Routine childhood immunization in Sub-Saharan Africa: addressing parental vaccine hesitancy.

OBJECTIVES: Parental vaccine hesitancy (VH) is a major barrier to childhood vaccination. We aimed to identify the determinants of parental VH towards routine childhood immunization in 12 Sub-Saharan African countries. STUDY DESIGN: A cross-sectional study was conducted from November 1 to December 15, 2022. METHODS: Parents of children aged 19 months to 6 years and residing in the Sub-Saharan Africa were included. An anonymous online survey and face-to-face interviews were conducted. The Parent Attitude about Childhood Vaccine Scale was used to identify vaccine-hesitant parents. Multivariate regression and mediating analysis were performed. RESULTS: Across the 5032 participants, 21.2% were hesitant towards routine childhood immunization. Urban residents (adjusted odds ratio [AOR] = 1.32, 95% confidence interval [CI]: 1.10-1.58), non-first-born children (AOR = 1.54, 95% CI: 1.19-1.98), and chronically ill children (AOR = 2.00, 95% CI: 1.69-2.37) increased the likelihood of parental VH. Mothers with higher education, attending at least one antenatal care (ANC) visit (AOR = 0.25, 95% CI: 0.19-0.32), and had a healthcare facility-based delivery (AOR = 0.55, 95% CI: 0.44-0.70) decreased the odds of parental VH. Parental VH mediated the effect of ANC and mothers' age on vaccination uptake. ANC increased the odds of vaccination uptake (odds ratio [OR] = 12.49, 95% CI: 9.68-16.13). Parental VH mediated the association between ANC and vaccination uptake, decreasing the likelihood of vaccination uptake (OR = 0.12, 95% CI: 0.10-0.14). Each additional year of the mother's age decreased the odds of vaccination uptake (OR = 0.95, 95% CI: 0.95-0.96). The indirect effect of mother's age on vaccination through parental VH decreased the odds of vaccination uptake (OR = 0.45, 95% CI: 0.44-0.45). Parental VH continued to be a mediator of the combined effect of mother's age and ANC on vaccination uptake, decreasing the likelihood of vaccination uptake (OR = 0.0017, 95% CI: 0.00166-0.00168). CONCLUSIONS: Context-specific interventions are needed to address parental VH and improve vaccine acceptance and coverage.

Development and validation of a French questionnaire that assesses knowledge, attitude, and practices toward Marburg diseases in sub-Saharan African countries.

OBJECTIVES: Marburg virus, previously referred to as Marburg hemorrhagic fever, is a highly severe and frequently fatal illness that affects humans. This study aimed to develop and validate a French questionnaire to assess knowledge, attitude, and practice toward Marburg virus disease (FKAP-MVD). STUDY DESIGN: An anonymous online survey was used, which was distributed through various platforms and emails. Data were collected from Burkina Faso, Guinea, the Democratic Republic of Congo, and Senegal. METHODS: To conduct the study, an anonymous online survey was used, which was distributed through various platforms such as Facebook, Twitter, WhatsApp, and emails. The survey was uploaded onto a Google form to facilitate data collection. Data were collected from Burkina Faso, Guinea, the Democratic Republic of Congo, and Senegal. RESULTS: Of the total sample of 510 participants, 60.0% were male, their mean age was 28.41 ± 6.32 years, 38.0% were married, 86.6% resided in urban areas and 64.1% had a university education. The questionnaire had good internal consistency; Cronbach's alpha was 0.87. The correlation between knowledge and attitude was 0.002, the correlation between knowledge and practice was 0.204, and the correlation between practice and attitude was relatively weak and negative at -0.060. This indicates the divergent validity of the questionnaire. The KMO value of 0.91 indicates a high level of adequacy, suggesting that the data are suitable for factor analysis. The Bartlett test of Sphericity yielded an approximate χ2 value of 4016.890 with 300 degrees of freedom and a P-value of 0.0001. The confirmatory factor analysis revealed 25 questions in three domains. The normed chi-square value is 1.224. The goodness of Fit Index (GFI) is 0.902, the Comparative Fit Index (CFI) is 0.982, the Root Mean Square Error of Approximation (RMSEA) is 0.033, and the Root Mean Square Residual (RMR) is 0.062. These values indicate a good fit of the model to the data. CONCLUSIONS: In general, the developed questionnaire has significant potential to inform public health initiatives and interventions related to MVD.