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Race for improved vaccines in battle against pneumonia

Thursday November 11 2010

By TABITHA MWANGI [email protected]

Little Naomi Mbuchi could easily have become one of the 5,000 children who die of pneumonia globally every day when she came down with the disease recently.

But 18-month-old Naomi was lucky. She was admitted to the Kilifi District Hospital just in time for diagnosis and treatment, saving her life.

And even as the World Pneumonia Day is marked on Friday, researchers are working to improve on vaccines that will save millions of children, like Naomi.

In Kenya, Kemri-Wellcome Trust (KWT) has been at the forefront in conducting research on a new vaccine. For the last five years, it has conducted tests on the effectiveness of the PCV-10 vaccine in Kilifi and Thika districts.

Half of all diagnosed pneumonia cases are a result of Haemophilus influenzae type B (Hib) and pneumococcus bacteria. Kenyan infants already receive Hib vaccines during clinic visits.

But the new project is meant to boost the protection they receive even further and consider whether their parents and those they live with can also benefit.

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PCV-10, which was licensed in 2000, has since been widely available in the West and in South Africa. In 2009, the Global Alliance for Vaccines and Immunisation donated the vaccine to the Gambia and Rwanda, resulting in a significant reduction in pneumococcal diseases among children.

It is these benefits that the Kilifi and Thika projects seek to bring to Kenya. This could come as early as January when the Ministry of Public Health launches the vaccine. From that point on, infants will receive two injections instead of one during routine clinic visits.

After the launch, the researchers will compare pre-vaccination and post-vaccination data to assess how many hospital admissions and deaths can be averted. They will also determine whether vaccinating children offers additional protection to other members of the household.

While conditions like malaria, HIV/Aids and malnutrition in children make headlines, pneumonia must also be looked at in its proper perspective. Annually, malaria is responsible for less than a million deaths in children under five in the world, while HIV/Aids causes less than 300,000 deaths. But every year, pneumonia kills 1.8 million children worldwide.

The disease is caused by bacteria, viruses and other bugs. Ironically, many of these agents live in the nose and upper breathing tubes of healthy people. They are normally passed on between generations within a household, but the especially vulnerable immune systems of the very young and the elderly put them at heightened risk.

As the body fights off these agents, fluid is produced in the lungs, making breathing difficult. Symptoms of pneumonia include coughing and breathlessness as the body struggles to get air into the lungs.

Indoor pollution

In severe pneumonia, the lungs get congested with fluid denying the blood oxygen, leading to respiratory failure and death. A number of factors — many related to poverty — lead to an increase in the risk of pneumonia in developing countries.

HIV infection is the major contributor — increasing the risk of infection by up to 40 times. Other factors include malnutrition, pollution, overcrowding and lack of breastfeeding. Indoor pollution from cigarette smoke to cooking with firewood have also been implicated.

Researchers note that in the US, proper nutrition and improved living standards halved pneumonia deaths long before antibiotics were widely available.

Pneumonia is so closely associated with poverty — statistics have shown that for every single child dying of pneumonia in the developed world, 2,000 die in the developing world.