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Vaccines could halve sickle-cell deaths in Africa

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Vaccines could halve sickle-cell deaths in Africa

Vaccination against bacterial infections using vaccines readily available in developed countries could save the lives of thousands of children with sickle-cell anemia in Africa, researchers said on Thursday.

Tom Williams, an expert in tropical diseases from the Kenya Medical Research Institute (KEMRI), said 90 percent of children born with sickle-cell anemia in Africa die before they are diagnosed and can get treatment, and half of those lives could be saved if sufferers were protected from bacterial infections.

“The problem here in Africa is that there is hardly anyone doing any screening,” Williams said. “So, as a result, most of the children in Africa who are born with sickle-cell anemia are dead before they are even diagnosed.”

Experts estimate that sickle-cell anemia kills more children in Africa than HIV, Williams said, but while HIV commands vast attention from the international community sickle-cell anemia is “virtually invisible.”

In a study conducted in rural Kenya and published in the Lancet medical journal, Williams and colleagues at the KEMRI/Wellcome Trust program in Kilifi screened almost 40,000 admissions to hospital and identified 2,000 cases of bacterial infection.

While in the general population fewer than three in 1,000 children were found to have sickle cell anemia, this figure increased more than 20-fold — to more than 60 per 1,000 — for children admitted to hospital with bacterial infections.

Sickle-cell anemia affects millions of people worldwide, but more than 80 percent of cases are in Africa, where around 200,000 children are born with the disease every year.

It is a genetic disease in which red blood cells deform into a sickle shape and cluster, blocking blood flow and causing pain, vulnerability to infections and organ damage.

The findings confirm that, just as in richer nations, African children with sickle-cell anemia are at huge risk of bacterial infections because the disease hampers blood flow and causes episodes of acute anemia, Williams said.

The most common causes of bacterial infection among children with sickle-cell were Streptococcus pneumoniae (41 percent of cases) and Haemophilus influenzae type b (12 percent of cases).

Vaccines against both — a pneumococcal vaccine and another called Hib — are given routinely in the United States and Europe, but have been slow getting to Africa because funds have largely been focused on other priorities.

Dan Thomas of the Global Alliance for Vaccines and Immunization (GAVI) in Geneva, said his group provides the Hib vaccine, which is made by a range of drug companies, to 35 African nations as part of a 5-in-1 shot.

GAVI has also introduced a pneumococcal vaccine made by Wyeth, a U.S. drug company which is being bought by Pfizer, to Rwanda and Gambia, and is “working on rolling an improved pneumococcal vaccine out across Africa in the next few years,” he said.

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Early daycare may not lower asthma risk

in.reuters.com

Early daycare may not lower asthma risk

Contrary to what some previous studies have suggested, children who enter daycare at an early age may not have a reduced risk of allergies and asthma later on, researchers reported Tuesday.

In a study of more than 3,600 children followed from birth, the investigators found that children who entered daycare before the age of 2 were no less likely than their peers to suffer from allergies or asthma at the age of 8.

But early daycare did not appear to raise those risks either, senior researcher Dr. Johan C. de Jongste, of Erasmus University in Rotterdam, the Netherlands, told Reuters Health in an email.

Instead, the findings suggest that daycare has little long-term effect on children’s respiratory health — and that it should not be seen as a way to protect them from allergies and asthma down the road, the researchers report in the journal American Journal of Respiratory and Critical Care Medicine.

The study, de Jongste said, challenges what is known as the “hygiene hypothesis” — the theory that the increasingly germ-free surroundings of modern life are actually contributing to an increase in allergies and asthma.

Some researchers speculate that exposure to viruses and other bugs at daycare may help push a young child’s immune system toward infection-fighting mode, and away from a tendency to over-react to the normally benign substances — the basis of allergic conditions.

Along with daycare attendance, certain other factors that suggest greater early-life exposure to infections — like having older siblings — have also been linked to lower risks of childhood allergies and asthma.

But in the current study, neither daycare nor the presence of older siblings showed long-term effects.

Of the 3,643 children followed from birth to age 8, 30 percent started daycare before age 2. These children were twice as likely as the rest to suffer breathing difficulties in the first year of life.

But the pattern shifted with time, and by the age of 8, early-daycare children were no more — or no less — likely to have episodes of wheezing or other signs or symptoms of asthma. Nor did early daycare affect the risk of showing reactions to airborne allergens during allergy testing.

Children with older siblings were also more likely to have wheezing symptoms in the first year of life, but were no more or no less likely to have signs or symptoms of allergies or asthma at age 8.

The findings, de Jongste’s team writes, suggests that early daycare simply “shifts the burden” of respiratory symptoms to an earlier age, with no tradeoff of protective effects later on.

“Hence,” they conclude, “early daycare should not be promoted for reasons of preventing allergy and asthma.”

SOURCE: American Journal of Respiratory and Critical Care Medicine, September 15, 2009.

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Study finds potential way to make an AIDS vaccine

in.reuters.com

Study finds potential way to make an AIDS vaccine

The discovery of immune system particles that attack the AIDS virus may finally open a way to make a vaccine that could protect people against the deadly and incurable infection, U.S. researchers said on Thursday.

They used new technology to troll through the blood of 1,800 people infected with the AIDS virus and identified two immune system compounds called antibodies that could neutralize the virus.

And they found a new part of the virus that the antibodies attack, offering a new way to design a vaccine, they reported in the journal Science.

“So now we may have a better chance of designing a vaccine that will elicit such broadly neutralizing antibodies, which we think are key to successful vaccine development,” said Dennis Burton of The Scripps Research Institute in La Jolla, California, who led the study.

“The findings themselves are an exciting advance toward the goal of an effective AIDS vaccine because now we’ve got a new, potentially better target on HIV to focus our efforts for vaccine design,” added Wayne Koff of the International AIDS Vaccine Initiative, or IAVI, which sponsored the study.

Since the AIDS pandemic started in the early 1980s, more than 25 million people globally have died from the virus. The World Health Organization estimates that 33 million are currently infected.

There is no cure, although a cocktail of drugs can help keep the virus under control. Efforts to make a vaccine have failed almost completely.

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