Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
Sunday Times (Johannesburg) - October 5, 2003
Claire Keeton
MANY of the babies with their heads shrouded by oxygen boxes in the children's ward of Chris Hani Baragwanath would not have been there - if they had been given a new pneumonia vaccine .
The vaccine, which was tested on almost 40 000 children in Soweto, reduced the incidence of pneumonia by 25% and worked against antibiotic-resistant strains of the disease.
It offers protection against the nine most common strains of pneumococcal bacteria - the main cause of pneumonia and meningitis.
Pneumonia is the biggest killer of children worldwide.
The vaccine is the first in the world that works for children with HIV and is safe for children under two years old.
Trial investigator Dr Shabir Madhi said the vaccine had the potential to save 500 000 lives each year. He said an estimated 2.5 -million children worldwide die annually from pneumonia .
Madhi said: "The children most at risk of pneumonia are those who are HIV infected, or socially disadvantaged children who do not have access to health care, like those in rural areas.
"A major focus must be how to make the vaccine accessible to children in developing countries."
The results of the vaccine study - conducted between 1998 and 2000, with follow-up research through 2001 - were published in the New England Journal of Medicine on Thursday.
The University of the Witwatersrand and the US-based universities of Emory and Johns Hopkins conducted the trial of the vaccine, developed by US drug company Wyeth Pharmaceutical.
The vaccine combats two more serotypes than an existing vaccine routinely used in the US, and registered in South Africa this year.
Principal investigator Professor Keith Klugman, a public health specialist at Emory University, said: "In an era in which there is little to offer children with HIV, we can clearly reduce invasive disease by providing this vaccine to all children."
The vaccine protected more than 65% of HIV-positive children (and 83% of those without HIV) from invasive pneumococcal disease caused by bacteria entering the bloodstream.
The trial also found the vaccine reduced mortality by 5% among all children, and 6% among those with HIV. The children on the trial were given three doses of the vaccine at Soweto clinics during their routine immunisation shots at six, 10 and 14 weeks old.
Trial researcher Dr Clare Cutland said more than 70 nursing staff and 17 doctors were employed for the trial .
It covered about 90% of children born in Soweto over the three year period, and the Respiratory and Meningeal Pathogens Research Unit is still monitoring them.
Nurse Gabisile Senne helped to enrol babies in 1998 and is enthusiastically doing follow-ups on any trial children admitted to the hospital.
Three-year-old Adon Mbewe, who was being treated in hospital this week after a fit, was one of them.
His mother, Jemina, said she was glad she let Adon be vaccinated at Meadowlands Clinic in Soweto.
"I did hesitate about the vaccine , but I thought I would take a chance and he's growing well," said Mbewe .
The vaccine still has to be licensed, which may take a few years.
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