Knowledge of Malaria and Malaria Vaccines (RTS,S/R21) Among Caregivers of Under-Five Children in Plateau State, Nigeria: A Cross-Sectional Study

Abstract

Background:
Malaria remains a major public health challenge in Nigeria, particularly among children under five years of age. The introduction of malaria vaccines, including RTS,S and R21, represents an important milestone in malaria prevention. However, caregivers’ knowledge of these vaccines is critical for their successful uptake and implementation.

Objective:
This study assessed the knowledge of malaria and malaria vaccines (RTS,S/R21) among caregivers of under-five children in Plateau State, Nigeria.

Methods:
A community-based cross-sectional study was conducted among caregivers of under-five children in three selected Local Government Areas of Plateau State. A multistage sampling technique was used to select 412 caregivers, of whom 408 completed the questionnaire. Data were collected using a structured interviewer-administered questionnaire. Knowledge scores were computed and categorized into good and poor knowledge based on predefined scoring criteria. Data were analyzed using descriptive statistics, chi-square tests, and binary logistic regression in SPSS version 25, with statistical significance set at p < 0.05.

Results:
All respondents (100%) demonstrated good knowledge of malaria transmission and prevention. However, knowledge of malaria vaccines was low, with only 10.5% of caregivers demonstrating good knowledge. Although 69.1% had heard of a malaria vaccine, only 1% understood how it works. Awareness of malaria vaccines was mainly obtained from health workers (64.7%) and social media (44.4%). Factors significantly associated with malaria vaccine knowledge included age (χ² = 18.213, p < 0.001), marital status (χ² = 10.663, p = 0.001), family type (χ² = 5.273, p = 0.022), and number of under-five children (χ² = 6.353, p = 0.012). Logistic regression analysis showed that married caregivers (aOR = 3.76; 95% CI: 1.62–8.74) and caregivers from polygamous families (aOR = 2.23; 95% CI: 1.11–4.47) were more likely to have good knowledge of malaria vaccines.

Conclusion:
Despite excellent knowledge of malaria, caregivers demonstrated poor understanding of malaria vaccines. Strengthened health education, targeted communication strategies, and community engagement are needed to improve malaria vaccine awareness as Nigeria prepares for wider deployment of RTS,S and R21 vaccines.