Clinical presentation of severe malaria in children who received the RTS,S/AS01E malaria vaccine, seasonal malaria chemoprevention or the combination of both interventions in Burkina Faso and Mali.
6 affiliations
- 1Malaria Research and Training Center, University of Science, Techniques and Technology of Bamako, Point G, P. O. Box 1805, Bamako, Mali. [email protected].
- 2Institut des Sciences et Techniques & Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso.
- 3Malaria Research and Training Center, University of Science, Techniques and Technology of Bamako, Point G, P. O. Box 1805, Bamako, Mali.
- 4London School of Hygiene and Tropical Medicine, London, UK.
- 5PATH, Washington, DC, USA.
- 6GSK, Wavre, Belgium.
Abstract
Background
Severe Plasmodium falciparum malaria is a leading cause of death in sub-Saharan Africa, with most deaths occurring in children younger than five years of age. The RTS,S/AS01E (RTS,S) malaria vaccine delivered seasonally with Seasonal Malaria Chemoprevention (SMC) led to a two-third reduction in severe malaria and malaria deaths compared with either intervention given alone. The aim of this study was to assess and compare the clinical phenotype distribution among severe malaria admissions by intervention groups and country.Methods
We conducted a secondary ad-hoc analysis of hospital admissions in children aged 5 to 17 months of age when enrolled in the RTS,S + SMC trial in April 2017 in Houndé, Burkina Faso, and Bougouni, Mali, and who were followed until they reached five years of age.Results
Among the 5,920 children enrolled in Burkina Faso and Mali, 337 serious adverse events were reported during the trial with 222 (65.9%) in Burkina Faso and 115 (34.1%) in Mali, and 48.1% (162/337) due to severe malaria. The mean age of children with severe malaria was 2.9 years; 79.0% (128/162) of the cases occurred in children aged 3 years or less and 21.0% (34/162) in those aged 4 to 5 years. The most common presentation was severe anemia reported in 50% (81/162) of children, followed by repeated convulsions 25.3%, (41/162), prostration 11.1%, (18/162), hyperparasitaemia 8.0%, (13/162) and cerebral malaria 6.2%, (10/162). The proportion of children with the severe malaria anemia phenotype was higher among severe malaria cases in the SMC alone arm 62.1%, (36/58) compared to those in the SMC + RTS,S arm 37.1%, (13/35), p = 0.048. There was no significant difference in the proportion of other clinical presentations between the study arms. Most severe malaria cases, 85.8% (139/162) occurred during the transmission season (July to December).Conclusions
Severe anemia was the most common presentation of severe malaria in study children and its proportion among severe malaria cases was highest in the SMC alone arm. Children aged 3 years or less were the most affected and almost all the severe malaria cases occurred between July and December. Trial registration ClinicalTrials.gov, NCT04319380.
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BibTeX
@article{issiaka2026clinical,
title = {{Clinical presentation of severe malaria in children who received the RTS,S/AS01E malaria vaccine, seasonal malaria chemoprevention or the combination of both interventions in Burkina Faso and Mali.}},
author = {Djibrilla Issiaka and Issaka Zongo and Youssoufa Sidibe and Yves Daniel Compaoré and Rakiswendé Serge Yerbanga and Mahamadou Kaya and Charles Zoungrana and Romaric Oscar Zerbo and Oumar M Dicko and Youssouf Kone and Amadou Tapily and Seydou Traore and Koualy Sanogo and Modibo Diarra and Amadou Barry and Almahamoudou Mahamar and Alassane Haro and Ismail Thera and M Sanni Ali and Paul Snell and Jane Grant and Irene Kuepfer and Cynthia K Lee and Christian F Ockenhouse and Opokua Ofori-Anyinam and Paul Milligan and Issaka Sagara and Halidou Tinto and Jean Bosco Ouedraogo and Daniel Chandramohan and Brian Greenwood and Alassane Dicko},
journal = {Malaria journal},
year = {2026},
month = jul,
doi = {10.1186/s12936-026-06062-0},
url = {https://europepmc.org/article/MED/42968153},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Clinical presentation of severe malaria in children who received the RTS,S/AS01E malaria vaccine, seasonal malaria chemoprevention or the combination of both interventions in Burkina Faso and Mali.
AU - Djibrilla Issiaka
AU - Issaka Zongo
AU - Youssoufa Sidibe
AU - Yves Daniel Compaoré
AU - Rakiswendé Serge Yerbanga
AU - Mahamadou Kaya
AU - Charles Zoungrana
AU - Romaric Oscar Zerbo
AU - Oumar M Dicko
AU - Youssouf Kone
AU - Amadou Tapily
AU - Seydou Traore
AU - Koualy Sanogo
AU - Modibo Diarra
AU - Amadou Barry
AU - Almahamoudou Mahamar
AU - Alassane Haro
AU - Ismail Thera
AU - M Sanni Ali
AU - Paul Snell
AU - Jane Grant
AU - Irene Kuepfer
AU - Cynthia K Lee
AU - Christian F Ockenhouse
AU - Opokua Ofori-Anyinam
AU - Paul Milligan
AU - Issaka Sagara
AU - Halidou Tinto
AU - Jean Bosco Ouedraogo
AU - Daniel Chandramohan
AU - Brian Greenwood
AU - Alassane Dicko
PY - 2026
DA - 2026/07/22
JO - Malaria journal
DO - 10.1186/s12936-026-06062-0
UR - https://europepmc.org/article/MED/42968153
AB - Background Severe Plasmodium falciparum malaria is a leading cause of death in sub-Saharan Africa, with most deaths occurring in children younger than five years of age. The RTS,S/AS01E (RTS,S) malaria vaccine delivered seasonally with Seasonal Malaria Chemoprevention (SMC) led to a two-third reduction in severe malaria and malaria deaths compared with either intervention given alone. The aim of this study was to assess and compare the clinical phenotype distribution among severe malaria admissions by intervention groups and country.Methods We conducted a secondary ad-hoc analysis of hospital admissions in children aged 5 to 17 months of age when enrolled in the RTS,S + SMC trial in April 2017 in Houndé, Burkina Faso, and Bougouni, Mali, and who were followed until they reached five years of age.Results Among the 5,920 children enrolled in Burkina Faso and Mali, 337 serious adverse events were reported during the trial with 222 (65.9%) in Burkina Faso and 115 (34.1%) in Mali, and 48.1% (162/337) due to severe malaria. The mean age of children with severe malaria was 2.9 years; 79.0% (128/162) of the cases occurred in children aged 3 years or less and 21.0% (34/162) in those aged 4 to 5 years. The most common presentation was severe anemia reported in 50% (81/162) of children, followed by repeated convulsions 25.3%, (41/162), prostration 11.1%, (18/162), hyperparasitaemia 8.0%, (13/162) and cerebral malaria 6.2%, (10/162). The proportion of children with the severe malaria anemia phenotype was higher among severe malaria cases in the SMC alone arm 62.1%, (36/58) compared to those in the SMC + RTS,S arm 37.1%, (13/35), p = 0.048. There was no significant difference in the proportion of other clinical presentations between the study arms. Most severe malaria cases, 85.8% (139/162) occurred during the transmission season (July to December).Conclusions Severe anemia was the most common presentation of severe malaria in study children and its proportion among severe malaria cases was highest in the SMC alone arm. Children aged 3 years or less were the most affected and almost all the severe malaria cases occurred between July and December. Trial registration ClinicalTrials.gov, NCT04319380.
SN - 1475-2875
ER -