By Mazhar Shahen – Art in Tanzania internship

In Tanzania over 90% of the population live in areas where there is risk of malaria. In Africa, Tanzania is the third largest population at risk of malaria. Most of the victims of the disease are children, with around 80,000 death annually caused by malaria. In Tanzania, the Kagera Region on the western shore of Lake Victoria has the highest risk of contracting the disease. The Arusha Region is a lower risk area. However due to climate change and people migration caused an increase in the migration of mosquitoes and caused areas that are malaria free to be exposed to the disease. 

MALARIA

Malaria is a life-threatening disease caused by the transmission through an infected female Anopheles mosquito. The infected mosquito is a carrier of Plasmodium parasite. The parasite is released into the human bloodstream through the mosquito bite. The parasite survives in tropical and subtropical climates. After the parasite enters the human bloodstream it travels to the liver to mature. Maturity of the parasite takes several days, then the parasite goes back to the bloodstream to travel to the red blood cells this time. Once the red blood cells are infected, the parasite starts multiplying withing 2-3 days, causing the infected red blood cells to burst. 

Malaria is an acute febrile disease, which means it shows signs of fever when infected. Symptoms appear in a non-immune person 10-15 days after the infection has occurred. Early symptoms are mild fever, chills, and headache. Since it is mild, it makes the malaria disease harder to detect early on. If not treated the plasmodium parasite can progress to severe illness, usually leading to death.

Severe malaria in children could lead to severe anaemia, respiratory distress, and/or cerebral malaria. Adults are at risk of multi-organ failure. 

In 2019 the World Health Organization (WHO) reported that half of the world’s population is at risk of malaria. With most of the cases and deaths are in the sub-Saharan Africa. This indicates that African community is in need of a malaria vaccine as soon as possible. Malaria control has been better, with the number of cases dropping significantly over the last decade, with the number of children dying from malaria being halved. 

MALARIA VACCINE

Vaccines are a hot topic in the world we live in. Vaccines help us strengthen our immune system against specific disease which protects us from that illness. Vaccines are usually needle injections but can also be given by mouth or sprayed into the nose.

WHO claims that the malaria vaccine is capable of reducing malaria cases by 75% and put us on goal of the eradication of the illness. Malaria is responsible for 219 million cases each year with an estimated 660,000 deaths of the illness.

Tanzania has the third largest population that is at risk of the illness in Africa, with 90% of the population at risk of contracting malaria. Tanzania has 10 to 12 million cases of malaria annually, with most of them being children. The number of cases has been controlled a lot better of the decade leading to significant decrease, and number of children dying from malaria halved. However, due to climate change and the migration of people malaria cases are rising in areas that were considered low risk in the past. This is complicating the fight against malaria. 

Vaccine RTS,S acts on Plasmodium falciparum, the most deadly malaria parasite in the world and specifically in Africa. The vaccine is the first and only successful vaccine for malaria, which helped in reduction of children death in Africa. This vaccination is part of the Malaria Vaccine Implementation Progamme (MVIP), this program is established by WHO to deliver the vaccine in selected areas of Africa with the help of each country’s governments. The 3 African countries that are currently in pilot introduction are Ghana, Malawi and Kenya. The goal is to supply the whole region by 2023. Vaccine RTS,S is considered a safe vaccine, and no proven direct side effects are there. The pharmaceutical giant GSK will be conducting a number of Phase 4 studies in the 3 African countries chosen for pilot. 

In 1987 the discovery of a synthetic peptide polymer (SPf66) in Columbia enabled the development of the first vaccine candidate. Tanzania was the second country after Columbia to participate the clinical trials of SPf66. This indicates that historically Tanzania has an advantage as researchers will have a deeper pool of information in Tanzania compared to other African countries. Researcher George M Bwire states in his article that the inclusion of Tanzania in the Malaria Vaccine Implementation Program for the current RTS, S vaccine is crucial.

REFERENCES

1. Agnandji, S. T., Agnandji, S. T., Asante, K. P., Lyimo, J., Vekemans, J., Soulanoudjingar, S. S., . . . Abdulla, S. (2010). Evaluation of the Safety and Immunogenicity of the RTS,S/AS01E Malaria Candidate Vaccine When Integrated in the Expanded Program of Immunization. The Journal of Infectious Diseases, 202(7), 1076-1087. Retrieved 2 11, 2021, from https://academic.oup.com/jid/article-abstract/202/7/1076/837083
2. Bwire, George & Sanga, Anna. (2019). Malaria control in Tanzania: Current status and future prospects. 2664-8490..
3. Dimala, C. A., Kika, B. T., Kadia, B. M., & Blencowe, H. (2018). Current challenges and proposed solutions to the effective implementation of the RTS, S/AS01 Malaria Vaccine Program in sub-Saharan Africa: A systematic review. PLOS ONE, 13(12). Retrieved 2 11, 2021, from https://ncbi.nlm.nih.gov/pubmed/30596732
4. Galactionova, K., Tediosi, F., Camponovo, F., Smith, T., Gething, P. W., & Penny, M. A. (2017). Country specific predictions of the cost-effectiveness of malaria vaccine RTS,S/AS01 in endemic Africa. Vaccine, 35(1), 53-60. Retrieved 2 11, 2021, from https://sciencedirect.com/science/article/pii/s0264410x16311033
5. Malaria vaccine implementation PROGRAMME (MVIP). (n.d.). Retrieved February 12, 2021, from https://www.who.int/news-room/q-a-detail/malaria-vaccine-implementation-programme
6. Malaria in Tanzania. (n.d.). Retrieved February 12, 2021, from https://malariaspot.org/en/eduspot/malaria-in-tanzania/
7. White, N. J. (2011). A vaccine for malaria. The New England Journal of Medicine, 365(20), 1926-1927. Retrieved 2 11, 2021, from https://nejm.org/doi/full/10.1056/nejme1111777