Acceptability and Potential Implementation Feasibility of Malaria Vaccination Combined with Perennial Malaria Chemoprevention.

January 10, 2025 | Ongoing Project | Reading time: 8 min

Introduction

KHRC and London School of Hygiene &Tropical Medicine (LSHTM) are conducting this study as part of the MalVac-PMC trial to assess how well people accept and how practical it is to combine perennial malaria chemoprevention (PMC) using either SP or SPAQ, with the RTS,S/AS01E malaria vaccine, to protect children from malaria. The study will also try to understand how health workers, caregivers, and communities feel about delivering and receiving this combined treatment. Funded by PATH, this study also seeks to provide evidence on the practical challenges of implementing the combined intervention in the routine health system.

Investigators

Samuel Afari-Asiedu, Jane Grant, Jayne Webster, Seth Arthur.

Main Trial Investigators: Kwaku Poku Asante, KHRC, Ghana, Daniel Chandramohan, LSHTM, UK, Brian Greenwood, LSHTM, United Kingdom, Rose Zulliger, USAID, USA, Nana Wilson, CDC, Ghana, Laura Steinhardt, CDC, USA, Julie Gutman, CDC, USA.

Background

Malaria remains a major health problem for children in sub-Saharan Africa. Many countries are now considering, or will soon consider, using a combination of malaria prevention methods such as year-round malaria chemoprevention (PMC) and/or malaria vaccination. However, there is no existing evidence to show how well these two methods work together.

To address this, the MalVac-PMC trial began in Ghana in 2023. This study is exploring the potential benefits of combining PMC, using either SP or SPAQ, with the RTS,S/AS01E malaria vaccine. It is the first trial to investigate this combination, with both interventions being delivered through the essential immunization program (EPI) to children under two years old.

Objectives
This study looks at how acceptable and practical it would be to combine malaria vaccination with PMC. It focuses on the views of healthcare workers who deliver these services and the communities that receive them. This study is part of the larger MalVac-PMC trial led by the Kintampo Health Research Centre and the London School of Hygiene and Tropical Medicine.

Study Methodology
This study uses a mixed-methods approach with two main components.

First, in-depth interviews (IDIs) and focus group discussions (FGDs) will be conducted with caregivers of children receiving the interventions, as well as health workers and managers delivering them. These discussions will explore how acceptable it is to combine PMC with the RTS,S malaria vaccine, the factors that influence this acceptability, and whether it is feasible to deliver both through the routine health system. Qualitative data will be collected in two phases: the first when children are receiving their initial doses of the malaria vaccine and PMC-SP/SPAQ/placebo in infancy, and the second when they are receiving follow-up doses in their second year of life.

Secondly, the insights from the qualitative data will be used to develop a discrete choice experiment (DCE). This experiment will measure health workers’ preferences for delivering either the RTS,S/AS01E vaccine alone or in combination with PMC-SP or PMC-SPAQ, considering the schedules and delivery methods within the routine immunization program (EPI).

Expected Outcomes
The study is expected to develop a comprehensive understanding of the acceptability and implementation feasibility of the combined malaria vaccine and PMC intervention from multiple stakeholder perspectives. It will also strengthen understanding of health worker preferences and suggested delivery approaches. The findings will be used alongside the trial result to inform policy decisions within Ghana and to strengthen global evidence on whether and how to co-administer these two interventions.

Funder
PATH, USA.

Study Duration
Two (2) Years
Start Date
March 2024
End Date
February 2026