Stephaney Gyaase1, Kwaku Poku Asante1,2, Elisha Adeniji1, Owusu Boahen1, Matthew Cairns2, Seth Owusu-Agyei3,4,5. 1. Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana. 2. Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK. 3. Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana. sowusuagyei@uhas.edu.gh. 4. Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK. sowusuagyei@uhas.edu.gh. 5. Institute of Health Research, University of Health and Allied Sciences, Ho, Volta, Ghana. sowusuagyei@uhas.edu.gh.
Abstract
BACKGROUND: In the phase III RTS,S /AS01 trial, significant heterogeneity in efficacy of the vaccine across study sites was seen. Question on whether variations in socio - economic status (SES) of participant contributed to the heterogeinity of the vaccine efficacy (VE) remains unknown. METHODS: Data from the Phase III RTS,S /AS01 trial in children aged 5-17 months in Kintampo were re-analysed. SES of each child was derived from the Kintampo Health and Demographic Surveillance System, using principal component analysis of household assets. Extended Cox regression was used to estimate the interaction between RTS,S/AS01 VE and household SES. RESULTS: Protective efficacy of the RTS,S/AS0 vaccine significantly varied by participant's household SES, thus increase in household SES was associated with an increase in protective efficacy (P-value = 0.0041). Effect modification persisted after adjusting for age at first vaccination, gender, distance from community to the health facility, child's haemoglobin level, household size, place of residence and mothers' educational level. CONCLUSION: Household SES may be a proxy for malaria transmission intensity. The study showed a significant modification of the RTS,S/AS01 malaria vaccine efficacy by the different levels of child's household socio - economic status. TRIAL REGISTRATION: Efficacy of GSK Biologicals' candidate malaria vaccine (25049) against malaria disease in infants and children in Africa. NCT00866619 prospectively registered on 20 March 2009.
BACKGROUND: In the phase III RTS,S /AS01 trial, significant heterogeneity in efficacy of the vaccine across study sites was seen. Question on whether variations in socio - economic status (SES) of participant contributed to the heterogeinity of the vaccine efficacy (VE) remains unknown. METHODS: Data from the Phase III RTS,S /AS01 trial in children aged 5-17 months in Kintampo were re-analysed. SES of each child was derived from the Kintampo Health and Demographic Surveillance System, using principal component analysis of household assets. Extended Cox regression was used to estimate the interaction between RTS,S/AS01 VE and household SES. RESULTS: Protective efficacy of the RTS,S/AS0 vaccine significantly varied by participant's household SES, thus increase in household SES was associated with an increase in protective efficacy (P-value = 0.0041). Effect modification persisted after adjusting for age at first vaccination, gender, distance from community to the health facility, child's haemoglobin level, household size, place of residence and mothers' educational level. CONCLUSION: Household SES may be a proxy for malaria transmission intensity. The study showed a significant modification of the RTS,S/AS01malaria vaccine efficacy by the different levels of child's household socio - economic status. TRIAL REGISTRATION: Efficacy of GSK Biologicals' candidate malaria vaccine (25049) against malaria disease in infants and children in Africa. NCT00866619 prospectively registered on 20 March 2009.
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Authors: Mustapha A Ahmed; Elvis O Ameyaw; Francis Ackah-Armah; Desmond O Acheampong; Benjamin Amoani; Paulina Ampomah; Emmanuel A Adakudugu; Christian K Adokoh Journal: J Tradit Complement Med Date: 2021-12-03