Knowledge and Compliance to the Uptake of Malaria Vaccines by Caregivers to under-5 Years at the Mambanda Community Douala Cameroon

Background: Malaria remains a leading cause of morbidity and mortality among children under five years in sub-Saharan Africa, with Cameroon ranking among the most affected countries. Despite advancements in malaria control strategies, the introduction and uptake of the RTS,S/AS01 malaria vaccine face significant challenges, particularly in underserved urban communities. This study assessed the knowledge and compliance of caregivers to the RTS,S malaria vaccine in Mambanda, a densely populated and peri-urban community in Douala, Cameroon.  Materials and method: A community-based cross-sectional study was conducted from June to July 2024 among 150 mothers of children under five years residing in Mambanda. Participants were selected using a convenient random sampling technique. Data were collected through a semi-structured, pilot-tested questionnaire assessing sociodemographic characteristics, knowledge of malaria and its vaccines, and compliance with the RTS,S vaccine schedule. Statistical analysis was performed using SPSS version 23, descriptive statistics was used to evaluate proportions and significance was set at p<0.05.  Results: The study revealed high general awareness of malaria (98%) and the importance of vaccination (79.3%) among participants. However, knowledge of specific malaria vaccines was low, with only 22% and 9.3% of participants aware of the RTS,S and R21 vaccines, respectively. Despite this, 92.7% of participants understood that vaccines help prevent malaria, and 86.7% knew vaccines were accessible in hospitals. The actual uptake of the RTS,S vaccine among children was 44.7%, with most mothers (68.7%) expressing willingness to vaccinate their children. However, compliance with the full four-dose RTS,S schedule was not evaluated due to early stages of rollout. Common barriers included limited knowledge, vaccine myths for example fear of pain (89.3%), and infrastructural constraints.  Conclusions: The findings highlight a significant gap between general malaria knowledge and specific awareness and uptake of the RTS,S vaccine. This study underscores the need for robust, community-centered communication strategies that go beyond traditional media. Recommendations include leveraging community health workers and religious leaders for sensitization, implementing digital reminder systems, enhancing transport infrastructure for better healthcare access, and providing continuous training for healthcare workers on vaccine communication.