“Relief” as RTS,S malaria vaccine rollout set to begin in Burkina Faso

Burkina Faso suffers a “deplorable” annual death toll from malaria, with clinics and hospitals filled to overwhelm during the worst season. Health workers, parents and leaders hope that burden is about to ease.

  • 1 February 2024
  • 8 min read
  • by Abdel Aziz Nabaloum
Tens of thousands of children may benefit from routine malaria vaccination beginning at the start of February. Credit : Abel Aziz Nabaloum
Tens of thousands of children may benefit from routine malaria vaccination beginning at the start of February. Credit : Abel Aziz Nabaloum
 

 

Aminata Ilboudo nearly lost her two children, Awa, aged 4, and Nafissatou, just 20 months, to malaria last July.

As a widow without a job, living in the working-class Sector 41 area of Ouagadougou, Burkina Faso's capital, Ilboudo had to seek help from kind-hearted individuals to secure the necessary infusions of antimalarial drugs and pain relief for her hospitalised children. "Honestly, without the support of those helping the sick who contributed to paying for the medications, my children wouldn't have made it. Just imagine, prescriptions costing 8,000 francs [West African CFA franc, about US$ 13] for a widow – it's tough to pay," she says, tears welling up in her eyes.

“This toll is deplorable. Children under five years old, as well as pregnant women, are the most vulnerable to malaria."

– Christian Kompaoré, Permanent Secretary for Malaria Elimination.

Like the Ilboudo family, the Sawadogo household is no stranger to a malaria crisis. During the rainy season, a time of increased malaria transmission, Latifatou Sawadogo's three children struggle to avoid mosquito bites. "And this presents numerous challenges for me. Affording their medications becomes a significant issue. Last August, my youngest, at one year old, fell ill. I had to borrow 7,000 francs (about US$ 12) to buy her medications. To this day, I still carry this debt," shares the young mother.

19,000 deaths a year

When it comes to malaria, Burkina Faso is one of worst-hit places in the world. In 2021, almost 12.5 million cases of the disease were recorded across the country, equating to an incidence rate of 569 cases per 1,000 population. 

Officially, 4,355 people were reported to have died of the parasitic infection, although World Health Organization estimates for the actual death toll that year stand as high as 18,976.

"This toll is deplorable. Children under five years old, as well as pregnant women, are the most vulnerable to malaria. It is precisely this segment of the population that bears the heaviest burden in the face of this disease. Their immunity, immature for children and declining for pregnant women, makes them particularly susceptible to malaria," explains Christian Kompaoré, Permanent Secretary for Malaria Elimination.

A health worker filling a syringe with malaria vaccine.
Credit : Gavi/2024/Go'tham Industry

Between June and October each year, a steep seasonal surge in cases sees health centres in the city and countryside alike struggle with overcrowding. In corridors, patients often lie on the floor, while others drag their IV drips to the shade of the trees in the hospital courtyard.

“For a parasitic disease like malaria, having multiple strategies is crucial. While we’ve had various approaches before, the incorporation of a vaccination strategy with RTS,S in 2024 marks a significant leap forward. It signifies a new direction that will fundamentally reshape our approach to tackling this disease,”

– Christian Kompaoré, Permanent Secretary for Malaria Elimination

"Often, there are no available beds to admit patients. Others are forced to return home after receiving a quick initial treatment to continue their therapy," laments Boukary Kafando, a health care worker at the Centre for Health and Social Promotion (CSPS) in Sector 8, Ouagadougou. In his health care facility, 80% of patients are ill with malaria. "In addition to the elderly, unfortunately, more than half of the patients are children. It's truly disheartening," he confirms.

Vaccination offers new hope

But on 5 February 2024, Burkina Faso will introduce the RTS,S malaria vaccine into its Expanded Programme on Immunization (EPI) across 27 health districts, adding a new tool to the arsenal of measures combating the vector-borne disease.

"For a parasitic disease like malaria, having multiple strategies is crucial. While we've had various approaches before, the incorporation of a vaccination strategy with RTS,S in 2024 marks a significant leap forward. It signifies a new direction that will fundamentally reshape our approach to tackling this disease," affirms Kompaoré.

250,000 children to benefit in first wave

The initial phase of the vaccine roll-out aims to reach nearly 250,000 children aged 5–23 months, across 27 health districts out of the total 70.

"Due to constraints tied to the limited number of available doses, our choice has been to concentrate the usage of this vaccine within these 27 districts. These areas were selected because of the consistently high number of cases and deaths recorded annually. In regions where infant mortality is notably high, the objective is to boost the immunity of at least 95% of children in these districts, significantly curbing mortality in the selected areas," explains Dr Issa Ouédraogo, the Director General of Health and Public Hygiene.

"In regions where infant mortality is notably high, the objective is to boost the immunity of at least 95% of children in these districts, significantly curbing mortality in the selected areas."

– Dr Issa Ouédraogo, the Director General of Health and Public Hygiene

In the districts chosen for vaccine deployment, doses will be administered during routine vaccination sessions at health care facilities as part of a fixed strategy, and additionally during outreach campaigns conducted in familiar vaccination locations in villages. "Every effort is being made to ensure the success of these vaccination campaigns. We have taken steps in all districts to ensure that health centres are equipped with refrigerators to effectively preserve the vaccines being deployed," states Dr Issa Ouédraogo.

Dr Rasmané Ouédraogo, a general practitioner based in the Karangasso Vigué health district in the west of the country, emphasises the immense benefits of deploying this vaccine in his district, where malaria is prevalent.

"In my district we foresee a decline in mortality cases. This underscores the importance of the vaccine, and its introduction promises substantial relief for children. Parents should feel confident in the vaccine and not be swayed by misinformation when it comes to vaccinating their children."

– Dr Rasmané Ouédraogo, general practitioner, Karangasso Vigué health district

"This will play a crucial role in reducing infant mortality, as the primary goal of the vaccine is to minimise complications that often lead to fatalities. In my district, by alleviating these complications, we foresee a decline in mortality cases. This underscores the importance of the vaccine, and its introduction promises substantial relief for children. Parents should feel confident in the vaccine and not be swayed by misinformation when it comes to vaccinating their children," the physician says.

Breaking the chains of vaccine misinformation

To combat the spread of false information about vaccination, particularly on social media, a series of measures has been implemented.

"We often hear women saying that vaccination aims to make their children sterile. We reassure them through hospital talks that this is not the case," says Ali Diallo, a Community-Based Health Agent in the health district of Dori in the Sahel region. "In the district's Health and Social Promotion Centres, when women come for consultations, we assure them that the vaccine is safe and effective. Our goal is to break these chains of false information," emphasises Diallo. Awareness campaigns, including door-to-door visits, are already underway to reassure all mothers and encourage them to vaccinate their children.

“You cannot imagine how much this vaccine will relieve us, the parents. Every year, at any time, my daughter experiences malaria crises. Health agents have assured us of the vaccine’s quality. We have trust.”

– Awa Compaoré, mother to 2-year-old Sarata

Ollo Sié, a Community-Based Health Agent and coordinator for vaccination mobilisation in the Loropeni municipality in the Southwest region, highlights the importance of awareness to counter vaccine-related rumours. "In our health centre, we regularly organise discussions with women to tell them not to believe false information. They have reaffirmed their commitment to come out massively to vaccinate their children," he claims.

The Permanent Secretariat for Malaria Elimination, led by Christian Kompaoré, expresses confidence. "We have no doubt about the population's adherence to this vaccine. We have intensified media awareness against false information and developed a communication plan that will enable us to achieve better participation from the communities," he confides.

Awa Compaoré, residing in Kombissiri, located 45km from Ouagadougou, expresses joy at the thought that her two-year-old daughter, Sarata, will soon no longer suffer from severe malaria, often referred to as the "child killer". She shares with a radiant smile: "You cannot imagine how much this vaccine will relieve us, the parents. Every year, at any time, my daughter experiences malaria crises. Health agents have assured us of the vaccine's quality. We have trust."

This article was translated from the original French. To view the original click here


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