{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:11:34Z","timestamp":1792433494134,"version":"4.5.0"},"reference-count":29,"publisher":"Pan African Medical Journal","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pan Afr Med J"],"abstract":"<jats:p>Introduction: Yellow fever (YF) remains a major public health concern in Ghana, with periodic outbreaks despite ongoing vaccination efforts. Nomadic populations, due to their mobility and remote settlements, are often underserved by vaccination campaigns, posing challenges to achieving herd immunity. The objective of the study was to estimate yellow fever vaccination coverage among nomadic populations in the Savannah Region of Ghana and compare it with the national average, and identify reasons for non-vaccination to inform future outbreak response strategies.\n\n \n\nMethods: a community-based cross-sectional study was conducted among 2,914 individuals from 414 nomadic households across 22 affected communities using a modified WHO vaccination coverage survey. Data were analyzed in Stata version 15. Descriptive statistics and t-tests were used to assess differences in vaccination coverage and associated factors.\n\n \n\nResults: overall vaccination coverage was 80.3% (SD = 0.24), significantly lower than the national average of 88% (t(413) = -4.00, p &lt; 0.001), though within the WHO-recommended threshold for herd immunity. A significant inverse relationship was observed between household size and vaccination coverage (p &lt; 0.001). Most respondents (93.2%) presented vaccination cards for verification, while 4.8% reported verbally. The main reasons for non-vaccination included absence during campaigns, lack of transportation, and limited information about the campaign. Perceptions of vaccine effectiveness were largely positive (67.5%), though 25.1% expressed doubts about efficacy.\n\n \n\nConclusion: yellow fever vaccination coverage among nomadic populations in the Savannah Region, though adequate for herd protection, remains below national targets. Strengthened outreach strategies, tailored health promotion, and targeted catch-up campaigns are essential to sustain high coverage and prevent future outbreaks among mobile and hard-to-reach populations.<\/jats:p>","DOI":"10.11604\/pamj.2026.53.24.49809","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:54:52Z","timestamp":1778158492000},"source":"Crossref","is-referenced-by-count":1,"title":["Yellow fever vaccination coverage among nomadic populations in the Savannah Region, Ghana: a cross-sectional study following an outbreak"],"prefix":"10.11604","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8184-7355","authenticated-orcid":false,"given":"Abdul-Wahab","family":"Inusah","sequence":"first","affiliation":[{"name":"Department of Global and International Health, School of Public Health, University for Development Studies, Tamale, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Mutaru","family":"Tahiru","sequence":"additional","affiliation":[{"name":"Northern Regional Health Directorate, Ghana Health Service, Tamale, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0979-6039","authenticated-orcid":false,"given":"Collins","family":"Gbeti","sequence":"additional","affiliation":[{"name":"Drylands Research Institute, University for Development Studies, Tamale, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9501-2116","authenticated-orcid":false,"given":"Peter","family":"Dzomeku","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tamale Teaching Hospital, Tamale, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1189-0531","authenticated-orcid":false,"given":"Michael","family":"Head","sequence":"additional","affiliation":[{"name":"Clinical Informatics Research Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9315-5778","authenticated-orcid":false,"given":"Shamsu-Deen","family":"Ziblim","sequence":"additional","affiliation":[{"name":"Directorate of Academic Planning and Quality Assurance, University for Development Studies, Tamale, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4870","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Kwallah A ole, Inoue S, Thairu-Muigai AW, Kuttoh N, Morita K, Mwau M. Seroprevalence of yellow fever virus in selected health facilities in Western Kenya from 2010 to 2012. Jpn J Infect Dis. 2015;68(3):230-4. PubMed | Google Scholar","DOI":"10.7883\/yoken.JJID.2014.288"},{"key":"ref1","unstructured":"Centers for Disease Control and Prevention (CDC). Yellow Fever Virus. Accessed 14th October 2025."},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Tomashek KM, Challberg M, Nayak SU, Schiltz HF. Disease Resurgence, Production Capability Issues and Safety Concerns in the Context of an Aging Population: Is There a Need for a New Yellow Fever Vaccine?. Vaccines. 2019 Nov 8;7(4):179. PubMed | Google Scholar","DOI":"10.3390\/vaccines7040179"},{"key":"ref3","unstructured":"World Health Organization (WHO). Eliminate yellow fever epidemics (EYE) strategy 2017-2026. Accessed 14th October 2025."},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Nwaiwu AU, Musekiwa A, Tamuzi JL, Sambala EZ, Nyasulu PS. The incidence and mortality of yellow fever in Africa: a systematic review and meta-analysis. BMC Infect Dis. 2021 Oct 23;21(1):1089. PubMed | Google Scholar","DOI":"10.1186\/s12879-021-06728-x"},{"key":"ref5","unstructured":"World Health Organization (WHO). Yellow Fever - West and Central Africa. Accessed 14th October 2025."},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Shearer FM, Moyes CL, Pigott DM, Brady OJ, Marinho F, Deshpande A et al. Global yellow fever vaccination coverage from 1970 to 2016: an adjusted retrospective analysis. Lancet Infect Dis. 2017 Nov;17(11):1209-1. PubMed | Google Scholar","DOI":"10.1016\/S1473-3099(17)30419-X"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Garske T, Van Kerkhove MD, Yactayo S, Ronveaux O, Lewis RF, Staples JE et al. Yellow Fever in Africa: Estimating the Burden of Disease and Impact of Mass Vaccination from Outbreak and Serological Data. Hay SI, editor. PLoS Med. 2014 May 6;11(5):e100163. PubMed | Google Scholar","DOI":"10.1371\/journal.pmed.1001638"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Gotuzzo E, Yactayo S, C\u00f3rdova E. Efficacy and Duration of Immunity after Yellow Fever Vaccination: Systematic Review on the Need for a Booster Every 10 Years. Am Soc Trop Med Hyg. 2013 Sept 4;89(3):434-44. PubMed | Google Scholar","DOI":"10.4269\/ajtmh.13-0264"},{"key":"ref9","unstructured":"World Health Organization (WHO). Weekly Epidemiological Record (WER). Accessed 15th October 2025."},{"key":"ref10","unstructured":"World Health Organization (WHO). Yellow fever. Accessed 15th October 2025."},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Flamand C, Bailly S, Fritzell C, Fernandes Pellerin S, Toure A, Chateau N et al. Vaccination coverage in the context of the emerging Yellow Fever threat in French Guiana. Poonawala H, editor. PLoS Negl Trop Dis. 2019 Aug 19;13(8):e0007661. PubMed | Google Scholar","DOI":"10.1371\/journal.pntd.0007661"},{"key":"ref12","unstructured":"World Health Organization (WHO). Yellow fever \u2013 Ghana. Accessed 15th October 2025."},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Inusah AW, Collins G, Dzomeku P, Head M, Ziblim SD. Knowledge, attitudes and practice towards yellow fever among nomadic populations: A cross-sectional study in yellow fever outbreak communities in Ghana. Robinson J, editor. PLOS Glob Public Health. 2023 Mar 16;3(3):e0000733. PubMed | Google Scholar","DOI":"10.1371\/journal.pgph.0000733"},{"key":"ref14","unstructured":"West Gonja Municipal Assembly. West Gonja Municipal Assembly. Accessed 15th October 2025."},{"key":"ref15","unstructured":"Centers for Disease Control and Prevention (CDC). Yellow Fever Vaccine. Accessed 15th October 2025."},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Bagonza J, Rutebemberwa E, Mugaga M, Tumuhamye N, Makumbi I. Yellow fever vaccination coverage following massive emergency immunization campaigns in rural Uganda, May 2011: a community cluster survey. BMC Public Health. 2013 Mar 7;13(1):202. PubMed | Google Scholar","DOI":"10.1186\/1471-2458-13-202"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Odhiambo JN, Dolan CB, Thompson E, O\u00b4Neill K, Sankok J, Kimani R. Childhood vaccination trends among the Maasai nomadic pastoralists: Insights from a community-based vaccine registry in Kenya. Saravanos GL, editor. PLOS Glob Public Health. 2025 Mar 25;5(3):e0004077. PubMed | Google Scholar","DOI":"10.1371\/journal.pgph.0004077"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Ozawa S, Yemeke TT, Evans DR, Pallas SE, Wallace AS, Lee BY. Defining hard-to-reach populations for vaccination. Vaccine. 2019 Sept;37(37):5525-34. PubMed | Google Scholar","DOI":"10.1016\/j.vaccine.2019.06.081"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Gammino VM, Diaz MR, Pallas SW, Greenleaf AR, Kurnit MR. Health services uptake among nomadic pastoralist populations in Africa: A systematic review of the literature. PLoS Negl Trop Dis. 2020 July 27;14(7):e0008474. PubMed | Google Scholar","DOI":"10.1371\/journal.pntd.0008474"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Schelling E, Bechir M, Ahmed MA, Wyss K, Randolph TF, Zinsstag J. Human and Animal Vaccination Delivery to Remote Nomadic Families, Chad. Emerg Infect Dis. 2007 Mar;13(3):373-9. PubMed | Google Scholar","DOI":"10.3201\/eid1303.060391"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Afari-Asiedu S, Febir LG, Tawiah C, Omoleke S, Ofosu-Apea P, Osei-Sarpong F et al. Factors influencing vaccination up-take among nomadic population in four regions of Ghana: a qualitative study. BMC Public Health. 2024 Oct 22;24(1):2921. PubMed | Google Scholar","DOI":"10.1186\/s12889-024-20397-w"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Domingo C, Fraissinet J, Ansah PO, Kelly C, Bhat N, Sow SO et al. Long-term immunity against yellow fever in children vaccinated during infancy: a longitudinal cohort study. Lancet Infect Dis. 2019 Dec;19(12):1363-70. PubMed | Google Scholar","DOI":"10.1016\/S1473-3099(19)30323-8"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Nambagyira A, Bosoka SA, Kwabla MP, Vechey GA, Djokoto SK, Aku FY. Routine immunization status of nomadic children aged five years and below in Volta Region, Ghana in the post-COVID-19 pandemic era: a cross-sectional study. BMC Public Health. 2025 June 5;25(1):2098. PubMed | Google Scholar","DOI":"10.1186\/s12889-025-23290-2"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Bangura JB, Xiao S, Qiu D, Ouyang F, Chen L. Barriers to childhood immunization in sub-Saharan Africa: A systematic review. BMC Public Health. 2020 July 14;20(1):1108. PubMed | Google Scholar","DOI":"10.1186\/s12889-020-09169-4"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Baatiema L, Kunfah SMP, Sanuade OA, Allen LN, Abimbola S, de-Graft Aikins A et al. To vaccinate or not to vaccinate? Experiences of COVID-19 vaccine uptake among people living with non-communicable diseases in Ghana: A qualitative study. Robinson J, editor. PLOS Glob Public Health. 2024 Oct 14;4(10):e0003820. PubMed | Google Scholar","DOI":"10.1371\/journal.pgph.0003820"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Ackah BBB, Woo M, Stallwood L, Fazal ZA, Okpani A, Ukah UV et al. COVID-19 vaccine hesitancy in Africa: a scoping review. Glob Health Res Policy. 2022 July 19;7(1):21. PubMed | Google Scholar","DOI":"10.1186\/s41256-022-00255-1"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Ndasauka Y, Twabi HS, Kainja J, Gunde AM, Makhumula-Mtimuni C. Knowledge, attitudes and demographic drivers for COVID-19 vaccine hesitancy in Malawi. Sci Rep. 2024 Apr 26;14(1):9578. PubMed | Google Scholar","DOI":"10.1038\/s41598-024-60042-5"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Unfried K, Priebe J. Vaccine hesitancy and trust in sub-Saharan Africa. Sci Rep. 2024 May 13;14(1):10860. PubMed | Google Scholar","DOI":"10.1038\/s41598-024-61205-0"}],"container-title":["Pan African Medical Journal"],"original-title":[],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:55:27Z","timestamp":1778158527000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.panafrican-med-journal.com\/content\/article\/53\/24\/full\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":29,"URL":"https:\/\/doi.org\/10.11604\/pamj.2026.53.24.49809","relation":{},"ISSN":["1937-8688"],"issn-type":[{"value":"1937-8688","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,16]]},"article-number":"49809"}}