METHODS: Monthly dose-specific immunization data for 23 sub-counties were obtained from routine health information systems at the facility level for 2019-2022. Coverage of each RTS,S/AS01 dose was determined using reported doses as a numerator and service-based (Penta 1 and Measles) or population (projected infant populations from WorldPop) as denominators. Descriptive statistics of vaccine delivery, dropout rates and coverage estimates were computed across the 36-month implementation period.
RESULTS: Over 36 months, 818,648 RTSS/AS01 doses were administered. Facilities managed by the Ministry of Health and faith-based organizations accounted for over 88% of all vaccines delivered. Overall, service-based malaria vaccine coverage was 96%, 87%, 78%, and 39% for doses 1-4 respectively. Using a population-derived denominator for age-eligible children, vaccine coverage was 78%, 68%, 57%, and 24% for doses 1-4, respectively. Of the children that received measles dose 1 vaccines delivered at 9 months (coverage: 95%), 82% received RTSS/AS01 dose 3, only 66% of children who received measles dose 2 at 18 months (coverage: 59%) also received dose 4.
CONCLUSIONS: The implementation programme successfully maintained high levels of coverage for the first three doses of RTSS/AS01 among children defined as EPI service users up to 9 months of age but had much lower coverage within the community with up to 1 in 5 children not receiving the vaccine. Consistent with vaccines delivered over the age of 1 year, coverage of the fourth malaria dose was low. Vaccine uptake, service access and dropout rates for malaria vaccines require constant monitoring and intervention to ensure maximum protection is conferred.
方法:从2019-2022年设施级别的常规卫生信息系统中获得了23个县的每月剂量特异性免疫数据。每个RTS的覆盖范围,S/AS01剂量是使用报告的剂量作为分子并以服务为基础(Penta1和麻疹)或人口(WorldPop的预计婴儿人口)作为分母来确定的。疫苗交付的描述性统计,辍学率和覆盖率估计是在36个月的实施期内计算的。
结果:超过36个月,施用818,648个RTSS/AS01剂量。由卫生部和宗教组织管理的设施占交付的所有疫苗的88%以上。总的来说,以服务为基础的疟疾疫苗覆盖率为96%,87%,78%,剂量1-4分别为39%。对符合年龄的儿童使用人口派生分母,疫苗覆盖率为78%,68%,57%,剂量1-4分别为24%。在9个月时接种了1剂麻疹疫苗的儿童中(覆盖率:95%),82%的人接受了RTSS/AS01剂量3,只有66%的儿童在18个月时接受了麻疹剂量2(覆盖率:59%)也接受了剂量4。
结论:实施计划成功地将RTSS/AS01的前三剂覆盖率维持在9个月以下被定义为EPI服务使用者的儿童中,但社区内的覆盖率要低得多,多达五分之一的儿童没有接种疫苗。与1岁以上交付的疫苗一致,第四次疟疾剂量的覆盖率很低。疫苗摄取,疟疾疫苗的服务获取和辍学率需要不断监测和干预,以确保给予最大限度的保护。