Public awareness and acceptance of malaria vaccine in Sub-Saharan Africa: a systematic review.

BACKGROUND: The African continent continues to experience a high prevalence of malaria more than three years after the licensure of the first malaria vaccine. This study aimed to review relevant literature on malaria vaccine awareness and acceptance among the public in sub-Saharan Africa (SSA). METHODS: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Statement of 2020 was used for reporting this systematic review. Related publications were searched from nine public databases. The search was restricted to studies published between January 2021 and March 2025, using the Population, Exposure, Outcome (PEO) framework to assess the eligibility. The Joanna Briggs Institute (JBI) Critical Appraisal Tools were used for critical appraisal, and relevant data were extracted into Microsoft Excel 2016, where they were synthesized. RESULTS: A total of 33 studies were included in this review, predominantly from West Africa and of cross-sectional design. Malaria vaccine awareness ranged from 7.26% in the Democratic Republic of Congo to 95.6% in Ghana, with healthcare workers as the main information source. Acceptance levels also varied widely, from 10.3% to 100%, and were generally higher in Nigeria and Ghana. Beyond acceptance, participants from both countries were also willing to recommend the vaccine to others. There was scant evidence on the acceptance of malaria vaccines among the vaccine types. Education and occupation were consistently associated with greater awareness and acceptance, while factors such as age, gender, and income showed inconsistent or limited influence. In three African nations (Uganda, Ghana, and Nigeria), higher education was associated with a greater likelihood of vaccine awareness. Employed people also had higher awareness and acceptance of the vaccines in SSA. Moreover, the awareness of the vaccine was associated with its acceptance. CONCLUSION: Malaria vaccine awareness and acceptance in SSA vary widely across regions, with education, occupation, and healthcare workers playing key roles in shaping positive uptake. Hence, more concrete steps are needed to increase regional awareness and acceptance.