Assessment of parental knowledge, attitude, and acceptance toward malaria vaccine for children under five years in Sudan, 2025

Abstract

Prevention methods for malaria include indoor residual spray, insecticide-treated bed nets, and, most recently, vaccines. Given widespread insecticide resistance impacting existing prevention methods, Sudan initiated malaria vaccination in November 2024.This studyaimed to assess parents’ knowledge, attitudes, and acceptance of the malaria vaccine for children under five years in Sudan. A descriptive cross-sectional study was conducted in high malaria-burden regions of Sudan from April to June 2025. Using a convenience sampling method,706 eligible parents participated. A structured questionnaire, piloted for reliability (Cronbach’s alpha = 0.741), was administered to gather data on demographics, malaria and vaccine knowledge, attitudes and acceptance. Nearly all participants (98.2%) were aware of malaria. However, only 268 (38.0%) participants had heard of the malaria vaccine. Fathers were more likely to be aware of the vaccine than mothers (19.0% vs. 10.7%, p = 0.002). Participants from Kassala (30.6%), those with postgraduate education (11.9%), public sector employees (13.1%), and those with higher monthly incomes (26.9% for > 500 K SDG; p = 0.010) exhibited higher levels of awareness. Parents in Sudan had strong general knowledge of malaria but limited awareness of the vaccine. Acceptance was high and influenced by sex, education, income, profession, and residence. These findings suggest a need for targeted awareness campaigns, integration of vaccine information into routine health services, and community-based education strategies to support Sudan’s national malaria program and elimination goals.