matrix-M vaccine, currently in phase 3 trials, has shown up to 75% efficacy in preventing clinical malaria. Due to this high efficacy, countries like Ghana and Nigeria have already approved the vaccine for use, despite it still undergoing phase 3 trials.
The World Health Organization (WHO) has endorsed the RTS, S vaccine for broader roll-out in malaria-endemic regions, and 18 million doses were allocated to 12 sub-Saharan African countries in 2023. However, the success of the vaccine rollout hinges on the public’s acceptance, which could be undermined by vaccine hesitancy fueled by misinformation
The findings from this study in Dar es Salaam underscore a critical opportunity for malaria eradication in Tanzania. Despite the low awareness of malaria vaccines, the high willingness to vaccinate children against malaria suggests a positive outlook for the future of malaria control in the region. To ensure the successful integration of the malaria vaccine into Tanzania’s Expanded Programme on Immunization (EPI), it is essential to conduct targeted information, education, and communication (IEC) campaigns to address misconceptions and build trust in the new vaccine.
With the advent of malaria vaccines, Tanzania is poised to take a significant step towards eradicating this deadly disease. However, it is imperative that the health sector works closely with local communities to combat vaccine hesitancy and ensure that the vaccine reaches those who need it most. Effective vaccination campaigns, alongside ongoing vector control measures, could pave the way for a malaria-free future in Tanzania.
