Ethical considerations for introducing RTS,S/AS01 in countries with moderate to high Plasmodium falciparum malaria transmission

D'Souza, Jeff; Nderitu, David

doi:10.1016/s2214-109x(21)00498-8

Cited by 5 publications

(4 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Importantly, our findings on the wide acceptance of RTS,S bring child caregiver voices to global discussions on the programmatic viability of a malaria vaccine with moderate efficacy [ 29 ]. They also inform demand creation and communications strategies.…”

Section: Discussionmentioning

confidence: 99%

Acceptance of and Adherence to a Four-Dose RTS,S/AS01 Schedule: Findings from a Longitudinal Qualitative Evaluation Study for the Malaria Vaccine Implementation Programme

Price,

Gurley,

Gyapong

et al. 2023

Vaccines

View full text Add to dashboard Cite

Background: The WHO recommended the use of the RTS,S/AS01 malaria vaccine (RTS,S) based on a pilot evaluation in routine use in Ghana, Kenya, and Malawi. A longitudinal qualitative study was conducted to examine facilitators and barriers to uptake of a 4-dose RTS,S schedule. Methods: A cohort of 198 caregivers of RTS,S-eligible children from communities where RTS,S was provided through the pilot were interviewed three times over a ≈22-month, 4-dose schedule. The interviews examined caregiver perceptions and behaviors. Children’s vaccination history was obtained to determine dose uptake. Results: 162 caregivers remained at round 3 (R3); vaccination history was available for 152/162 children. Despite early rumors/fears, the uptake of initial doses was high, driven by vaccine trust. Fears dissipated by R2, replaced with an enthusiasm for RTS,S as caregivers perceived its safety and less frequent and severe malaria. By R3, 98/152 children had received four doses; 34 three doses; 9 one or two doses; and 11 zero doses. The health system and information barriers were important across all under-dose cases. Fears about AEFIs/safety were important in zero-, one-, and two-dose cases. Competing life/livelihood demands and complacency were found in three-dose cases. Regardless of the doses received, caregivers had positive attitudes towards RTS,S by R3. Conclusions: Findings from our study will help countries newly introducing the vaccine to anticipate and preempt reasons for delayed acceptance and missed RTS,S doses.

show abstract

Section: Discussionmentioning

confidence: 99%

Acceptance of and Adherence to a Four-Dose RTS,S/AS01 Schedule: Findings from a Longitudinal Qualitative Evaluation Study for the Malaria Vaccine Implementation Programme

Price,

Gurley,

Gyapong

et al. 2023

Vaccines

View full text Add to dashboard Cite

show abstract

“…Interestingly, adopting the knowledge, expertise, and capacity of early-career scientists in vaccine-development activities is the key, as such, the teaching of vaccinology will allow for a better understanding of important areas of the vaccine-development process [ 68 ]. It is also necessary to develop effective strategies and policies that will bridge the gap between vaccine equity and acceptance within communities in sub-Saharan Africa [ 69 , 70 ].…”

Section: Conclusion and Recommendations For Future Researchmentioning

confidence: 99%

Increasing challenges of malaria control in sub-Saharan Africa: Priorities for public health research and policymakers

Oladipo

Tajudeen

Oladunjoye

et al. 2022

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

“…The suggested P. falciparum vaccine is ineffective against P. vivax and other types of malaria [ 14 ]. Adopting RTS,S would also provide indirect benefits, such as a decrease in malaria-related all-cause hospitalization, which would free up possibly limited health resource allocations for other people in need [ 47 ].…”

Section: Control Challengesmentioning

confidence: 99%

Plasmodium vivax: the potential obstacles it presents to malaria elimination and eradication

Habtamu

Petros

Yan

2022

Trop Dis Travel Med Vaccines

View full text Add to dashboard Cite

Initiatives to eradicate malaria have a good impact on P. falciparum malaria worldwide. P. vivax, however, still presents significant difficulties. This is due to its unique biological traits, which, in comparison to P. falciparum, pose serious challenges for malaria elimination approaches. P. vivax's numerous distinctive characteristics and its ability to live for weeks to years in liver cells in its hypnozoite form, which may elude the human immune system and blood-stage therapy and offer protection during mosquito-free seasons. Many malaria patients are not fully treated because of contraindications to primaquine use in pregnant and nursing women and are still vulnerable to P. vivax relapses, although there are medications that could radical cure P. vivax. Additionally, due to CYP2D6's highly variable genetic polymorphism, the pharmacokinetics of primaquine may be impacted. Due to their inability to metabolize PQ, some CYP2D6 polymorphism alleles can cause patients to not respond to treatment. Tafenoquine offers a radical treatment in a single dose that overcomes the potentially serious problem of poor adherence to daily primaquine. Despite this benefit, hemolysis of the early erythrocytes continues in individuals with G6PD deficiency until all susceptible cells have been eliminated. Field techniques such as microscopy or rapid diagnostic tests (RDTs) miss the large number of submicroscopic and/or asymptomatic infections brought on by reticulocyte tropism and the low parasitemia levels that accompany it. Moreover, P. vivax gametocytes grow more quickly and are much more prevalent in the bloodstream. P. vivax populations also have a great deal of genetic variation throughout their genome, which ensures evolutionary fitness and boosts adaptation potential. Furthermore, P. vivax fully develops in the mosquito faster than P. falciparum. These characteristics contribute to parasite reservoirs in the human population and facilitate faster transmission. Overall, no genuine chance of eradication is predicted in the next few years unless new tools for lowering malaria transmission are developed (i.e., malaria elimination and eradication). The challenging characteristics of P. vivax that impede the elimination and eradication of malaria are thus discussed in this article.

show abstract

Ethical considerations for introducing RTS,S/AS01 in countries with moderate to high Plasmodium falciparum malaria transmission

Cited by 5 publications

References 4 publications

Acceptance of and Adherence to a Four-Dose RTS,S/AS01 Schedule: Findings from a Longitudinal Qualitative Evaluation Study for the Malaria Vaccine Implementation Programme

Acceptance of and Adherence to a Four-Dose RTS,S/AS01 Schedule: Findings from a Longitudinal Qualitative Evaluation Study for the Malaria Vaccine Implementation Programme

Increasing challenges of malaria control in sub-Saharan Africa: Priorities for public health research and policymakers

Plasmodium vivax: the potential obstacles it presents to malaria elimination and eradication

Contact Info

Product

Resources

About