This Week in Mac Sports: 9/15

Promising New Malaria Vaccine Has Been Approved In Two Countries, With Others Likely To Follow

Ghana and Nigeria both approved a new malaria vaccine this month — an important step in the fight against a disease that kills more than 600,000 people annually.

At least 10 other African countries are reviewing trial data for the shot, according to the World Health Organization, so more approvals are expected in the coming weeks.

The vaccine, developed by researchers at Oxford University, is the second to become publicly available. The first, a shot called Mosquirix from drugmaker GSK, has been administered through a pilot program in Kenya, Ghana and Malawi since 2019 but is still in limited supply.

The new vaccine is the first malaria shot to be approved in Nigeria, whose deaths from the disease make up 31% of the worldwide total.

"It's good news," said Dyann Wirth, an infectious diseases professor at the Harvard T.H. Chan School of Public Health, adding, "These vaccines can save lives and save hospitalizations, reduce the impact of the disease in the most vulnerable young children."

An estimated 619,000 people died of malaria in 2021, the latest annual total available, and 96% of those deaths occurred in Africa, according to the WHO. The disease is caused by a parasite that spreads to humans through mosquito bites.

Scientists have been researching possible malaria vaccines since the 1960s; Mosquirix took more than 30 years to develop and test. To prevent infection, countries with high rates of malaria mostly rely on mosquito nets, insecticides or antimalarial drugs for children.

Next steps for the new malaria shot

The Oxford vaccine consists of three doses administered every four weeks, followed by a fourth dose a year later. So far, the only peer-reviewed data on it comes from a small trial of 450 infants up to 17 months old in Burkina Faso. Among that group, the shot was found to reduce the risk of malaria by 77%.

Adrian Hill, the vaccine's lead developer and co-director of the Oxford Martin Program on Vaccines, said a Phase 3 trial of 4,800 children up to 3 years old showed similar safety and efficacy. But those findings have not been published in a peer-reviewed journal.

The WHO is still evaluating data on the Oxford vaccine and has not yet recommended it for use. Countries without their own regulatory processes for approving vaccines often defer to the WHO's recommendations, Wirth said, so they may still wait for that.

The WHO said it does not have a specific timeline for its decision.

"Sadly, we're not seeing the urgency that WHO and every other regulator in the planet showed with Covid," Hill said, "which is disappointing, given that there are huge numbers of deaths from malaria in young children in Africa."

The new vaccine could reach more people more quickly

The WHO's recommendation of Mosquirix in 2021 represented a major milestone, but manufacturing challenges have led to a slow rollout.

In 2015, GSK closed the Belgium plant where the vaccine was produced, and it did not reopen until 2019. Last year was the first in which the plant continuously manufactured the vaccine's antigen — the component that stimulates an immune response.

GSK has asked a company in India, Bharat Biotech, to produce the antigen instead, but that won't happen until 2028.

To date, 1.5 million children have received the Mosquirix shot, according to the WHO. In addition to the three countries already administering it, 11 others have applied to receive doses, the WHO said.

"The demand for this vaccine has been unprecedented, with 29 countries already coming forward to Gavi saying that they would like to introduce this vaccine already," Dr. Mary Hamel, the WHO's team lead for malaria vaccines, said on a media call Wednesday. (Gavi is an international vaccine alliance that partners with the WHO, governments and nonprofit groups.)

"Demand far outstrips the supply that's currently available," Hamel added.

GSK said it expects to have around 4 million doses available later this year, and a total of 18 million by the end of 2025.

But the WHO estimates that 80 to 100 million annual vaccine doses are required to immunize children at risk of malaria.

The Oxford vaccine could help alleviate the shortage. The Serum Institute of India has already committed to produce 20 million doses in the next two months. (The company is manufacturing the doses "at risk," meaning it hasn't made a deal with a buyer yet.)

The Oxford shot is also cheaper, at $3 per dose relative to around $10 for the GSK shot.

How do the two malaria shots compare?

Like the Oxford vaccine, Mosquirix consists of four doses. The first three are administered monthly, starting when an infant is 5 months old, followed by the fourth once they reach 15 to 18 months.

In a large-scale trial, three doses of the vaccine reduced the risk of malaria in children by 28% after four years, while four doses had a slightly higher efficacy of 36%.

Hill said the Oxford vaccine's efficacy also wanes over time but was "still very high" after at least 3 1/2 years.

It's possible, though, that the Oxford shot will prove less effective outside of a trial setting, Wirth said, since the study in Burkina Faso largely administered vaccines before the seasonal peak in malaria transmission, which comes in July.

"I expect that, when released at large scale, it will have a similar efficacy to the existing recommended vaccine," she said.

Neither vaccine will eliminate the need for additional measures to keep malaria from spreading, Wirth added.

"Is it a magic bullet? Will the vaccine alleviate the need for bed nets or insecticide spraying? No, definitely not," she said. "The vaccine will also not replace the need for drugs, but it can be added to the existing tools to have greater impact."

Adansi-North Residents Asked To Use Of Interventions To Reduce Malaria Incidence

By Muyid Deen Suleman

Ayaase (Ash) April 28, GNA – Mr Eric Atuahene Agyemang, Adansi North District Director of Health Services, has called on the people to take the interventions of various stakeholders serious to help reduce the incidence of malaria in the district.

He said though the incidence of malaria had reduced significantly, there was the need for the people to continue to adhere to good environmental sanitation and sleep under insecticide treated mosquito nets to further reduce the infection rates.

Speaking at a health screening clinic for the people of Ayaase to mark this year's world malaria day, Mr Agyeman pointed out that, it was important for the people to be aware of the dangers of malaria and take the needed precautionary measures to prevent it.

The clinic was organised by AngloGold Ashanti Obuasi Mine, as part of its 10-year development plan to promote the health of the people in its operational areas.

Mr Agyeman said Ghana was steadily progressing in the fight against malaria infections as a result of various interventions such as the indoor residual spraying campaign being spearheaded by the AngloGold health foundation, to clamp down malaria in the area.

Again, for the past four years, Ghana with other countries like Kenya and Malawi had intensified malaria control injection to infants and babies, which was yielding positive results.

He said the general reduction of the incidence of malaria infection in the district implied that, the health directorate, and its key stakeholders such as AngloGold Ashanti, was doing a good job.

Mr Agyeman encouraged residents of the district to take good care of themselves in order not to fall prey to the malaria parasite.

Mr Edmond Oduro, Stakeholders Engagement Superintendent at AGA Malaria Control Programme, said the mining giant took keen interest in malaria control program due to frequent malaria infections among its workers.

He stressed the need for all stakeholders to support the programme and other interventions by the government to help prevent malaria from the district.

According to the latest World Malaria Report published in December 2022, in 2021, malaria caused 619,000 deaths with 247 million new cases recorded across the world.

Although a global issue, 95 per cent of all malaria cases are in World Health Organisation (WHO) African Region, with nearly 80 per cent of malaria deaths in the African Region being among children under the age of five.

In Ghana, according to the WHO, malaria is both endemic and perennial throughout the country, putting the entire population at risk.

In 2021, WHO estimated that there were about 5.3 million malaria cases with 12,500 estimated deaths were recorded.

GNA

Provided by SyndiGate Media Inc. (

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Watch Out For Acute Kidney Disease As A Complication Of Malaria

While most cases show mild symptoms, a minority of cases could be fatal. The estimated number of malarial deaths stood at 6,19,000 in 2021. In severe disease, multi-organ dysfunction affects organs such as the lungs, kidneys, and brain.

Damage to the kidney resulting in acute kidney injury (AKI) is also a complication of malaria. It is more common among children. AKI caused due to malaria can lead to immune dysregulation and inflammation and can contribute to physical and mental ailments.

Severe malaria causes damage to fine urinary tubes within the kidney, a condition called acute tubular necrosis. AKI is defined by increased creatinine by more than 0.3 mg/dl within 48 hours or a reduction in urine volume to less than 0.5ml/kg/hour for 6 hours.

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In most cases, AKI due to malaria is reversible if treated early. At the onset, mild laboratory abnormalities such as reduced hemoglobin, higher white cell count, low platelets, elevated ESR, liver enzyme abnormalities, and electrolyte (salts) disturbances may occur.

With worsening disease conditions, severe symptoms related to anemia, liver disease, and acute kidney injury may manifest. Reduced kidney function may result in the build-up of fluids, waste products, or disturbances in salts like sodium and potassium.

Splenic rupture is a much more serious problem occurring in a minority of individuals with AKI and severe malaria. Symptoms, as well as the severity of the disease, can vary from individual to individual.

Seeking professional medical help at the earliest and appropriate investigations can lead to a rapid diagnosis. Initiating therapy at the outset can contain the disease and prevent progression to a severe disease state.

Given the significant morbidity associated with AKI secondary to malaria, it is imperative to have access to expert nephrologists, as such situations need close monitoring and treatment. There is a possibility of patients with severe AKI needing temporary dialysis therapy to deal with fluid overload and salt disturbances.

Emphasis on bridging the significant health literacy gap is needed to effectively tackle the complications related to malaria, especially AKI. As we move into a fast-paced world it is important to prioritize one's health by having regular check-ups to detect clinical irregularities (if any) and take precautions accordingly.

These tests also draw attention to any abnormalities that might lead to chronic illnesses. In general, kidney disease remains a huge burden on society, and it is estimated that about 10% of the adult population has some form of kidney disease.

Approximately 220,000 people have severe kidney disease (end-stage kidney disease) needing dialysis every year and the lack of access and affordability to renal replacement therapy in the form of dialysis or transplantation to the majority is unfortunate.

These staggering numbers should draw the attention of the public and government to stem the epidemic of kidney disease at its roots.

Source: Medindia

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