Abstract

BackgroundWithin the context of combined interventions, malaria vaccine may provide additional value in malaria prevention. Stakeholders’ perspectives are thus critical for informed recommendation of the vaccine in Tanzania. This paper presents the views of stakeholders with regards to malaria vaccine in 12 Tanzanian districts.MethodsQuantitative and qualitative methods were employed. A structured questionnaire was administered to 2123 mothers of under five children. Forty-six in-depth interviews and 12 focus group discussions were conducted with teachers, religious leaders, community health workers, health care professionals, and scientists. Quantitative data analysis involved frequency distributions and cross tabulations using Chi square test to determine the association between malaria vaccine acceptability and independent variables. Qualitative data were analysed thematically.ResultsOverall, 84.2 % of the mothers had perfect acceptance of malaria vaccine. Acceptance varied significantly according to religion, occupation, tribe and region (p < 0.001). Ninety two percent reported that they will accept the malaria vaccine despite the need to continue using insecticide-treated nets (ITNs), while 88.4 % reported that they will accept malaria vaccine even if their children get malaria less often than non-vaccinated children. Qualitative results revealed that the positive opinions towards malaria vaccine were due to a need for additional malaria prevention strategies and expectations that the vaccine will reduce visits to the health facility, deaths, malaria episodes and treatment-related expenses. Vaccine related questions included its side effects, efficacy, protective duration, composition, interaction with other medications, provision schedule, availability to the pregnant women, mode of administration (oral or injection?) and whether a child born of HIV virus or with a chronic illness will be eligible for the vaccine?ConclusionStakeholders had high acceptance and positive opinions towards the combined use of the anticipated malaria vaccine and ITNs, and that their acceptance remains high even when the vaccine may not provide full protection, this is a crucial finding for malaria vaccine policy decisions in Tanzania. An inclusive communication strategy should be designed to address the stakeholders’ questions through a process that should engage and be implemented by communities and health care professionals. Social cultural aspects associated with vaccine acceptance should be integrated in the communication strategy.

Highlights

  • Within the context of combined interventions, malaria vaccine may provide additional value in malaria prevention

  • The current malaria interventions in Tanzania include malaria testing by microscopy and/or rapid diagnostic tests, treatment with affordable and effective malaria treatment, such as artemisinin-based combination therapy (ACT), protection using long-lasting insecticide-treated nets and indoor residual spraying with insecticides, intermittent preventive therapy with sulfadoxine-pyrimethamine for pregnant women [2]

  • Most questions were mostly related to the side effects of the vaccine and the government response to them, efficacy, protective duration, composition, interaction with other medications, relation of vaccine schedule with existing EPI schedule, availability of the vaccine to the pregnant women, mode of administration and whether child born of HIV virus or with a chronic illness will be eligible for the vaccine? (Fig. 2)

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Summary

Introduction

Within the context of combined interventions, malaria vaccine may provide additional value in malaria prevention. Despite a declining trend in the number of admissions and deaths over the last few years, the country experiences a marked variation across regions having some with high malaria prevalence and others with low prevalence. The current malaria interventions in Tanzania include malaria testing by microscopy and/or rapid diagnostic tests, treatment with affordable and effective malaria treatment, such as artemisinin-based combination therapy (ACT), protection using long-lasting insecticide-treated nets and indoor residual spraying with insecticides, intermittent preventive therapy with sulfadoxine-pyrimethamine for pregnant women [2]. Challenges are reported on existing malaria interventions with regards to resistance of malaria parasites to ACT, as well as non-use of mosquito nets [5, 6]. Considering variations in malaria prevalence and challenges related to the existing malaria interventions, more innovative response including the vaccines to prevent malaria is likely to improve the impact of available interventions

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