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After more than a year of community engagement and preparation in 100 villages with 12,000 populations across the Chittagong Hill Tracts, the mass malaria vaccine (R21/Matrix M) and drug (DHA, piperaquine, and single low dose primaquine) administration study started on 15 Feb.

Health care workers in Bangladesh © MORU. Photo: Rupam Tripura/Fojle Rabbi
First day of malaria vaccinations with R21/Matrix-M in Chittagong Hill Tracts, Bangladesh on 15 Feb 2025.

Following a series of logistical challenges related to vaccine supply, regulatory approvals and government overthrow, the team in Lama received the malaria prevention vaccines, R21/Matrix M from the Serum Institute of India on 10 Feb.

Supervised by Prof Abul Faiz in Bangladesh, with the ground operations led by MORU’s Dr Rupam Tripura backed up by the team of 162 staff, this large-scale community randomised clinical trial will generate crucial evidence on the efficacy and effectiveness of the R21 vaccine alone and in combination with antimalarial treatments. In addition, sub-studies will carefully document the immunogenicity as well as engagement design, strategies, and outcomes exploring the feasibility and acceptability of this large-scale intervention.

Each village in this study consists of 5-53 households (20 households on average/village) with village populations ranging from 51 to 324 people. The study consists of four arms, with each arm of 25 villages randomised to one of the following four interventions:

  • Vaccine only
  • Vaccine + drug
  • Drug only
  • Standard of care (control group)

 Funded by the Hanako Foundation, Singapore, this large community randomised study is expected to provide valuable insights into malaria prevention strategies in one of Asia’s most malaria-prone regions.

- Text courtesy of Rupam Tripura. Photographer: Fojle Rabbi.