Protect children against severe diarrhoea: here is the long awaited vaccine!
Dr. Clarisse Loe Loumou of GAVI’s Civil Society Organization Constituency makes a major announcement that will affect the health of millions of children around the globe.
During my years of practice in the largest pediatric hospital of Cameroon in Yaoundé, I remember that the 300 beds were rarely empty. I was in charge of the gastroenterology and paediatric nutrition ward, where 28 beds were occupied more than 90 percent of the time by infants who were dehydrated and suffering from severe diarrhea.
Our problem was not the diarrhea itself — its treatment protocols are well known; oral re-hydration salts, adequate re-nutrition, zinc supplementation, intravenous (IV) fluids for the most severe cases — but in making real the possibility of preventing severe diarrhea. It was and still is common for children in Cameroon and other parts of Africa who are suffering from severe diarrhea to die due to limited access to oral re-hydration salts, IVs, clean drinking water, or even the inability to reach a hospital in time.
Rotavirus is the leading cause of severe diarrhea in children under five years of age worldwide, killing more than half a million children each year and hospitalizing millions more. Nearly 50 percent, or 230,000 of those rotavirus deaths, happen in Africa. Worldwide, more than one third of the 1.34 million diarrhea deaths in children under five years of age, and 40 percent of the 9 million diarrhea-related hospitalizations are due to rotavirus disease. In Africa, the percentage of rotavirus-related hospitalizations is even a bit higher at 41 percent. These facts may be little-known, yet diarrhea remains the primary cause of child mortality in Africa. In Cameroon, diarrhea is the third highest cause of death in children under five years old. Thirty percent of those diarrheal deaths are due to rotavirus.
We need to draw attention to the devastating role of rotavirus in causing death to millions of young children. My hopes of delivering a rotavirus vaccine across all of Africa must one day become a reality, not only to prevent hundreds of thousands of unnecessary deaths, but to boost our fight against poverty.
And let’s not forget the economic costs of diarrhea; of hospitalization, of medications, of parents or caregivers who must stop work, and of young lives lost. This leads to a vicious circle, where diarrhea that is inadequately treated can cause malnutrition, which can decrease immunity and lead to further re-infection with diarrhea or other diseases. Vaccination offers the best hope for preventing severe rotavirus disease and the deadly dehydrating diarrhea that it causes.
I am proud that in July 2011, with the support of the GAVI Alliance, Cameroon introduced a vaccine against pneumococcal disease, the leading cause of pneumonia, and aims to introduce the rotavirus vaccine in 2013. None of this would be possible without political will, the active contribution of donors, and the efforts of the Government of Cameroon and its Immunization Programme, which have made the environment conducive to helping these life-saving vaccines reach the children who need them most.
I am delighted that our children are finally going to be protected against the main causes of diarrhea and pneumonia, the world’s two biggest killers of children under five and the leading killers here in Cameroon. There is no reason for such unjust deaths, and we now eagerly await the rotavirus vaccine to reach us in 2013.
Dr. Clarisse Loe Loumou, pediatrician and member of the Steering Committee of the GAVI Civil Society Organization Constituency.
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04/10/2011 at 12:14 pm
I empathize totally with needless deaths and Rotavirus is a terrible disease. However, studies show that while the rotavirus vaccine cut deaths of Mexican babies from diarrhoea by 40%, BMJ, it compares poorly with a study of Brazilian children that found that exclusive breastfeeding cut diarrhea by 90%.
Breastfed children are over 6 times less likely to die from diarrhea, The Disease Control Priorities Project (DCPP) gives this important data: Exclusive breastfeeding means no other food or drink, not even water, is permitted, except for supplements of vitamins and minerals or necessary medicines. The optimal duration of exclusive breastfeeding is six months (WHO 2001). A meta-analysis of three observational studies in developing countries shows that breastfed children under age 6 months are 6.1 times less likely to die of diarrhea than infants who are not breastfed (WHO Collaborative Study Team 2000).
http://www.dcp2.org/pubs/DCP/19/Section/2542
The other major concern is the administering of these live vaccines. With several rotavirus vaccines given before 6 months, how can one know if that baby is suffering from Aids or HIV? The manufacturers of these live vaccines warn AGAINST administering live vaccines to such children. The effect on their health is unknown they say, and the lower their immune system, the longer this live vaccine sheds into the water system for up to 4 weeks. See the insert.
Then there is the problem of intussusception… 9 per 31,500 doses. They justify these figures as the placebo is linked with 16 cases. But here is the question. What was the placebo? As ALL vaccine safety studies do NOT use benign placebos, usually they are the same formulation without the viral antigenis, is this a good study? And don’t forget healthy children are used.
“In a major study, in which over 31,500 babies received Rotarix and over 31,500 received placebo, nine babies developed intussusception following vaccination with Rotarix, compared with 16 who developed it after receiving placebo. This study did not show an increased risk of intussusception with Rotarix.” Well of course not.
Surely then, promotion of breastfeeding, access to clean water, responsible administration of vaccines and post surveillance of vaccines should be standard to ensure that needless deaths and disability are reduced.
I look forward to your comments, thank you.
31/01/2012 at 7:39 am
Children are easily affected by sickness. Like the usual fever and flue, we should protect them and give a good medication and vaccine that will help them to prevent such diseases. And for the protecting your child against abused and violence David Hausdroff can help you.