Malaria vaccination coverage, completeness, and timeliness among children aged 6-24 months: a cross-sectional survey conducted in the Western region of Cameroon, 1 year following the vaccine introduction

Malaria vaccination was introduced as part of Cameroon EPI vaccine to prevent malaria morbidity and mortality among children aged 6-24 months. This study aims to assess the coverage, completeness, and timeliness of this vaccine, and explore parental perceptions on children access to vaccination. This was a community-based, descriptive cross-sectional study targeting children aged from 6 to 24months and caregivers, selected by stratified cluster random sampling in Foumbot and Foumban health districts. Data were collected from caregivers by trained and supervised enumerators using a face-to-face, pretested questionnaire. Malaria vaccine coverage, completeness, and timeliness were estimated with 95% confidence interval. The contribution of caregivers perception on the first dose malaria vaccination status was explored by estimating crude Odd Ratio (cOR) and Adjusted Odd ratio (aOR) estimated from mixed effect logistic regression. Of the 55 targeted and reached clusters 399 children were included in this study. Vaccination coverage of the first, second and the third dose malaria vaccination was 31.20% (95%CI 30.38 - 32.02), 22.61% (95%CI 21.85 - 23.37) and 17.70% (95%CI 16.88 - 18.52) respectively. Among the children exposed to the first dose, 56.49% (95%CI 44.61 - 68.37) completed the third dose. The timeliness of the three administered doses was around 50-57%. In multivariate analysis, parental perception remained significantly associated with dose 1 malaria administration (aOR 15.54 95%CI 12.63 - 19.10 p= <0.001), dose 1 timeliness (aOR 2.36 95%CI 1.52 - 3.65 p= <0.001) and dose 2 completeness (aOR 9.81 95%CI 7.78 - 12.36 p= <0.001). More than a year after the malaria vaccine introduction in the health districts of Foumbot and Foumban, the performance indicators for this vaccination are below expectations for the vaccine to have a significant impact on reducing malaria morbidity in children. Communicating to positively influence caregivers perceptions on malaria vaccination expected to contribute in improving the situation.