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From: "IRIN" <[email protected]>
Date: 28 Mar 2014 20:39
Subject: Pneumonia vaccine shows promise in Kenya
To: "Elisabeth Janaina" <[email protected]>
Cc:

Pneumonia vaccine shows promise in Kenya

KISUMU, 28 March 2014 (IRIN) - Better uptake of the new pneumococcal
conjugate vaccine (PCV) in children under five alongside more robust health
monitoring systems at community level could help stem pneumonia
related-deaths in children in Kenya: 20 percent of deaths in children under
five are attributable to the disease, according to the Ministry of Public
Health and Sanitation.

Immunization against Hib (Haemophilus influenzae type b), pneumococcus (a
bacterium that can cause ear, sinus and bloodstream infections and
pneumonia), measles and whooping cough (pertussis) is the most effective
way to prevent the disease, says the World Health Organization (WHO).

Globally, pneumonia is the leading cause of death in children under five,
killing an estimated 1.1 million each year, according to WHO. [ WHO
http://www.who.int/mediacentre/factsheets/fs331/en/ ] Caused by viruses,
bacteria or fungi, pneumonia "can be prevented by immunization, adequate
nutrition and by addressing environmental factors", says WHO.

The Kenyan government has been targeting under-five children for PCV
vaccination through a partnership with the Global Alliance for Vaccines and
Immunizations, GAVI. [ http://www.gavialliance.org/] Since January 2011,
scientists have been tracking [
http://www.kemri-wellcome.org/index.php/en/study_page/16 ] the vaccine's
coverage versus pneumococcal disease-related hospital admissions among
residents of the costal town of Kilifi.

The research, Pneumococcal Conjugate Vaccine Impact Study (PCVIS) [
http://www.kemri-wellcome.org/index.php/en/studies_inner/75 ] compares "the
incidence rates of invasive pneumococcal disease, radiologically proven
pneumonia, and all-cause admissions to hospital in the period before
vaccine introduction and the period after vaccine introduction." The study
is due to be completed by the end of 2015, and uses the PCV10 vaccine, a
two-dose vial without preservatives approved by WHO. [
http://apps.who.int/iris/bitstream/10665/90378/1/WHO_IVB_13.09_eng.pdf ]

The results of PCVIS, which is being carried out by the Kenya Medical
Research Institute, KEMRI-Wellcome Trust Research Programme [
http://www.kemri-wellcome.org/index.php/en/about ] alongside the Division
of Vaccines and Immunization (DVI), are expected to help DVI determine
future vaccine policy.

Meanwhile, the PCV vaccine seems to be paying off.

"Already, the incidence of the illness in children aged [under] five has
gone down by approximately two-thirds in Kilifi since the PCV vaccine was
introduced three years ago," Anthony Scott, the lead researcher with KEMRI,
told IRIN.

More data needed.

Alongside the vaccine, better-equipped health monitoring and delivery
systems are also needed. According to the GAVI alliance, data-mining
electronic medical records are vital at a policy level to understanding the
efficacy of medicines. [
http://www.gavialliance.org/delivering/pdf/delivering-together-kenya/ ]

"With good data, it is very easy to show the minister and the country's
leaders the importance of bringing a new vaccine to Kenya," said S.K.
Sharif, Kenya's director of public health and sanitation. "Not only do we
have senior leaders who are passionate about vaccinations, but another
advantage for Kenya is that we are very good at collecting scientific
evidence about vaccinations."

But a lot more needs to be done to digitize more records, especially in
rural areas. "Our data are wanting. The Government needs to invest heavily
in data collection to improve Kenya's data system," Shikanga O-tipo, the
head of the integrated disease surveillance department in the Ministry of
Public Health and Sanitation, told IRIN.

and better diagnostic equipment.

Healthcare professionals also lack the equipment and knowledge to diagnose
pneumonia early in many parts of Kenya.

"The disease requires specialized clinical attention, but many of Kenya's
health facilities don't have X-ray equipment to diagnose chests for
pneumonia," said O-tipo. Additionally, "health workers have sometimes
failed to identify the disease-causing micro-organisms and would constantly
prescribe any other antibiotic that often leads to resistance," added
O-tipo.

Some of these difficulties are a result of how the disease presents itself
early-on. "There are many other conditions that come with heavy breathing.
This makes pneumonia, which shares similar symptoms, hard to detect at
early stages," said Donald Apat, a health specialist with Millennium
Villages. [ http://www.earth.columbia.edu/articles/view/1799 ]

and more community awareness
Community awareness about pneumonia is also needed in many parts of Kenya.
"A lot of cases have been reported where sick people in the communities
would sit back, hoping that the disease would go. And the moment they are
taken to the health facilities, the disease would have eaten them up," said
O-tipo.

Globally, nearly half of early childhood deaths as a result of pneumonia
are estimated to be as a result of a failure or delay in diagnosing the
illness and adequate treatment, according to the Melinda and Bill Gates
Foundation, which supports the GAVI alliance. [
http://www.gatesfoundation.org/What-We-Do/Global-Health/Pneumonia ]

Health officials now recommend educating communities about personal
hygiene, such as covering the mouth when coughing and washing hands
properly to curb the spread of the disease.

"More attention should be focused at the community levels, where a lot of
infections are community acquired," said O-tipo.

ho/aw/aps/cb[END]

This report online: http://www.irinnews.org/report.aspx?reportID=99858



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