Abstract

The management of the diphtheria epidemic overlooked the behavioral aspects of children's parents regarding vaccination. This study examined the behavioral factors associated with parental non-adherence to diphtheria vaccination in the sub-prefecture of Kintinia, Guinea. The persistence of this epidemic in 2023 highlighted the importance of this research in understanding the behavioral factors associated with parental non-adherence to childhood vaccination. A cross-sectional quantitative-analytical study was conducted among parents with at least one child under 15 years of age living in the Kintinia sub-prefecture. The study used a self-administered questionnaire based on the theory of planned behavior. The sample size was calculated using the OPEN EPI version 3 application, following Schwartz's formula, which resulted in 400 parents of children. Variables studied included socio-demographic characteristics, attitude, subjective norms, perceived behavioral control, and parental vaccination intention. The results showed that unfavorable subjective norms reduced parents' intention to vaccinate their children (OR = 0.2; p ≤ 0.05), while a poor attitude decreased parents' intention to vaccinate (OR = 13; p ≤ 0.05). Good perceived behavioral control strongly increased vaccination intention (OR = 431; p ≤ 0.05). Parental gender and childhood vaccination status were associated with parental intention to vaccinate children, but these associations were not statistically significant. The study concluded that parents' subjective norms, attitudes, and perceived behavioral control were key factors influencing their intention to vaccinate their children against diphtheria. These results underline the importance of considering behavioral and social aspects in vaccination programs to improve immunization coverage in Guinea.

Key words: Diphtheria, vaccination, theory of planned behavior, Guinea, behavioral factors.