RTS,S/AS01, a vaccine targeting pre-erythrocytic stages of Plasmodium falciparum

2017 ◽  
Vol 1 (6) ◽  
pp. 533-537
Author(s):  
Lorenz von Seidlein ◽  
Borimas Hanboonkunupakarn ◽  
Podjanee Jittmala ◽  
Sasithon Pukrittayakamee
Keyword(s):  
Protective Efficacy ◽  
Age Groups ◽  
Sub Saharan Africa ◽  
Phase Iii ◽  
European Medicines Agency ◽  
Older Children ◽  
Pivotal Phase ◽  
Malaria Epidemiology ◽  
Maximum Benefit ◽  
Sub Saharan

RTS,S/AS01 is the most advanced vaccine to prevent malaria. It is safe and moderately effective. A large pivotal phase III trial in over 15 000 young children in sub-Saharan Africa completed in 2014 showed that the vaccine could protect around one-third of children (aged 5–17 months) and one-fourth of infants (aged 6–12 weeks) from uncomplicated falciparum malaria. The European Medicines Agency approved licensing and programmatic roll-out of the RTSS vaccine in malaria endemic countries in sub-Saharan Africa. WHO is planning further studies in a large Malaria Vaccine Implementation Programme, in more than 400 000 young African children. With the changing malaria epidemiology in Africa resulting in older children at risk, alternative modes of employment are under evaluation, for example the use of RTS,S/AS01 in older children as part of seasonal malaria prophylaxis. Another strategy is combining mass drug administrations with mass vaccine campaigns for all age groups in regional malaria elimination campaigns. A phase II trial is ongoing to evaluate the safety and immunogenicity of the RTSS in combination with antimalarial drugs in Thailand. Such novel approaches aim to extract the maximum benefit from the well-documented, short-lasting protective efficacy of RTS,S/AS01.

scholarly journals The toll of COVID-19 on African children: A descriptive analysis on the COVID-19-related morbidity and mortality among the pediatric population in Sub-Saharan Africa

2021 ◽  
Author(s):  
Sabina Rodriguez Velasquez ◽  
Lea Jacques ◽  
Jyoti Dalal ◽  
Paolo Sestito ◽  
Zahra Habibi ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Pediatric Population ◽  
Adult Population ◽  
Age Groups ◽  
Sub Saharan Africa ◽  
Morbidity And Mortality ◽  
African Countries ◽  
Regional Office ◽  
Sub Saharan ◽  
Epidemiological Characteristics

Introduction: Since the beginning of the COVID-19 pandemic, very little data on the epidemiological characteristics among the pediatric population in Africa has been published. This paper examines the age and sex distribution of the morbidity and mortality rate in children with COVID-19 and compares it to the adult population within 15 Sub-Saharan African countries. Methods: A merge line listing dataset using a reverse engineering model shared by countries within the Regional Office for Africa was analyzed. Patients diagnosed within 1 March 2020 and 1 September 2020 with confirmed positive RT-PCR test for SARS-CoV-2 were analyzed. Children data were stratified into three age groups: 0-4 years, 5-11 years, and 12-17 years, while adults were combined. The cumulative incidence of cases including its medians and 95% confidence intervals were calculated. Results: 9% of the total confirmed cases and 2.4% of the reported deaths were pediatric cases. The 12-17 age group in all 15 countries showed the highest cumulative incidence proportion in children. COVID-19 cases in males and females under the age of 18 were evenly distributed. Among adults, a higher case incidence per 100,000 people was observed compared to children. Conclusion: The cases and deaths within the children population was smaller than the adult population. These differences can reflect biases in COVID-19 testing protocols and reporting implemented by countries, highlighting the need for more extensive investigation and focus on the effects of COVID-19 in children.

scholarly journals Individualising Anticoagulant Therapy in Atrial Fibrillation Patients

2016 ◽  
Vol 5 (2) ◽  
pp. 102 ◽  
Author(s):  
Marco Alings ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Oral Anticoagulants ◽  
Vitamin K Antagonist ◽  
The Other ◽  
Phase Iii ◽  
European Medicines Agency ◽  
Efficacy And Safety ◽  
Pivotal Phase ◽  
Phase Iii Clinical Trials ◽  
Dosing Regimens

Non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) have emerged as alternatives to VKAs for the prevention of stroke in patients with non-valvular atrial fibrillation. Four NOACs: dabigatran, apixaban, rivaroxaban and edoxaban, have received regulatory approval in Europe from the European Medicines Agency. Numerous factors can influence the decision to prescribe a NOAC, the most important of which are assessment of stroke and bleeding risks. Given the variation in design of the pivotal phase III clinical trials investigating the efficacy and safety of NOACs, and in the absence of head-to-head comparative data, it is impossible to recommend one NOAC over the other. However, NOACs offer the opportunity for individualised therapy based on factors such as renal function, age or patient/doctor preference for once- or twice-daily dosing regimens. Dose reduction of some NOACs should be considered in at-risk patient populations.

TRACKING CHANGES IN STATES OF CONTRACEPTIVE USE OVER TIME IN SUB-SAHARAN AFRICA THROUGH COHORT AND PERIOD ANALYSES

2014 ◽  
Vol 47 (3) ◽  
pp. 329-344 ◽  
Author(s):  
ELIZABETH LEAHY MADSEN ◽  
BERNICE KUANG ◽  
JOHN ROSS
Keyword(s):  
Contraceptive Use ◽  
Age Groups ◽  
Unmet Need ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Younger Women ◽  
Health Survey Data ◽  
Sub Saharan ◽  
Representative Samples ◽  
Unmet Need For Contraception

SummaryIt is difficult to gauge the success of programmatic efforts to reduce unmet need for contraception without knowing whether individual women have had their need met and adopted contraception. However, the number of true longitudinal datasets tracking the transition of panels of individual women in and out of states of contraceptive use is limited. This study analyses changes in contraceptive use states using Demographic and Health Survey data for 22 sub-Saharan African countries. A cohort approach, tracking representative samples of five-year age groups longitudinally across surveys, as well as period-based techniques, are applied to indicate whether new users of contraception have been drawn from women who previously had no need and/or those who had unmet need for family planning. The results suggest that a greater proportion of increases in contraceptive use in recent years can be attributed to decreases in the percentage of women with no need, especially among younger women, than to decreases in the proportion with unmet need.

scholarly journals Getting closer to a vaccine against malaria

2011 ◽  
Vol 32 (3) ◽  
pp. 127
Author(s):  
Robin F Anders
Keyword(s):  
Malaria Vaccine ◽  
Protective Efficacy ◽  
Sub Saharan Africa ◽  
Bed Nets ◽  
Effective Vaccine ◽  
Early Case ◽  
Sub Saharan ◽  
Global Eradication ◽  
Effective Use ◽  
Early Case Detection

Despite recent progress in the control of malaria in several countries, this disease still kills nearly one million young children in sub-Saharan Africa each year and it contributes significantly to poverty in many of the poorest countries in the world. The effective use of existing control tools (insecticide-impregnated bed nets, residual insecticide spraying and early case detection with effective treatment) should eliminate malaria from additional regions but global eradication of malaria is not feasible without the development of a highly effective vaccine. The most advanced malaria vaccine, known as RTS,S, is likely to be licensed for use in the next few years. The protective efficacy of RTS,S is unlikely to exceed 50% but numerous other approaches to vaccinating against malaria are showing some promise and, consequently, there are good prospects that a second-generation malaria vaccine will be much more effective.

scholarly journals Helminths in South Africa: management of cestode and trematode infections in humans

2020 ◽  
pp. 33-38
Author(s):  
RL van Zyl
Keyword(s):  
South Africa ◽  
South African ◽  
Age Groups ◽  
Signs And Symptoms ◽  
Epidemiological Data ◽  
Sub Saharan Africa ◽  
The South ◽  
Increased Risk ◽  
Sub Saharan ◽  
The Impact

Sub-Saharan Africa has to contend with many challenges, including inadequate healthcare systems, lack of optimal sanitation, and clean water and food. All of these contribute to malnutrition and an increased risk of infections, including parasitism by cestodes and trematodes. Schistosomiasis is a category-2 notifiable trematode (fluke) infection, whereas cestode (tapeworm) infections need not be reported to the South African Department of Health. Epidemiological data for helminthiasis in South Africa is scant, with a paucity of publications on the South African scenario. As such, a complete picture of the impact of helminth infections on all age groups in South Africa does not exist. These parasitic diseases not only have an impact on socio economic development of a country, community and families, but also contribute to the chronic and detrimental effects on the health and nutritional status of the host, including the impaired development of children. In order to break the cycle of poverty and disease, a strong education drive is required in schools and communities to provide effective strategies and guidelines on preventative measures that result in avoidance of exposure to infective stages of Schistosoma and Taenia tapeworms. Also, it is imperative that healthcare professionals are able to recognise the signs and symptoms, so that interventions can be promptly initiated. The current anthelmintic treatments available in South Africa are effective against cestodes and trematodes, with no drug resistance having being reported. The need for compliancy when taking anthelmintic drugs must be emphasised.

scholarly journals Presence of additional P. vivax malaria in Duffy negative individuals from Southwestern Nigeria: Short Report

2020 ◽  
Author(s):  
MARY Aigbiremo OBOH ◽  
Upasana Shyamsunder Singh ◽  
Daouda Ndiaye ◽  
Aida Sadikh Badiane ◽  
Nazia Anwar Ali ◽  
...  
Keyword(s):  
Vivax Malaria ◽  
National Level ◽  
Sub Saharan Africa ◽  
Diagnostic Tools ◽  
Short Report ◽  
Southwestern Nigeria ◽  
Malaria Epidemiology ◽  
High Prevalence ◽  
Sub Saharan ◽  
Duffy Negative

Abstract Background Malaria in sub-Saharan Africa (sSA) is thought to be hugely caused by Plasmodium falciparum . Recently, growing reports of cases due to P. ovale , P. malariae , and P. vivax have been significantly reported to play a role in malaria epidemiology in sSA. This in fact is due to the usage of very sensitive diagnostic tools (e.g. PCR) which have highlighted the underestimation of non-falciparum malaria in this sub-region. P. vivax was historically thought to be absent in sSA due to the high prevalence of the Duffy null antigen in individuals residing in this sub-continent. For example, recent studies reporting the detection of vivax malaria in Duffy-negative individuals from Mali, Mauritania, Cameroon to mention a few challenges this notion.Methods Following our earlier report of P. vivax in Duffy-negative individuals, we have collected and assessed RDT and/or microscope malaria positive samples following the conventional PCR method and DNA sequencing to confirm both single/mixed infections as well as the Duffy status of the individuals.Results Amplification of Plasmodium gDNA was possible in 59.9% (145/242) of the evaluated isolates and as expected P. falciparum was the most predominant (91.7%) species identified. Interestingly, four P. vivax isolates were identified either as single (3) or mixed (1 – P. falciparum / P. vivax ) infection. Sequencing results confirmed, all vivax isolates as truly vivax malaria and their Duffy status to be that of the Duffy-negative genotype.Conclusion Identification of more vivax isolates among these Duffy-negative individuals from Nigeria, substantiate the expanding body of evidence on the ability of P. vivax to infect RBCs that do not express the DARC gene. Hence, such genetic-epidemiological study should be conducted at the national level in order to evaluate the actual burden of P. vivax in the country.

scholarly journals Regional Overview on the Double Burden of Malnutrition and Examples of Program and Policy Responses: African Region

2019 ◽  
Vol 75 (2) ◽  
pp. 127-130 ◽  
Author(s):  
Adelheid W. Onyango ◽  
Juddy Jean-Baptiste ◽  
Betty Samburu ◽  
Tshimi Lynn Moeng Mahlangu
Keyword(s):  
Age Groups ◽  
Health Sector ◽  
Lifestyle Changes ◽  
Sub Saharan Africa ◽  
World Health ◽  
Noncommunicable Diseases ◽  
African Region ◽  
Double Burden ◽  
Double Burden Of Malnutrition ◽  
Sub Saharan

Sub-Saharan Africa is experiencing the double burden of malnutrition (DBM) with high levels of undernutrition and a growing burden of overweight/obesity and diet-related noncommunicable diseases (NCDs). Undernourishment in sub-Saharan Africa increased between 2010 and 2016. Although the prevalence of chronic undernutrition is decreasing, the number of stunted children under 5 years of age is increasing due to population growth. Meanwhile, overweight/obesity is increasing in all age groups, with girls and women being more affected than boys and men. It is increasingly recognized that the drivers of the DBM originate outside the health sector and operate across national and regional boundaries. Largely unregulated marketing of cheap processed foods and nonalcoholic beverages as well as lifestyle changes are driving consumption of unhealthy diets in the African region. Progress toward the goal of ending hunger and malnutrition by 2030 requires intensified efforts to reduce undernutrition and focused action on the reduction of obesity and diet-related NCDs. The World Health Organization is developing a strategic plan to guide governments and development partners in tackling all forms of malnutrition through strengthened policies, improved service delivery, and better use of data. It is only through coordinated and complementary efforts that strides can be made to reduce the DBM.

scholarly journals Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance

2019 ◽  
Vol 69 (Supplement_2) ◽  
pp. S105-S113 ◽  
Author(s):  
Saffiatou Darboe ◽  
Uduak Okomo ◽  
Abdul-Khalie Muhammad ◽  
Buntung Ceesay ◽  
Mamadou Jallow ◽  
...  
Keyword(s):  
Age Groups ◽  
Invasive Disease ◽  
Surveillance Data ◽  
Sub Saharan Africa ◽  
Bacterial Disease ◽  
Bacterial Diseases ◽  
Disease Patterns ◽  
Sub Saharan ◽  
Clinically Significant ◽  
The Impact

Abstract Background. Invasive bacterial diseases cause significant disease and death in sub-Saharan Africa. Several are vaccine preventable, although the impact of new vaccines and vaccine policies on disease patterns in these communities is poorly understood owing to limited surveillance data. Methods. We conducted a hospital-based surveillance of invasive bacterial diseases in The Gambia where blood and cerebrospinal fluid (CSF) samples of hospitalized participants were processed. Three surveillance periods were defined in relation to the introduction of pneumococcal conjugate vaccines (PCVs), before (2005- 2009), during (2010–2011) and after (2012–2015) PCV introduction. We determined the prevalences of commonly isolated bacteria and compared them between the different surveillance periods. Results. A total of 14 715 blood and 1103 CSF samples were collected over 11 years; overall, 1045 clinically significant organisms were isolated from 957 patients (972 organisms [6.6%] from blood and 73 [6.6%] from CSF). The most common blood culture isolates were Streptococcus pneumoniae (24.9%), Staphylococcus aureus (22.0%), Escherichia coli (10.9%), and nontyphoidal Salmonella (10.0%). Between the pre-PCV and post-PCV eras, the prevalence of S. pneumoniae bacteremia dropped across all age groups (from 32.4% to 16.5%; odds ratio, 0.41; 95% confidence interval, .29–.58) while S. aureus increased in prevalence, becoming the most prevalent bacteria (from 16.9% to 27.2%; 1.75; 1.26–2.44). Overall, S. pneumoniae (53.4%), Neisseria meningitidis (13.7%), and Haemophilus influenzae (12.3%) were the predominant isolates from CSF. Antimicrobial resistance to common antibiotics was low. Conclusions. Our findings demonstrate that surveillance data on the predominant pathogens associated with invasive disease is necessary to inform vaccine priorities and appropriate management of patients.

scholarly journals Comparison of Memory B Cell, Antibody-Secreting Cell, and Plasma Antibody Responses in Young Children, Older Children, and Adults with Infection Caused by Vibrio cholerae O1 El Tor Ogawa in Bangladesh

2011 ◽  
Vol 18 (8) ◽  
pp. 1317-1325 ◽  
Author(s):  
Daniel T. Leung ◽  
Mohammad Arif Rahman ◽  
M. Mohasin ◽  
M. Asrafuzzaman Riyadh ◽  
Sweta M. Patel ◽  
...  
Keyword(s):  
Young Children ◽  
Immune Responses ◽  
B Cell ◽  
Protective Efficacy ◽  
Age Groups ◽  
Older Children ◽  
Secreting Cell ◽  
Content Type ◽  
Antibody Secreting Cell ◽  
Plasma Antibody

ABSTRACTChildren bear a large component of the global burden of cholera. Despite this, little is known about immune responses to cholera in children, especially those under 5 years of age. Cholera vaccine studies have demonstrated lower long-term protective efficacy in young children than in older children and adults. Memory B cell (MBC) responses may correlate with duration of protection following infection and vaccination. Here we report a comparison of immune responses in young children (3 to 5 years of age;n= 17), older children (6 to 17 years of age;n= 17), and adults (18 to 60 years of age;n= 68) hospitalized with cholera in Dhaka, Bangladesh. We found that young children had lower baseline vibriocidal antibody titers and higher fold increases in titer between day 2 and day 7 than adults. Young children had higher baseline IgG plasma antibody levels toVibrio choleraeantigens, although the magnitudes of responses at days 7 and 30 were similar across age groups. As a surrogate marker for mucosal immune responses, we assessed day 7 antibody-secreting cell (ASC) responses. These were comparable across age groups, although there was a trend for older age groups to have higher levels of lipopolysaccharide-specific IgA ASC responses. All age groups developed comparable MBC responses toV. choleraelipopolysaccharide and cholera toxin B subunit at day 30. These findings suggest that young children are able to mount robust vibriocidal, plasma antibody, ASC, and MBC responses againstV. choleraeO1, suggesting that under an optimal vaccination strategy, young children could achieve protective efficacy comparable to that induced in adults.

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