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TIPS ON MALARIA

  • HOW CAN MOSQUITOES BE CONTROLLED?

    Mosquitoes around the home can be reduced significantly by minimizing the amount of standing water available for mosquito breeding. Residents are urged to reduce standing water around the home in a variety of ways.

  • HOW CAN I PROTECT MYSELF FROM MOSQUITO-BORN DISEASES?

    The best way is to avoid being bitten by mosquitoes.This can be accomplished using personal protecting  while outdoors when mosquitoes are present. Treated bed nets should be used sleeping. Mosquito repellent should be used when outdoor.

  • WHO ARE AT RISK?


    Nearly half of the world’s population is at risk of getting malaria. Pregnant women are particularly at risk of malaria. Children under 5 years are at high risk of malaria.
     

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  • Volume 1

Vaccine trials liven up Siaya

By Linet Atieno Otieno- Kenya

Nancy walks into Siaya District Hospital carrying her twin babies. While she knows that only one of them is ill, she could not leave the other unattended to at home.

A team, led by Study Pediatrician, Dr. Martina Oneko, receives Nancy, as her children are part of the KEMRI/CDC RTS,S malaria vaccine trial.

Samples are taken from the sick child and in record time Nancy is informed that her baby has a rare form of meningitis caused by salmonella bacteria.

On hearing that one of the twins has salmonella, a test is carried out for the other child, and soon, it is discovered that both children have meningitis. They are both put on treatment.

Dr Oneko’s eyes light up when she recounts this story. She is talking about a revolution in healthcare that is taking place at the Siaya District Hospital (SDH) pediatric ward as a result of the ongoing RTS,S malaria vaccine trial.

“We would not have found the salmonella before the trial began because the SDH lacked micro-biology equipment,” says Dr. Oneko. 

The SDH, which serves as the district referral hospital, is the largest hospital in the Siaya district and can be counted among the largest district hospitals in the Nyanza Province in southwestern Kenya.

Under-five mortality rates are high in Karemo division, where the SDH is located, with about 184 deaths per 1,000 live births, according to the KEMRI/CDC Health and Demographic Surveillance System (HDSS).

                        Credit: PATH/MVI

The area also has a high burden of infectious diseases, and malnutrition is not uncommon.

HDSS findings show that the highest cause of mortality among infants in Karemo Division is malaria. Out of the 3,138 children admitted into SDH in 2008, 223 died and 66 of these deaths were due to malaria.

Given the burden of malaria in the Siaya area, the people have a pressing need for a new weapon in the fight against the disease.

In late 2008, Siaya, one of the poorest districts in Kenya, started planning  for the launch of a large-scale trial on the ground breaking malaria vaccine candidate called RTS,S.

With its track record of world-class medical research, KEMRI-CDC positioned itself to host the trial, which is being conducted at 11 sites in seven African countries, targeting the enrolment of  up to 16,000 study participants.

The trial officially began at Siaya on July 7, 2009. Today, about 1,200 participants, of a target 1,800 children, are enrolled in the study.

Already medical and research staff are seeing changes in the health of their clients, especially children under-five years who come to the hospital.

These changes started with the significant investment in equipment, staff, training, and renovations that were carried out during a preparatory study for the malaria trial. 

During the initial study, known as pre-Mal 055, GlaxoSmithKline (GSK), Biologicals (the developer and manufacturer of the vaccine) and the PATH Malaria Vaccine Initiative, conducted an evaluation and developed a plan to ensure that the site was ready for this major vaccine trial.

Equipment was provided for the hospital, including oxygen concentrators, vital signs monitoring equipment and a modern digital x-ray machine. The acute room in the pediatric ward was given a facelift with new and better beds and a laboratory with state-of–the art equipment.

To man the trial, the study employed about 68 clinical staff for four health facilities.

The clinical staff is made up of a pediatrician, medical officers, clinical officers, nurses, laboratory technologists and pharmacists.

There is a staff member on call every night in the pediatric ward. The doctors and pediatrician are often consulted for unusual illnesses in the ward for non-study participants, while the hospital also benefits from the other clinical staff assisting in activities such as resuscitations and inserting of intravenous lines.

From the beginning of the study, the participants were offered free healthcare and KEMRI/CDC provided high-level care quickly.

Children are also tested for HIV if the tests are thought to be necessary, so that they can be put on HIV care and treatment. Of the 1,200 children in the study, 30 have been found to be infected with HIV and 20 of them taken into care.

On one occasion, a mother, Jane, brought her child to join the study. Jane was HIV infected but had not participated in a prevention of mother-to-child transmission program.

While she also knew that her baby may have had HIV/AIDS, she did not divulge this information.  Her baby lost weight and at one-and-a-half years old, weighed only 6 Kg (a healthy child this age generally weighs about 10–11 Kg).

Jane was frantic and revealed her secret because she thought she was going to lose her baby. The child was tested, found to be HIV positive, and put on treatment. Now, just a few months later, he is almost 10kg and his mother is all smiles.

The pediatric ward at the SDH received its new lease of life at the start of the RTS,S studies about one and half years ago.

The Study Pediatrician Dr. Oneko is proud to be part of the team that is improving the lives of the children at the hospital.

“I am excited that now there are facilities to check diseases quickly,” she says. “This is an exciting opportunity for a district hospital where such diagnoses and care are not usually the case.”

Editions: 
Sixth Edition