Observational studyMalaria journal2026
The Malaria Vaccine Programme Evaluation in Kenya: results of a baseline household survey prior to the introduction of the RTS,S/AS01 vaccine.
Observational study in Malaria journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03806465 (An Evaluation of the Pilot Implementation of RTS,S/AS01 Through Routine Health Systems in Moderate to High Malaria Transmission Settings in Africa), which is not on this map. Not yet cited in PubMed.
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An Evaluation of the Pilot Implementation of RTS,S/AS01 Through Routine Health Systems in Moderate to High Malaria Transmission Settings in Africa
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18 authors.
Funding
Abstract
backgroundIn September 2019, Kenya began pilot introduction of the RTS,S/AS01
methodsA cross-sectional, population-representative household survey was conducted from July to October 2019 in all 46 MVIP sub-counties. Using two-stage cluster sampling, 4065 households were enrolled, including 4948 children aged 5-48 months. Structured questionnaires captured data on insecticide-treated net (ITN) ownership and use, vaccination status, recent febrile illness and care-seeking, and vaccine acceptability. Malaria rapid diagnostic tests were performed to estimate malaria prevalence. Analyses accounted for cluster design and sampling weights.
resultsOverall P. falciparum malaria prevalence was 22% (95% CI 19-26), with substantial sub-county variation (1-71%). Prevalence was higher in rural areas, among older children, in lower wealth households, and in areas randomized to vaccine introduction vs. comparison areas, indicating baseline imbalance between the arms. ITN ownership and use were high (93% and 87%). Thirty-eight percent of children had fever in the prior two weeks; 70% sought care, 39% of whom received antimalarials, nearly all artemisinin-combined therapies. Availability of home-based vaccination records declined with age (93% among 5-11 months vs. 63% among 36-48 months). Coverage exceeded 85% for first-year-of-life vaccines, but was lower for measles dose 2 (49%). Vitamin A supplementation (46%) and deworming (50%) coverage were also suboptimal. Before introduction, only 36% of caregivers had heard of the malaria vaccine, yet willingness to vaccinate exceeded 98%.
conclusionsHigh malaria burden, strong coverage of core interventions, and strong caregiver support provided a favorable context for RTS,S introduction. However, gaps in second-year-of-life services and suboptimal vaccination records retention may challenge delivery and monitoring of the 4th RTS,S dose. These findings establish a benchmark for evaluating RTS,S rollout and integration into routine child health services. Trial registration number NCT03806465.
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