DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY

Shifts in the metabolic and virulence profiles of Streptococcus pneumoniae following the introduction of conjugate-polysaccharide vaccine in Malawi

Project disclaimer

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Description

It is estimated that in 2010-2011, there were 120 million episodes of pneumonia in young children worldwide, and 1.3 million pneumonia-related deaths. A microbe called Streptococcus pneumoniae or the pneumococcus, which frequently lives at the back of the nose in healthy children and adults, is a leading cause of childhood pneumonia in many African countries, and is also associated with a high burden of meningitis and severe blood infection. Reducing the burden of pneumococcal disease is therefore a major public health priority. Pneumococcal conjugate vaccines (PCV) are highly effective at reducing this disease and have been introduced into the routine infant immunisation programmes of several sub-Saharan African countries, including Malawi. We now have evidence from our ongoing work in Malawi that there has been a large direct benefit of vaccination occurring early after introduction. The critical question is whether this protection will be long-lasting and result in protection of individuals in the wider community who have not received or have responded poorly to the vaccine (so-called "herd immunity"). We have recently established a programme of surveillance in Malawi that is looking out for changes in the pneumococcus carried by otherwise healthy children and HIV-infected adults that may indicate that the vaccine will become less effective. In this proposed project we will exploit this ongoing work together with a wealth of data from pneumococci causing pneumonia, meningitis and blood poisoning to find out whether the introduction of PCV into the national childhood immunisation programme in Malawi leads to a change in the profile of carried pneumococci that has the potential to undermine vaccine impact; and then use a mathematical model to test potential strategies to prolong PCV effectiveness in Malawi and in other similar settings. This study will draw on expertise in Malawi, Liverpool and Oxford enabling us to exploit state-of-the-art genetic fingerprinting of these bacteria and new mathematical modelling approaches. Given that maintaining the effectiveness of pneumococcal vaccines is critical in resource constrained sub-Saharan African countries such as Malawi, this project is very timely in addressing the long term impact of these vaccines, particularly in vulnerable populations with a high burden of HIV, malnutrition and malaria.

Objectives

The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.

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Location

The country, countries or regions that benefit from this Programme.

Malawi

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