Effectiveness of malaria vaccination against clinical malaria in Ethiopia: a test-negative study adjusting for vaccine uptake and bed net utilization
PhD candidate: Chaltu Fikru
Institution: Jimma University, Department of Epidemiology and Biostatistics
Supervisors: Dr. M. Sanni Ali, Prof. Delenasaw Yewhalaw
This PhD research aims to assess the effectiveness of malaria vaccination against clinical malaria among under-five children in Ethiopia using a test-negative study design, while examining trends in clinical malaria to contextualize changes in disease burden. Malaria remains a major public health challenge in the WHO African Region, with Ethiopia contributing significantly to the overall disease burden. In 2024, more than 7.3 million malaria cases and 1,157 deaths were reported nationwide, marking the highest incidence recorded in the past seven years. This recent increase has been linked to disruptions in malaria prevention and control interventions, health system limitations, climate variability, and rapid urbanization.
Ethiopia has initiated the implementation of malaria vaccination (R21/Matrix-M) as part of its broader malaria control strategy, in selected settings. This evolving intervention landscape highlights the need for robust, context-specific evidence to better understand the real-world performance of malaria control efforts and to inform program optimization.
The study will be conducted in selected high-transmission areas of Ethiopia. A test-negative design will be employed to examine differences in exposure patterns between children who test positive and those who test negative for malaria. In addition, routine health information system data will be used to analyze trends in malaria incidence over time. The study will also explore the coverage and utilization of key interventions, including access to and use of insecticide-treated nets, as well as community acceptance and uptake of malaria vaccination.
The findings from this research are expected to inform malaria control strategies, strengthen program implementation, and contribute to reducing malaria-related morbidity and mortality in Ethiopia.