Reducing malaria deaths in infants

By Flavia Nassaka

World’s first malaria vaccine could be available early 2015

In the sector performance report released last year by the Ministry of Health, Malaria was ranked the number one killer disease claiming about 80,000 lives. It accounts for 20- 23% of all deaths among children under five, 25-40% of all outpatient attendances, 20% of all admissions and 9-14% of all in-patient deaths. But, Uganda is not the only country battling the deadly disease in sub-Saharan Africa.

Dr. Joaniter Nankabirwa, an epidemiologist at Makerere University College of Health Sciences says that children are at a bigger risk of death due to lack of access to timely and appropriate malaria treatment.

“Though Malaria cases are decreasing with the many awareness programs such as sleeping under mosquito nets and other measures. Malaria cases are still toping in hospital admissions; we need more measures to counter the predicament”.

Among the efforts to curb malaria, GlaxoSmithKline (GSK), a global pharmaceutical has developed a vaccine to cater for infants below five years.

After thirty years of research, GSK has applied to European Medicine Agency (EMA) and World Health Organization (WHO) seeking approval for its vaccine RTS.S meant to counter malaria among infants in sub-Saharan countries.

GSK’s head of malaria vaccine franchise Dr Sophie Biernaux says this is a key moment in GSK’s thirty year journey to develop RTS.S and brings us a step closer to making available the world’s first vaccine that can help protect children in Africa from malaria.

According to Nathan Wasolo, GSK’s Uganda Country Director, though the vaccine is designed to be used exclusively in Africa, it’s up to the European standards and will be the first to offer protection against malaria. It comes after many trials for malaria vaccines have been made before but have not succeeded.

Last year, the company announced the results of its vaccine trial in infants of 6 to 12 weeks old and older babies 5 to 17 months old at their first vaccination. After 18 months of follow-up, the younger group experienced a 27 percent decrease in cases of clinical malaria compared to like-aged infants who had received a placebo vaccination.

Babies who received their first vaccination at 5 to 17 months of age experienced 48 percent fewer cases than same-aged infants injected with the placebo. GSK estimated that for the older babies, the vaccination prevented an average of 941 cases of clinical malaria for every 1000 children vaccinated. For the younger group, the vaccine prevented 444 cases for every 1000 vaccinations.

“Since over 600,000 Africans; mostly children under five-years old, die from malaria every year, this vaccine could potentially have a huge impact on public health,” Wasolo said in an interview with The Independent.

According to information published in the PLOS Medicine Journal, the vaccine trials were conducted at eleven research centers in eight African countries including Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique, Nigeria, and Tanzania and 15,000 children participated.

The study indicated that the vaccine’s efficacy decreased with time citing 65%, after six months and about 15% after four years.

Wasolo says if approved, the vaccine is to be used alongside other measures such as bed nets, indoor residual spraying and anti-malarial medicines for efficacy.

Dr. Nankabirwa says that the vaccine would be a huge step in countering malaria since some people in Uganda, due to overuse, have grown resistance to the commonly used anti-malarials like Chloroquine and resorted to a more expensive alternative medicine known as Artemisinin Based Combination Treatments (ACTs) which comprise of the commonly known COARTEM used as the first line of treatment for malaria.

She says there is a significant over-use of anti-malarial drugs because many cases of fever are immediately treated as malaria even without a blood test or laboratory confirmation.

The doctor advises that it is important that use of anti-malarials be restricted to people who are diagnosed with a blood test to avoid treating wrong ailments since not all fever is malaria.

The WHO has indicated it may recommend use of RTS.S from as early as 2015 if EMA drugs regulators back its license application.