Covid-19 vaccine uptake and its associated factors among rural households in The Gambia: a community-based cross-sectional study

Abstract

BACKGROUND: The Covid-19 pandemic has affected the globe in all spheres of human life: physical health, mental health, economic burden, and social lives. Population-based vaccination is considered one of the core global response strategies for the containment of Covid-19 across regions, including developing countries. The study aimed to determine the prevalence of Covid 19 vaccine uptake and the factors associated with it among rural dwellers in the North Bank Region (NBR) of The Gambia. METHODS: A community-based cross-sectional study design was used in the NBR from 1st to 10th October 2021. The study was carried out among 504 rural households across districts in the NBR through a multistage sampling procedure. Structured interviews were used to generate data for this study. Chi-square/Fisher exact tests, as well as logistic regression analysis, were used to examine the associations, with statistical significance set at a p-value <0.05 and the computed adjusted odds ratio (aOR) set at a 95% confidence interval (CI). RESULTS: Covid-19 vaccination prevalence uptake was 44%, out of which 87% received Johnson while 13% received AstraZeneca vaccines. In terms of associated factors, males [aOR: 2.728, 95% CI (1.638 - 4.542)] and those at the senior secondary educational level [aOR: 4.525, 95% CI (1.272 - 16.098)] were more likely to utilize Covid-19 vaccines. However, other factors such as being Wollof by ethnicity [aOR: 0.334, 95% CI (0.132 - 0.845)], those who earned D1,000 – D4,999 [aOR: 0.125, 95% CI (0.029 - 0.541)], D5,000 – D9,999 [aOR: 0.096, 95% CI (0.021 - 0.440)], those who tested for Covid-19 vaccines [aOR: 0.227, 95% CI (0.121 - 0.428)], and those who travelled outside the country [aOR: 0.576, 95% CI (0.367 - 0.904)] were less likely to utilize Covid-19 vaccines after controlling for confounders. CONCLUSION: The study revealed a low Covid-19 vaccine uptake in the region, with associated factors including gender, ethnicity, and educational level. There is a need for social and political commitment in the drive to increase vaccine uptake across the country. Target-specific messaging for the population should be developed in local languages across media outlets in The Gambia.