EVALUATION OF MALARIA VACCINATION WITH RTS,S/AS01 (MOSQUIRIX™) AMONG CHILDREN ATTENDING TWO DISTRICT HOSPITALS IN THE CENTRAL REGION OF CAMEROON

Abstract

Malaria is a major cause of illness and death among children under five in sub-Saharan Africa. Recent progress in vaccine development, including RTS,S/AS01 shows promise for disease control with encouraging efficacy and safety profiles. This cross-sectional study assessed malaria prevalence and vaccination coverage among children under five years in two district hospitals, Soa and Biyem-Assi, in the Central Region of Cameroon. Among 450 children, 19.56% (88/450) tested positive for malaria, while 47.11% (212/450) had received at least one malaria vaccine dose. Malaria prevalence was lower among vaccinated than unvaccinated children (13.21% vs. 25.21%; OR=0.45, 95% CI: 0.28–0.73; p=0.0013). Rural residence was associated with higher malaria prevalence (30.77% vs. 18.09% in urban areas; p=0.0302). Among vaccinated children, malaria was significantly associated with age, residence, household income, number of vaccine doses, and time since the last dose. In multivariable analysis, ≥3 vaccine doses were associated with lower odds of malaria infection (AOR=0.33, 95% CI: 0.19–0.57; p<0.001), while ≥3 months since the last dose was associated with higher odds (AOR=2.22, 95% CI: 1.52–3.25; p<0.001). Vaccination status itself was not significantly associated with malaria after adjustment (AOR=1.10, 95% CI: 0.29–4.15; p=0.886). Although vaccinated children had lower malaria prevalence in the crude analysis, vaccination status was not independently associated with malaria infection after adjustment. Completion of the recommended vaccine doses and timely receipt of subsequent doses were associated with lower malaria infection, highlighting the importance of maintaining the recommended vaccination schedule.