Malaria vaccine will be field tested in Africa next year

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By Anastasia Netrunenko Contributing Writer At the start of 2016, there were a total 91 countries in which malaria was endemic. Chills, fever, vomiting and sweating, all are symptoms experienced by those infected mere weeks after being bitten by a female Anopheles mosquito. While multiple types of the parasite exist in the world, over 100, none are as virulent as the form caused by Plasmodium falciparum. Found worldwide, but predominantly in Africa, P.falciparum multiplies rapidly and adheres to the walls of red blood cells. Once infected, the parasite moves to the liver for incubation and reproduction, at which stage the immune system of the host may or may not respond, typically five to sixteen days. It is only upon migrating into the bloodstream and infecting healthy red blood cells, continuing to reproduce, that the host experiences the aforementioned symptoms. In uncomplicated cases, symptoms last between six to ten hours, in cycles of every second day, although both cycles and duration depend highly upon the immune system of the host and specific strain of Plasmodium. In their 2016 World Malaria Report, the World Health Organization (WHO) reported a heartening decrease in both cases of and deaths from malaria, between 2000 to 2015, a striking forty-one percent decrease of the former and sixty-two percent of the latter. Despite the optimistic number however, due primarily to funding shortfalls and crashing health systems, “less than half of the 91 malaria-affected countries and territories are on track to achieve the 2020 milestone of a forty percent reduction in case incidence and mortality” (WHO). The vaccine, having passed the Phase III clinical trial, implemented in seven African countries, has situated itself as a shining source of hope. Formally known as RTS,S or Mosquirix (first developed in 1987), the vaccine was distributed to children five to seventeen months of age in four intermuscular (IM) doses between 2009 and 2014. As a result, mortality rates in said countries and regions decreased by approximately fifty percent. In lieu of its success, WHO has announced that beginning in 2018, a WHO-coordinated pilot program will be implemented in Ghana, Kenya and Malawi. Said countries were selected based on “high coverage of long-lasting insecticidal-treated nets; well-functioning malaria and immunization programs, a high malaria burden even after scale-up of LLINs, and participation in the Phase III RTS,S malaria vaccine trial” (WHO). The vaccination will be administered via four IM doses to five to seventeen month old children as part of the national immunization program. “The prospect of a malaria vaccine is great news. Information gathered in the pilot program will help us make decisions on the wider use of this vaccine,” said Dr. Matshidiso Moeti, the WHO regional director for Africa. The vaccine will be used alongside other forms of treatment, among which are insecticide-treated mosquito nets (increased in the past five years), indoor residual spraying (decreased globally), chemoprevention for pregnant women and lastly, malaria diagnostic testing. The use of the latter has increased from forty percent in 2010 to nearly seventy-six percent in 2015. Additionally, the vaccine could not have come at a better time, for as reported by the CDC and WHO, of the 73 countries that offered monitoring after 2010, over 60 countries reported an increase in resistance of at least one of the insecticides used for nets and spraying. It is, as such, the hope that with the use of Mosquirix alongside the already established treatment and prevention programs, WHO’s goal of eliminating malaria at least ninety percent by 2030, is achievable. For more information, visit malariavaccine.org, cdc.gov, and take a look at the World Health Organization 2016 World Malaria Report.

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