title: Predictions of the epidemiologic impact of introducing a pre-erythrocytic vaccine into the expanded program on immunization in sub-Saharan Africa.
abstract: We predict the effects of introduction of a pre-erythrocytic vaccine against Plasmodium falciparum into a malaria-endemic population in Africa. We use a stochastic simulation model that includes components of transmission, parasitology, and clinical epidemiology of malaria and was validated using the results of field trials of the RTS,S/AS02A vaccine. The results suggest that vaccines with efficacy similar to that of RTS,S/AS02A have a substantial impact on malaria morbidity and mortality during the first decade after their introduction, but have negligible effects on malaria transmission at levels of endemicity typical for sub-Saharan Africa. The main benefits result from prevention of morbidity and mortality in the first years of life. Vaccines with very short half-life or low efficacy may have little overall effect on incidence of severe malaria. A similar approach can be used to make predictions for other strategies for deployment of the vaccine and to other types of malaria vaccines and interventions.
authors.affiliation: Swiss Tropical Institute, Basel, Switzerland. nicolas.maire@unibas.ch
authors.forename: Nicolas
authors.initials: N
authors.lastname: Maire
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Tediosi
authors.forename: Amanda
authors.initials: A
authors.lastname: Ross
authors.forename: Thomas
authors.initials: T
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004912:Erythrocytes / Q000469:parasitology; D006801:Humans; D007223:Infant; D017780:Malaria Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D008875:Middle Aged; D008954:Models, Biological; D012621:Seasons; D013997:Time Factors; D014611:Vaccination
chemical_list: D017780:Malaria Vaccines