Zacharia Mansulu Mohammed, Ziema Sorengmen Amos, Abanga Williams Azumah, Kyeremeh Richard Adinkrah, Tamal Christopher Sunkwa, Adjei Michael Rockson, Kubio Chrysantus
Sunyani Municipal Health Directorate, Ghana Health Service, Sunyani, Ghana.
Department of Health Information and Records Management, Ho Teaching Hospital, Ho, Ghana.
Vaccine. 2024 Dec 2;42(26):126490. doi: 10.1016/j.vaccine.2024.126490. Epub 2024 Oct 31.
Following the successful pilot of RTS,S malaria vaccine, it has been recommended by the WHO for prevention of Plasmodium falciparum malaria in children living in endemic areas. Despite the proven benefits of the malaria vaccine, uptake especially of the fourth dose, remains relatively low. We assessed complete uptake of RTS,S malaria vaccine among children 24-59 months and associated factors in the Sunyani Municipality of Ghana.
A cross-sectional study was conducted among 361 caregivers of children aged 24-59 months in the Sunyani Municipality, who had received at least one dose of RTS,S malaria vaccine. Structured questionnaires were administered to caregivers and relevant vaccination information was extracted from the maternal and child health record books. Binary logistic regression analysis was used to determine factors associated with complete uptake of the vaccine at 95 % confidence interval (CI).
Approximately 45 % (164/361) of the children had completed the RTS,S malaria vaccination schedule. Children aged 48-59 months (AOR:0.26, 95 %CI:0.09-0.76), those with caregivers who believed that children were being used for experiment (AOR:0.29, 95 %CI:0.16-0.54) or doubted the safety of the vaccine (AOR:0.27, 95 %CI:0.14-0.52) were less likely to complete the four doses. On the other hand, children of caregivers who reported vaccine shortages and travelled long distances to access immunization services (AOR:3.15, 95 %CI:1.17-8.47), and those with adequate knowledge on the malaria vaccine (AOR:1.89, 95 %CI:1.08-3.29) were more likely to complete the vaccination schedule.
Less than half of the children who started RTS,S malaria vaccination completed the full schedule. Age of child, caregiver knowledge and perception of the malaria vaccine, and access to immunization service were associated with complete uptake of the RTS,S malaria vaccine. Strengthening caregiver education and access to immunization services could improve uptake of the subsequent doses and coverage of the fourth dose.
在RTS,S疟疾疫苗试点成功后，世界卫生组织已建议在疟疾流行地区用于预防儿童感染恶性疟原虫。尽管疟疾疫苗的益处已得到证实，但其接种率，尤其是第四剂的接种率仍然相对较低。我们评估了加纳苏尼亚尼市24至59个月儿童中RTS,S疟疾疫苗的全程接种情况及相关因素。
对苏尼亚尼市361名24至59个月儿童的看护者进行了一项横断面研究，这些儿童至少接种过一剂RTS,S疟疾疫苗。向看护者发放结构化问卷，并从母婴健康记录簿中提取相关疫苗接种信息。采用二元逻辑回归分析确定在95%置信区间（CI）下与疫苗全程接种相关的因素。
约45%（164/361）的儿童完成了RTS,S疟疾疫苗接种程序。48至59个月的儿童（调整后比值比[AOR]：0.26，95%CI：0.09 - 0.76）、看护者认为儿童被用于实验的儿童（AOR：0.29，95%CI：0.16 - 0.54）或对疫苗安全性存疑的儿童（AOR：0.27，95%CI：0.14 - 0.52）完成四剂接种的可能性较小。另一方面，看护者报告疫苗短缺且长途跋涉获取免疫服务的儿童（AOR：3.15，95%CI：1.17 - 8.47）以及对疟疾疫苗有充分了解的儿童（AOR：1.89，95%CI：1.08 - 3.29）更有可能完成接种程序。
开始接种RTS,S疟疾疫苗的儿童中不到一半完成了全程接种。儿童年龄、看护者对疟疾疫苗的了解和认知以及免疫服务的可及性与RTS,S疟疾疫苗的全程接种相关。加强看护者教育和免疫服务可及性可能会提高后续剂次的接种率和第四剂的覆盖率。
