A Descriptive-Multivariate Analysis of Community Knowledge, Confidence, and Trust in COVID-19 Clinical Trials among Healthcare Workers in Uganda
Keneth Iceland Kasozi,
Anne Laudisoit,
Lawrence Obado Osuwat,
Gaber El-Saber Batiha,
Naif E. Al Omairi,
Eric Aigbogun,
Herbert Izo Ninsiima,
Ibe Michael Usman,
Lisa M. DeTora,
Ewan Thomas MacLeod,
Halima Nalugo,
Francis P. Crawley,
Barbara E. Bierer,
Daniel Chans Mwandah,
Charles Drago Kato,
Kenedy Kiyimba,
Emmanuel Tiyo Ayikobua,
Linda Lillian,
Kevin Matama,
Shui Ching Nelly Mak,
David Onanyang,
Theophilus Pius,
David Paul Nalumenya,
Robinson Ssebuufu,
Nina Olivia Rugambwa,
Grace Henry Musoke,
Kevin Bardosh,
Juma John Ochieng,
Fred Ssempijja,
Patrick Kyamanywa,
Gabriel Tumwine,
Khalid J. Alzahrani,
Susan Christina Welburn
Affiliations
Keneth Iceland Kasozi
Infection Medicine, Deanery of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh EH8 9JZ, UK
Anne Laudisoit
EcoHealth Alliance, 520 Eighth Ave, Suite 1201, New York, NY 10018, USA
Lawrence Obado Osuwat
School of Health Sciences, Soroti University, P.O. Box 211 Soroti, Uganda
Gaber El-Saber Batiha
Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour 22511, AlBeheira, Egypt
Naif E. Al Omairi
Department of Internal Medicine, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
Eric Aigbogun
Kampala International University Western Campus, P.O. Box 71 Bushenyi, Uganda
Herbert Izo Ninsiima
School of Medicine, Kabale University, P.O. Box 317 Kabale, Uganda
Ibe Michael Usman
Kampala International University Western Campus, P.O. Box 71 Bushenyi, Uganda
Lisa M. DeTora
Department of Writing Studies and Rhetoric, Hofstra University, Hempstead, NY 11549, USA
Ewan Thomas MacLeod
Infection Medicine, Deanery of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh EH8 9JZ, UK
Halima Nalugo
Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410 Mbarara, Uganda
Francis P. Crawley
Good Clinical Practice Alliance-Europe and Strategic Initiative for Developing Capacity in Ethical Review, BE-1050 Brussels, Belgium
Barbara E. Bierer
Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
Daniel Chans Mwandah
Faculty of Science, Muni University, P.O. Box 725 Arua, Uganda
Charles Drago Kato
College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, P.O. Box 7062 Kampala, Uganda
Kenedy Kiyimba
Department of Pharmacology and Therapeutics, Faculty of Health sciences, Busitema University, P.O. Box 206 Mbale, Uganda
Emmanuel Tiyo Ayikobua
School of Health Sciences, Soroti University, P.O. Box 211 Soroti, Uganda
Linda Lillian
Uganda National Health Laboratory Services, Ministry of Health, P.O. Box 7272 Kampala, Uganda
Kevin Matama
Kampala International University Western Campus, P.O. Box 71 Bushenyi, Uganda
Shui Ching Nelly Mak
Infection Medicine, Deanery of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh EH8 9JZ, UK
David Onanyang
Department of biology, Faculty of Science, Gulu University, P.O. Box 166 Gulu, Uganda
Theophilus Pius
Kampala International University Western Campus, P.O. Box 71 Bushenyi, Uganda
David Paul Nalumenya
College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, P.O. Box 7062 Kampala, Uganda
Robinson Ssebuufu
Kampala International University Western Campus, P.O. Box 71 Bushenyi, Uganda
Nina Olivia Rugambwa
Department of Library and Information Science, Faculty of Computing, Library and Information Science, P.O. Box 317 Kabale, Uganda
Grace Henry Musoke
Faculty of Science and Technology, Cavendish University, P.O. Box 33145 Kampala, Uganda
Kevin Bardosh
Center for One Health Research, School of Public Health, University of Washington, Seattle, WA 98195, USA
Juma John Ochieng
Kampala International University Western Campus, P.O. Box 71 Bushenyi, Uganda
Fred Ssempijja
Kampala International University Western Campus, P.O. Box 71 Bushenyi, Uganda
Patrick Kyamanywa
Kampala International University Western Campus, P.O. Box 71 Bushenyi, Uganda
Gabriel Tumwine
College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, P.O. Box 7062 Kampala, Uganda
Khalid J. Alzahrani
Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
Susan Christina Welburn
Infection Medicine, Deanery of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh EH8 9JZ, UK
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.
