International typhoid experts in Nepal to facilitate introduction of typhoid vaccines

Dr. Christian Loucq, Director General of International Vaccine Institute (IVI) and Dr. Christopher B. Nelson, Director of Coalition against Typhoid (CaT) Secretariat, Sabin Vaccine Institute, arrived in Kathmandu Wednesday to take part in the consultation meeting for the Introduction of Typhoid Fever Vaccination Program in Nepal, a critical part of typhoid fever control in Nepal, to be held on July 12.

Speaking to media persons in the capital this afternoon, Dr. Nelson cited World Health Organisation (WHO) data as per which there are 21.6 million of cases of typhoid fever and 216,000 deaths each year, predominantly among children of school age or younger, with 90% of deaths occurring in Asia.

He further said that in populations with access to medical care, management with appropriate antibiotics has effectively reduced typhoid fever mortality from over 25% to 1% or less.

"However, the high prevalence of multi-drug resistant typhoid is now widespread and growing, even in Nepal, and has resulted in a trend towards more severe outcomes and costly illness," Dr. Nelson said.

He informed that WHO has recommended the use of typhoid vaccines for the control and prevention of typhoid fever among school children, and added that several countries, including Thailand, China and Vietnam and the municipality of New Delhi, India, have already used typhoid vaccines to successfully control disease in school-and community-based programs.

"Other countries, such as Malaysia, the Philippines, and Singapore, have targeted food handlers for typhoid vaccination," he said.

According to Dr. Nelson, the National Committee on Immunization Practices (NCIP) has recommended the use of typhoid vaccines for disease control in the Kathmandu Valley and discussions are currently underway among the Ministry of Health and Population and other national stakeholders, including the Nepal Pediatric Association, to determine the feasibility of
implementation, including program financing.

"To inform an evidence-based discussion, extensive technical work has been completed in Nepal with support from the International Vaccine Institute (IVI)."

Also, speaking on the occasion, Dr Loucq, who has over 30 years of professional experience in medicine, vaccines, pharmaceuticals, and global health in various countries, said that IVI has been providing technical assistance to the government of Nepal through the Vi-based Vaccines for Asia (VIVA) Initiative- a program funded by the Bill & Melinda Gates
Foundation.

He said VIVA, IVI and local partners including Mitra Samaj have been working with the government to facilitate the introduction of typhoid vaccines in Nepal by providing the necessary scientific evidence on the need for such vaccines and their effectiveness.

"Pilot typhoid vaccination campaigns targeting school children in Lalitpur and Bhaktapur districts and adults who work in the tourism sector - major risk groups for typhoid - were conducted in 2011 and 2012," he said, adding that findings from the campaigns show the typhoid vaccine was safe, vaccination was acceptable by the public and implementation of such a program was feasible.

"This type of work exemplified IVI's approach, which is based on partnerships and capacity building from the ground up, to ensure that vaccines are sustainably developed and delivered through the local context in developing countries," he said, and hoped that people will support the adoption of the typhoid vaccines into the national immunization program.

Child Health Division of the Ministry of Health and Population had successfully completed the pilot introduction project of the Vi polysaccharide typhoid vaccine with technical support from IVI.

Even though burden of typhoid is high in Nepal, it remains a neglected disease. Public awareness of typhoid and ways to control it is also relatively low in Nepal.

Typhoid, a water borne disease spread through fecal contamination of water, causes high fever and if untreated can lead to intestinal perforation. Children are at highest risk for typhoid and studies have shown that the economic burden of treating typhoid is high for families. nepalnews.com