Epidemiology and Infection

Original Papers

Vaccination

Socio-cultural determinants of anticipated acceptance of an oral cholera vaccine in Western Kenya

N. SUNDARAMa1a2 c1, C. SCHAETTIa1a2, C.-L. CHAIGNATa3, R. HUTUBESSYa4, E. O. NYAMBEDHAa5, L. A. MBONGAa5 and M. G. WEISSa1a2

a1 Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland

a2 University of Basel, Basel, Switzerland

a3 Global Task Force on Cholera Control, World Health Organization, Geneva, Switzerland

a4 Initiative for Vaccine Research, World Health Organization, Geneva, Switzerland

a5 Department of Sociology and Anthropology, Maseno University, Kisumu, Kenya

SUMMARY

Determinants of anticipated acceptance of an oral cholera vaccine (OCV) were studied in urban and rural communities of Western Kenya. An explanatory model interview administered to 379 community residents assessed anticipated vaccine acceptance at various prices from no cost to full-cost recovery, socio-cultural features of cholera and social characteristics. Nearly all (99%) residents indicated willingness to accept a no-cost OCV, 95% at a price of US$ 0·8, 73% at US$ 4·2 and 59% at US$ 8·4. Logistic regression models analysed socio-cultural determinants of anticipated OCV acceptance. Prominence of non-specific symptoms for cholera was negatively associated with acceptance. A cholera-specific symptom (thirst), self-help referring to prayer, income and education were positively associated. In the high-cost model, education was no longer significant and reliance on herbal treatment was a significant determinant of vaccine non-acceptance. Findings suggest high motivation for OCVs, if affordable. Socio-cultural determinants are better predictors of anticipated acceptance than socio-demographic factors alone.

(Received November 16 2011)

(Revised March 17 2012)

(Accepted April 10 2012)

(Online publication May 08 2012)

Key words

  • Cholera;
  • Kenya;
  • oral cholera vaccine;
  • social and cultural determinants;
  • vaccine acceptance

Correspondence:

c1 Author for correspondence: Ms. N. Sundaram, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, CH-4002 Basel, Switzerland. (Email: neisha.sundaram@stud.unibas.ch)

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