Malawi is going to hold the first African typhoid vaccine trial next year. The trial will be done in Ndirande and Zingwangwa townships in Blantyre, targeting at least 24, 000 children aged between nine months and 12 years which will run for six months. Recently in November the World Health Organization recommended the typhoid vaccine for use in countries with high incidence. An international organization which funds vaccines in low and middle income Gavi, has also announced it they will put US$85 million in funding vaccine campaigns in countries which want to adopt them.
According to Dr. James Meiring, another researcher working with the Malawi Liverpool Wellcome Trust, “This comes after research for over 15 years, mainly done in Blantyre. The next stage for the work is to test the new vaccine for typhoid which we think has a protective effect of about 90%. It’s never been tested in Africa before neither has it been given to African children so we want to see whether it works in Malawi and what impact it could have on reducing the rates of typhoid fever. There will be a period of surveillance for between two and three years, according to Dr. Meiring who said the vaccine is being produced in India where it was also tested.”
He further said, “It also has just undergone efficacy studies (human challenge study) in Europe where it had an effectiveness of 87%. 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 US$36 million.”
Blantyre District Health Officer Dr Medson Matchaya urges parents and guardians to enroll their children in the study. He said, “I would encourage whoever is approached to participate; there’s no danger otherwise there would be an advantage in that if it works it means there will be no need to get vaccinated again.”
Ministry of Health Expanded Programmes on Immunization (EPI) Manager Geoffrey Chirwa said, “The study will help Malawi gather data on typhoid. The government could not fully commit to run the programme countrywide before knowing the magnitude of the disease. 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.”
The disease symptoms are very familiar; fever, headache, shivering and stomachache. But unlike the usual suspect malaria, these symptoms point to another condition – Typhoid fever. Caused by Salmonella bacteria, Typhoid fever is a disease that affects over 100 in every 100, 000 people a year in Malawi’s commercial capital Blantyre.
Typhoid fever is slowly becoming more prevalent among the population of Malawi, with outbreaks reported in Zomba, Blantyre, Mangochi, Thyolo and Mulanje districts. Typhoid fever affects an estimated 20.6 million people globally each year, causing an estimated 223,000 deaths.
In Malawi, the prevalence of typhoid fever is mainly being attributed to lack of good sanitation, poverty and overpopulation. There is also a new strain of typhoid resistant to the common antibiotics.
