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A woman with her children near her home in Sahre Bocar, Senegal. Pregnant women and children are the most vulnerable to death from malaria. Image by Jonathan Torgovnik / Getty Images / Images of Empowerment, August 11, 2014. (CC BY-NC 4.0)
The world continues to falter from the devastating deaths caused by COVID-19. More than 2.2 million people have contracted the virus and almost 180,000 people worldwide have died from it.
Starting April 23, the nations of Europe lead the world death load caused by the new coronavirus. In the same period, 1,199 viruses deaths have been reported in Africa.
Meanwhile, Africa has continued to live with the heavy burden of malaria, a much more deadly disease that has affected communities in Africa for centuries. In 2018 alone, 405,000 died of malaria in sub-Saharan Africa, report the Centers for Disease Control.
Malaria is preventable and curable, but with a tropical climate responsible for year-round transmission of malaria, compounded by poor socioeconomic conditions, makes it difficult to effectively control and treat malaria cases.
Now, a new malaria vaccine called Mosquirix offers hope to communities in Africa that have struggled against the deadly disease for years.
Malaria, a murderer of women and children.
Malaria, a tropical disease transmitted by the female Anopheles mosquito is caused by the Plasmodium falciparum parasite. The disease usually manifests with symptoms like fever, fatigue, vomiting, and body aches.
Every 60 seconds, a child dies of malaria in many African countries; outside Of every 10 malaria patients, nine deaths occur, according to the World Health Organization (WHO).
Most malaria-related deaths occur among pregnant women and children. United Nations Children’s Fund (UNICEF) state that Every two minutes, a child under the age of 5 dies of malaria, which translates to 730 children who die daily from the disease.
Sub-Saharan Africa, along with India, has the global burden of malaria with about 85 percent of cases in 2018. In addition, the WHO claims that These six African countries account for more than 50 percent of all global malaria cases: “Nigeria (25 percent), Democratic Republic of the Congo (12 percent), Uganda (5 percent), and Ivory Coast, Mozambique, and Niger (4 percent each). “
In 2018, sub-Saharan African countries spent $ 12 billion United States dollars in malaria case management, according to UNICEF.
Vaccine against malaria
Mosquirix malaria vaccine at the World Youth International Odede Community Health Center in Kenya. Image used with permission.
Mosquirix, also known by its scientific name, RTS, S, is a pre-erythrocytic malaria vaccine, which refers to the stage of The transmission of malaria before the victim manifests clinical symptoms that generally appear in the erythrocytic stage, according to a study by Ashley M. Vaughan and two other colleagues from the Seattle Biomedical Research Institute in Washington state, USA. USA
The idea is that RTS, S “activates the immune system to defend against the early stages” when the parasite first enters the bloodstream after being bitten by an infected mosquito.
The surface of the malaria parasite (plasmodium falciparum) contains a protein or antigen that causes the body’s immune system to make antibodies. Mosquirix, an attenuated form of the parasite, precipitates the body’s own reaction, producing antibodies that fight malaria, according to 2004 research by a team of scientists led by Dr. Pedro L. Alonso of the Centro de Salut Internacional, Hospital Clinic, Barcelona, Spain.
Scientists working with the British Pharmaceutical Laboratory, GlaxoSmithKline created the vaccine in 1987. The first clinical trials were conducted in 1995 with adult volunteers living in the United States and Belgium. In 1998, the vaccine was tested on adult volunteers in The Gambia.
The second series of clinical trials was carried out between 2004 and 2007 in Mozambique. The 2004 vaccine trial involved 2,022 children aged 1 to 4 years, while the 2007 double-blind randomized trials had 214 babies as participants.
The third series of clinical trials began in May 2009 and ended in early 2014 with 15,459 babies in seven African countries; Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique, and Tanzania.
WHO launched the first pilot study of RTS, S in Malawi, followed by Ghana and Kenya in April 2019.
Following the results of the third clinical trials, Professor Peter Aaby of the Bandim Health Project in Guinea-Bissau, and four other colleagues identified three security concerns Regarding the RTS, S vaccine: “increased risks of meningitis, cerebral malaria, and doubled female mortality.”
Aaby and colleagues. recommended that the investigation of the “pilot implementation” of the vaccine that began in 2019 should use “overall mortality” to assess the performance of RTS, S and that “study populations are followed for the full 4-5 years of the study before making an implementation decision”
However, in January 2016, the WHO reported that it had already recommended a further evaluation of RTS, S in “a series of pilot deployments” with the aim of “addressing several gaps in knowledge” before the vaccine is certified as safe for the general public.
Pilot implementation of the vaccine.
Malaria vaccine administered by a nurse at the Odede Community Health Center. Image used with permission.
Kenya Cabinet Health Secretary Sicily Kariuki, ruling out the pilot implementation of RTS, S on September 13, 2019, stated that the vaccine will be implemented in counties with “the highest malaria burden of up to 20 percent “namely: Kakamega, Vihiga, Bungoma, Busia, Kisumu, Homa Bay, Migori and Siaya.
The Odede Health Center, located in Siaya County, is one of the rural hospitals chosen by the country’s ministry of health to implement the pilot malaria vaccine in Kenya.
Gabriella Ocenasek from World Youth International, an Australian non-governmental organization, informed Global Voices through a press release that the vaccine is administered three times to children 6, 7 and 9 months of age and this is repeated at the age of two. As of March 2020, more than 250 children received the vaccine at the health center.
A mother at the health center expressed initial fears that her son “would react to vaccines”:
When I brought John for his first puncture, I was afraid he would react to vaccines as many people had believed, but he took it well and never cried or got sick from the vaccine. I have been letting my community know that this is good for our children, everyone needs it.
However, the WHO has not yet approved the implementation of this vaccine for public use. This will depend on the results that emerge at the end of this pilot implementation stage.
If the results are positive without debilitating side effects, the RTS, S vaccine will be the key to dramatically reducing child mortality associated with malaria.
This will be an an unprecedented change in malaria management in sub-Saharan Africa, a region burdened with this scourge for centuries.
