Dec 14, 2017 Last Updated 3:12 PM, Dec 14, 2017
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A new vaccine that could prevent up to nine-in-10 cases of typhoid fever has been recommended by the World Health Organization.

Experts say it could have a "huge impact" on the 22 million cases, and 220,000 deaths, from typhoid each year.

Crucially it works in children, who are at high-risk of the infection, unlike other typhoid vaccines.

It is hoped the vaccine could eventually help countries eliminate typhoid.

Typhoid fever is caused by Salmonella Typhi bacteria and patients have:

  • prolonged fever
  • headache
  • nausea
  • loss of appetite
  • constipation
  • in one-in-100 cases it causes fatal complications

The bacteria are highly contagious and spread through contaminated food or water.

The infection is most common in countries with poor sanitation and a lack of clean water, particularly in south Asia and sub-Saharan Africa.

Two typhoid vaccines already approved to help reduce the number of cases, but none are licensed for children under the age of two.

The decision to recommend the new conjugate typhoid vaccine was made by the WHO's Strategic Advisory Group of Experts on Immunization (Sage).

Prof Alejandro Cravioto, the chairman of Sage, said: "For the first time I think we do have a very effective vaccine."

Sage commended the vaccine should be given to children aged six-months old and said catch-up campaigns focusing on children up to 15 years old should also take place.

Prof Cravioto said the vaccine was vital as the world was "reaching the limit" of current treatments due to the "crazy amount" of antibiotic resistance the typhoid bacterium had acquired.

Data from a clinical trial of the vaccine, carried out by the University of Oxford, was published just last month in the Lancet medical journal. 

The "challenge study" gave the vaccine to 112 people and then deliberately infected (challenged) them with typhoid-causing bacteria.

Such an approach gives a clear picture of a vaccine's effectiveness without having to immunise thousands of people. It showed the vaccine was up to 87% effective.

Prof Andrew Pollard, who ran those trials, told the BBC News website: "It could have a huge impact.

"If it can be rolled out in all communities, it must be possible to prevent the majority of cases and if it also interrupts transmission, which hasn't been shown yet, then it could be eliminated from those regions."

Gavi, the global body that pays for vaccines in 68 low and middle-income countries, is now considering whether to add the typhoid vaccine.

Dr Seth Berkley, the chief executive of Gavi, said: "Not only could this vaccine save lives, it could also prove to be a valuable weapon in the fight against antimicrobial resistance."

Before antibiotics, typhoid killed one-in-five people infected. Now there is growing levels of typhoid that is resistant to drugs.

Health officials from around the world are meeting in France to commit to preventing 90% of cholera deaths by 2030.

The disease, which is spread through contaminated water, kills about 100,000 people every year.

It is the first time governments, the World Health Organization, aid agencies and donors have made such a pledge.

It comes as Yemen continues to fight one of the worst cholera outbreaks on record.

Cholera has been spreading in the war-torn country due to deteriorating hygiene and sanitation conditions and disruptions to the water supply.

More than 770,000 people have been infected with the disease, which is easily treatable with the right medical equipment, and 2,000 have died. Many of the victims are children.

These huge outbreaks tend to grab the headlines, but there are also frequent outbreaks in so-called cholera "hotspots".

Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholera.

It can spread quickly and widely in cramped, dirty conditions.

The infection is cheap to treat with rehydration salts, and easy to avoid altogether if people have access to clean water and decent toilet facilities.

But about two billion people globally lack access to clean water and are potentially at risk of cholera, according to the World Health Organization.

The UN health agency says weak health systems, and outbreaks not being detected early enough also contribute to the rapid spread of outbreaks.

Dr Dominique Legros, who heads up the WHO's cholera programme, told the BBC: "We can't keep seeing these huge outbreaks every year.

"We have the tools at hand to prevent them, so let's use them.

"If you provide water and sanitation, it's enough to stop the transmission of cholera.

"We've seen that today in countries like Senegal, where we have been able to stop transmission."

Cholera is a disease of the poor, and building basic infrastructure for communities costs money.

However, there is no expectation of any major pledges of cash at Tuesday's meeting.

 

Representatives of maternal health program being implemented in Malawi’s four districts have disclosed to have so far spent over MK2 billion.

This follows provision of cash bonuses to expectant women, health workers, infrastructure development as well as procurement of medical supplies to participating health facilities.

The revelation comes as the Malawi government under Ministry of Health is implementing a maternal health program with financial support from the governments of Norway and.

Speaking to Capital FM, the Deputy Program Director revealed that so far over 100, 000 expectant women have benefited in the conditional cash transfer with over MK600 million disbursed to them.

Reagan Kaluluma further adds that money totaling to MK849 Million has been spent on infrastructure expenses in all the four districts.

He however disclosed the program still faces constraints pointing out staff attrition which is high, delay in infrastructure and procurement of medical equipment among others.

“Some communities do not understand the target criteria hence create the myth that the money is associated with spiritualism,” added Kaluluma

The project dubbed Results Based Financing for Maternal and Neonatal Health (RBF4MNH) is being implemented in 33 health facilities in Ntcheu, Dedza, Mchinji and Balaka.

It is aimed at contributing to the reduction of maternal and neonatal deaths in the impact districts.

This is so through provision of incentives inform of cash bonus to staff as well conditional cash transfer to expectant women in a bid to increase hospital deliveries.

Apart from that, the program also procures medical equipment besides infrastructure development to benefiting health facilities in a bid to improve quality health care.

In a quest to promote high quality, accountable and responsive public health service delivery, the Catholic Commission for Justice and Peace (CCJP) of Karonga diocese of the Catholic Church is implementing a one year health governance project in the northern districts of Karonga and Chitipa.

The CCJP has noted with great concern that the health sector in the country is facing a number of challenges manifested in meager allocation of resources which are further abused poor quality and inaccessible health services and limited access to information, contrary to the Abuja Declaration.

According to the CCJP Desk Officer, the project aims at strengthening citizen’s participation in health governance and decision-making in six traditional authorities in Chitipa and Karonga.

Apart from that it will also promote access to budgetary, policy information so to improve transparency and accountability in the health sector.

Louis Nkhata said, “We are going to facilitate the establishment of already existing health sector and revamp NGO response coordination committees in Chitipa and Karonga and to engage a consultant to review NGO and private sector health resources, allocation, utilization and results”.

Nkhata further explained that among other activities to achieve the project goal, they will also facilitate the establishment of secondary school based ‘My health, My right’ clubs in order to raise awareness on health rights among school-going youth who may in turn help support community awareness exhibitions.

He said, “This will be made possible by conducting district and inter-district youth conferences to establish a youth movement for health to be dubbed ‘Youth for Health in order to amplify the voice of young people in health governance”. 

the CCJP is implementing a second phase of Health Governance project with funding from Open Society Initiative for Southern Africa (OSISA) to the tune of US$ 120,000 which is about MK85 million.

This is in the areas of T/As Wasambo, Kyungu and Kilupula in Karonga district and in T/As Mwenewenya, Nthalire and Misuku in Chitipa district.

An institution is expected to be established in Malawi to track the accreditation of all health care workers.

The public has been expressing concern with the poor health care delivery in the country, particularly in public hospitals.

In most of these hospitals, people wait for hours before being assisted and are in some cases, forced to buy drugs from pharmacies.

Speaking to Capital FM, Douglas Lungu who is President of the Society of Medical Doctors in Malawi (SMD) disclosed that the institution will help lessen the challenges that arise between practitioners and patients in hospitals.

Meanwhile, the 7th annual Medical and Scientific Conference that seeks to improve health care delivery in public hospitals is under way in Mangochi.

The conference has brought together doctors from across the country and sub-Saharan Africa.

The Society of Medical Doctors was established with the aim of providing a vehicle through which doctors can support the government and other players in their efforts to improve the delivery of health care in Malawi.  

In the country, the model of health care delivery it is assumed that the medical doctors will provide leadership in the provision of quality care and thereby ensure the credibility of medical care in Malawi.

So far the efforts by the medical doctors have been commendable, but could have more impact if they had a collective voice.

The SMD is there to provide a voice for doctors and facilitate their participation in and create an interface with government, the public and the health profession.

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