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Malaria vaccine pilot test raises hopes of taming killer disease

malaria graphic
Mosquirix, the brand name for RTS, S vaccine, triggers the immune system to defend itself against the first stages of the disease. GRAPHIC | NMG 

Kenya will in weeks start a large-scale pilot test for a malaria vaccine in efforts to reduce the burden of the disease.

Malawi, which has started its pilot, will also be joined by Ghana, the three States being first in Africa to test the waters with the mosquirix vaccine, which will be administered as part of routine childhood immunisation.

Mosquirix, the brand name for RTS, S vaccine, triggers the immune system to defend itself against the first stages of the disease shortly after a malaria parasite enters the bloodstream through a mosquito bite.

The mosquirix immunisation will take place in nine counties in Western Kenya, including all eight counties in the lake endemic zone.

Sub-counties (or segments of large sub-counties) will be randomised to have all children receive four doses of RTS, S at six, seven, nine, and 24 months of age in addition to standard vaccines or to have all children receive the standard vaccines.

The pilot will run from 2019 and continue through 2021.

RTS, S received a positive scientific opinion from the European Medicines Agency in 2015 and was recommended by the World Health Organisation (WHO) for a pilot implementation.

The vaccine, whose maximum impact is achieved if children receive all four doses, adds to the arsenal of weapons to fight malaria.

Although it has an efficiency of 40 percent at best, it is expected to reduce the number of malaria deaths in the country.

The country had about 7.96 million cases of malaria infection in 2017, according to the WHO.

Data from the Kenya Malaria Indicator Survey show that prevalence of the disease is now at about eight percent, down from 11 percent in 2010.

In Western Kenya — hard-hit by malaria over the years — prevalence is estimated at 27 percent, down from 38 percent in 2010.

The malaria vaccine pilot aims to reach about 360,000 children per year across the three countries. Known side effects include pain and swelling at the injection site and fever, similar to reactions observed with other vaccines given to children.

Fever seizures

The WHO, however, states that, children will occasionally have fever seizures.

“During the phase three trial, an increased risk of febrile seizures was seen within days of the administration of any of the RTS, S vaccine doses.

Children who had febrile seizures after vaccination recovered completely and there were no long-lasting consequences,” says the WHO.

There Ministry of Health has adopted a multipronged approach in trying to bring down the overall disease burden.

It has implemented WHO recommendation on use of insecticide treated bed nets for prevention, which have been proven to cut transmission by 50 percent.

It also calls for indoor residual spraying which kills mosquitoes on walls of houses or other surfaces before they can bite people and transmit the disease.

It also identifies and destroys mosquito breeding sites with chemicals, as well as uses environmental management practises such as draining stagnant water and filling depressions that collect water.

To further cut the disease burden, doctors prescribe malaria prevention drugs to expectant mothers.

The drugs avert detrimental effects of the disease. But for people already infected, prompt diagnosis and treatment with recommended antimalarial drugs such as ACTs is paramount for speedy recovery.

The government has deployed experts to improve its odds in the malaria fight. Last year it brought in vector control experts from Cuba to help in the control of malaria in endemic regions.

Insufficient funding

However, even as Kenya joins the rest of the world in marking the World Malaria Day today, insufficient funding remains one of the biggest challenges in the malaria war. For years the country has relied heavily on donor funding.

A recent WHO report showed that the Global Fund was the biggest funder on anti-malaria campaigns in Kenya contributing Sh6 billion in 2017, followed by the USAid at Sh3.5 billion and the UK at Sh240 million.

Contrastingly, the Kenyan government only allocated Sh100 million to fight the disease.

A separate research by the Roll Back Malaria initiative on funding requirements revealed that Kenya will need about $427,860,536 (Sh42.8 billion) between 2018 and 2020 in the fight.

But in spite of the funding hurdle, the government is stepping up the war with an ambitious five-year strategy to reduce cases by 75 percent.

The strategy will be unveiled during today’s World Malaria Day fete.

For now the government is looking to get as much boost from the vaccine pilot as it can to help it minimise the social-economic burden of the disease with a past study showing it costs Kenya about $109 million (Sh10.9 billion) annually.

This shoots up to $250.7 million (Sh25 billion) when costs associated with productivity losses due to malaria deaths are captured.