A Descriptive-Multivariate Analysis of Community Knowledge, Confidence, and Trust in COVID-19 Clinical Trials among Healthcare Workers in Uganda
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Date
2021-03-12
Journal Title
Journal ISSN
Volume Title
Publisher
MDPI.
Abstract
Background—misinformation and mistrust often undermines community vaccine uptake,
yet information in rural communities, especially of developing countries, is scarce. This study aimed
to identify major challenges associated with coronavirus disease 2019 (COVID-19) vaccine clinical
trials among healthcare workers and staff in Uganda. Methods—a rapid exploratory survey was
conducted over 5 weeks among 260 respondents (66% male) from healthcare centers across the
country using an online questionnaire. Twenty-seven questions assessed knowledge, confidence,
and trust scores on COVID-19 vaccine clinical trials from participants in 46 districts in Uganda.
Results—we found low levels of knowledge (i.e., confusing COVID-19 with Ebola) with males being
more informed than females (OR = 1.5, 95% CI: 0.7–3.0), and mistrust associated with policy decisions
to promote herbal treatments in Uganda and the rushed international clinical trials, highlighting
challenges for the upcoming Oxford–AstraZeneca vaccinations. Knowledge, confidence and trust
scores were higher among the least educated (certificate vs. bachelor degree holders). We also found
a high level of skepticism and possible community resistance to DNA recombinant vaccines, such as
the Oxford–AstraZeneca vaccine. Preference for herbal treatments (38/260; 14.6%, 95% CI: 10.7–19.3)
currently being promoted by the Ugandan government raises major policy concerns. High fear and
mistrust for COVID-19 vaccine clinical trials was more common among wealthier participants and
more affluent regions of the country. Conclusion—our study found that knowledge, confidence,
and trust in COVID-19 vaccines was low among healthcare workers in Uganda, especially those
with higher wealth and educational status. There is a need to increase transparency and inclusive
participation to address these issues before new trials of COVID-19 vaccines are initiated
Description
Keywords
COVID-19 clinical trials in resource poor countries, COVID-19, Clinical trials in Africa, COVID-19 and medical workers;, Vaccines, COVAX
Citation
Kasozi, K.I.; Laudisoit, A.; Osuwat, L.O.; Batiha, G.E.-S.; Al Omairi, N.E.; Aigbogun, E.; Ninsiima, H.I.; Usman, I.M.; DeTora, L.M.; MacLeod, E.T.; et al. A Descriptive-Multivariate Analysis of Community Knowledge, Confidence, and Trust in COVID-19 Clinical Trials among Healthcare Workers in Uganda. Vaccines 2021, 9, 253. https://doi.org/10.3390/ vaccines9030253