About this trial
This is a multi-site, multi-disciplinary, Phase-4 two-arm cluster-randomised non-inferiority trial in Burkina Faso and Mali to evaluate the effectiveness and real-life impact of a novel integrated delivery strategy of the R21 malaria vaccine alongside SMC among children in areas with highly seasonal malaria transmission. In this study, a cluster is defined as the catchment area of a health centre. Clusters will be randomised to receive either year-round age-based routine EPI vaccination for children aged 5-36 months ("Routine EPI Vaccination") in Burkina Faso or an annual campaign of the 3-dose primary series in children aged 5-36 months prior to the malaria season and SMC delivery (''Routine Pre-SMC vaccination'') in Mali versus an annual campaign of the 3-dose primary series aligned with SMC distribution in children aged 3-59 months ("Integrated SMC Vaccination") in each country. Effectiveness will be assessed in terms of clinical malaria, vaccine coverage, acceptability, feasibility, and cost-effectiveness.
Malaria incidence will be determined using routine surveillance activities for clinical malaria detection and reporting in each country. Cross-sectional surveys will be conducted to determine the prevalence of parasitaemia in the communities. In addition, the acceptability, feasibility, coverage and cost-effectiveness of the different delivery systems of R21/Matrix-M will be assessed.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Children aged 5-36 months in Burkina Faso and Mali at the time of first study vaccination;
Resident in the catchment area of a health centre assigned to the control arm;
Willingness to comply with the study procedures;
Written informed consent from Parent/Guardian.
Disqualifiers
History of allergic disease or reactions likely to be exacerbated by any component of the Vaccines;
Any history of anaphylaxis in relation to vaccination;
Known chronic illness;
Any other significant disease, disorder or situation which, in the opinion of the Investigator, may either put the participants at risk because of participation in the trial, or may influence the result of the trial, or the participant's ability to participate in the trial;
Trial design
Parallel
Treatments tested in this trial
Annual campaign of the 3-dose primary series vaccine R21/Matrix-M aligned with SMC distribution in children aged 3-59 months
Other interventionin the intenvention arm, the children will get the vaccine R21 Matrix M together with the CPS
Treatment groups
Trial outcomes
Primary outcomes
Malaria Incidence on 5-36 months at 12 months
Malaria incidence among children aged 5-36 months over 12 months post first dose using routine surveillance activities for clinical malaria detection and reporting
Secondary outcomes
Malaria incidence among children aged 5-36 months over 24 and 36 months
Malaria incidence among children aged 5-36 months over 24 and 36 months post first dose using routine surveillance activities for clinical malaria detection and reporting;
Malaria incidence among children aged 3-59 months over 24 and 36 months
Malaria incidence among children aged 3-59 months over 24 and 36 months post first dose using routine surveillance activities for clinical malaria detection and reporting
Malaria prevalence at peak transmission
Malaria prevalence at peak transmission in November after SMC campaigns in 2025 and 2026
Vaccine coverage
Pourcentage of children who has received 3 or 4 doses at 24 months post 1st vaccination
Sponsors and contacts
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Epicentre
Lead sponsor
R-Evolution Worldwide
Collaborator
CNRST Burkina Faso
Collaborator
USTTB Mali
Collaborator
Liverpool School of Tropical Medicine
Collaborator