By Daniel Wako
The development of a malaria vaccine and its recommendation by the World Health Organization (WHO) for widespread use among children living in sub-Saharan Africa and other countries with moderate to high P. falciparum malaria transmission is a huge milestone in the fight against the disease.
Data from WHO shows that in the year 2019, there were 229 million recorded cases of malaria globally with over 90% of them coming from Africa. In the same year the world recorded 409, 000 deaths due to malaria.
Some population groups are at considerably higher risk of contracting malaria and developing severe disease: infants, children under 5 years of age, pregnant women and patients with HIV/AIDS, as well as people with low immunity moving to areas with intense malaria transmission such as migrant workers, mobile populations and travelers.
Children under 5 years of age are the most vulnerable group affected by malaria; in 2019 they accounted for 67% (274 000) of all malaria deaths worldwide.
In Kenya, there are an estimated 3.5 million new cases of infection with 10700 deaths each year. These infection and deaths occur mostly among children under the age of five years and pregnant women.
The lake endemic region which encompasses a total of eight counties namely; Bungoma, Vihiga, Busia, Kakamega, Kisumu, Siaya, Homabay, and Migori are leading in this data with a prevalence rate of 19.6% in last year. The cases in these regions are attributed to their closeness to Lake Victoria which creates favorable breeding environment to mosquitoes.
According to Malaria prevalence survey in Bungoma county, in 2020 the prevalence rate of malaria infection was 28.2%. This saw hospitals receiving a high number of infected children and pregnant women every day.
Dr. Moses Wambusi, the County Malaria Coordinator in Bungoma county, reveals that the sub counties leading in malaria cases includes Sirisia, Bumula, Kanduyi, Webuye west, Kabuchai and Webuye east. These regions are termed as malaria endemic region with a previlance of 19.6%. The other regions with less malaria cases (epidemic regions) are Mount Elgon, Cheptais, and Tongaren which have a prevalence rate of 1%.
In 2020, Bungoma county recorded a total of 289,051 malaria cases. Among this was 94,979 children below five years. The number of Malaria cases involving pregnant women (M I P) in the same year was 8,564. This year, from the month January to June, Bungoma County had recorded a total of 234,750 cases. Among that, the number of cases involving children was 71,241 while that of pregnant women was at 5,445 cases.
Dr. Dickens Lubanga, a pediatrician at Bungoma Referral Hospital, says “malaria infection rates area high among children but those with sickle cell condition are at high risk of losing life if infected.”
Lubanga acknowledges how the free distribution of mosquito nets has helped to reduce the infections but he is happier of Mosquirix Malaria vaccine that was first launched in Bungoma County in September 2019 at Bumula sub county hospital.
“I have learnt how the vaccine works and I am sure it will reduce the number of Malaria cases and deaths in this county,” he said.
According to Clara Bundotich, the Sub County Public Health Nurse at Bumula sub county hospital, administration of Mosquirix malaria vaccine started in September 2019.
She further states that the vaccine does not stop infection but rather reduces the chances of children being infected with severe forms of Malaria.
“They can still get infected after vaccination but not with severe forms that make them admitted in hospitals,” Bundotich said.
“The Malaria vaccine is given to children below one year. The vaccine is administered in four doses. We give the first dose of vaccine at the age of six (6) months then the second at seven (7) months. After the second dose, the third dose is given at nine (9) months and the last fourth dose at exactly two years.”
Till now Bumula sub county hospital has vaccinated a total of five thousand one hundred and eighty-four (5184) children with Mosquirix Malaria vaccine.
Out of this number three thousand six hundred and fifty-nine (3659) have received up to the third dose of the vaccine while one thousand six hundred and two (1,602) have completed the vaccination after receiving their fourth booster dose.
Among the challenges encountered in administering malaria vaccine include parents refusing their children to be vaccinated bearing in mind it is on trial.
Bundotich further adds that some parents do not bring their children to complete the four doses of the vaccine.
“I don’t know if it is because of forgetting or they are assuming the importance of this vaccine”. Bearing in mind this vaccine is new,”she said, adding that the nurses and doctors have to really convince the parents before they accept their children to be vaccinated.
On the side effects of Mosquirix vaccine, Bundotich said the only negative effect reported on the children after receiving this vaccine is high fever. In 2021, Bumula sub county hospital has recorded five cases of high fever among the vaccinated children. The five were confirmed Malaria positive before undergoing treatment.
Bundotich notes that the vaccine has helped to reduce the number of children being admitted with severe forms of Malaria at the facility.
She adds that the vaccine is given for free and calls upon the residents of Bumula to bring their children to receive it.
Mary Nafula, the mother to Hilary Shikuku aged two and half year’s said her son has completed the four doses of Mosquirix vaccine. She maintains the vaccine was friendly to his son who witnessed zero side effects after receiving it.
“The vaccine is good; my son has never been admitted in hospital because of Malaria,” Nafula affirms.
The other counties trying Mosquirix vaccine are; Homabay, Kisumu, Migori, Busia, Vihiga, Siaya and Kakamega.
Mosquirix Malaria vaccine was developed by GlaxoSmithKline (GSK) Vaccines) laboratories in Belgium in 1987. The vaccine was approved for widespread use by World Health Organization (WHO) on 6th October this year. Notably, to now more 650 000 children from different countries including Kenya, Malawi and Ghana have been vaccinated.
