General knowledge and attitude of healthcare professionals and infrastructural readiness prior to implementation of malaria vaccine in selected hospitals in Tororo district, Uganda: a cross-sectional study

Abstract

Background The introduction of malaria vaccines (RTS, S/SA01 and R21/Matrix-M) in malaria control brings hope for malaria burden reduction globally. Uganda is one of the countries that applied for support to introduce R21 malaria vaccine and expects to commence with its implementation in April/May 2025. However, as the country prepares for R21 malaria vaccine rollout, the extent to which hospitals are ready for its implementation remains unclear. This study therefore assessed the general knowledge, attitudes of all healthcare professionals regardless of their role in providing immunization services and infrastructural readiness prior to rolling out of R21 malaria vaccine in an endemic setting, Tororo district. Methods This cross-sectional study was conducted at Tororo General hospital and St. Anthony Hospital in Tororo district. Data was collected before the vaccine was rolled out through interviews with purposively selected healthcare professionals irrespective of their role in vaccination programs. Additional data was collected through inspection of the hospital infrastructure for malaria vaccine implementation. Data on healthcare professionals’ knowledge and attitudes was collected using self-administered questionnaires, while a checklist was used to capture data on the availability and functional state of the infrastructure in hospitals for vaccine roll-out. Fully completed questionnaires were entered into Epi-data version 4.7 for coding and cleaning, thereafter exported to STATA version 16 for analysis. Results A total of 211 healthcare professionals were included into the study. The study participants had predominantly negative attitudes towards the malaria vaccine, with 70% (147/211, 95% CI: 63–76) displaying unfavorable attitudes compared to 30% (64/211, 95% CI: 25–37) with positive attitudes, and the overall mean score (SD) of 3.30 (0.489)., many of whom expressed concerns about its affordability, accessibility and effectiveness. Knowledge on the malaria vaccine was notably low, with 99% (208/211, 95% CI: 96–100) of respondents demonstrating poor knowledge, while only 1% (3/211, 95% CI: 0.5–4.4) had good knowledge.Conclusion The knowledge gap coupled with negative attitudes on malaria vaccine were prevalent among all healthcare professionals prior to the roll-out of R21 vaccine in Tororo district. There was limited preparedness as regards the infrastructure required for the malaria vaccine implementation. The Ministry of Health should consider conducting targeted training programs for all healthcare professionals and provision of additional essential infrastructure to accommodate the inclusion of the malaria vaccine roll-out with other routine vaccines.