Blantyre children to lead typhoid vaccine trial

Up to 24 000 children aged between nine months and 12 years in Blantyre City’s populous Ndirande and Zingwangwa townships are set to kick-start Africa’s first typhoid conjugate vaccine trial, authorities have confirmed.

Ministry of Health officials and researchers at the Malawi-Liverpool Wellcome Trust (MLWT) said yesterday the trial will be a culmination of 15 years of research that focused on the disease patterns in urban Blantyre.

The officials said Malawi’s fight against typhoid is likely to secure funding from Gavi—an international organisation which funds vaccines in low and middle-income countries.

An official statement on the project said Gavi has pledged to assign K60.9 billion ($85 million) in vaccine campaigns in low income countries which want to adopt them.

The statement said researchers hope the vaccine will exhibit a 90 percent protection against typhoid among children in the country.

But the vaccine’s efficacy studies (on human challenges) in Europe have chalked up an effectiveness of 87 percent.

Parallel studies are being conducted in Kathmandu, Nepal, and  Dhaka, Bangladesh, with funding from the Bill and Melinda Gates Foundation at a grand total of over K25 billion ($36 million), the statement added.

The statement said typhoid fever patients exhibit symptoms of fever, headache, shivering and stomachache. Caused by salmonella bacteria, typhoid fever affects over 100 in every 100 000 people a year in Blantyre, it added.

Lately, typhoid fever has been prevalent in Malawi, with outbreaks reported in the southern districts of Zomba, Blantyre, Mangochi, Thyolo and Mulanje.

Typhoid fever affects an estimated 20.6 million people globally each year, causing an estimated 223 000 deaths.

In Malawi, the prevalence of the disease is attributed to poor sanitation, poverty and over-population. Since 2010, a new strain of typhoid has emerged that is resistant to the common antibiotics available in most health clinics.

MLWT researcher Dr. James Meiring is quoted in the statement as having said the Malawi vaccine trial is key.

He said: “We want to see whether this vaccine works in Malawi by protecting Malawian children and what impact it could have on reducing the rates of typhoid fever.”

Welcoming the project, Ministry of Health Expanded Programmes on Immunisation (EPI) manager, Geoffrey Chirwa, said the Blantyre trial will help Malawi to gather reliable data on typhoid.

He said: “At the moment, we don’t have statistics on typhoid. So, it is very hard for us to justify the introduction of the vaccine; we need figures to know how big the problem is in Malawi.

“We, however, appreciate the work being done by the Malawi Liverpool Wellcome Trust; they have helped us before with the pneumonia and Rota vaccines,” Chirwa is quoted in the statement.

Outgoing Blantyre district health officer (DHO) Medson Matchaya yesterday said the vaccine trial will begin as soon as preparatory work and sensitisation of stakeholders, including Blantyre City Council officials, is completed.

He commended international stakeholders for putting Malawi ahead of other countries in Africa in the vaccine trial whose results will inform medical and research authorities on effectively combating typhoid on the continent and beyond.

“I urge parents and guardians to let their children participate in the vaccine trial that has proved harmless wherever it has been conducted,” said Matchaya who is being transferred to Mwanza District Health Office. n