Typhoid is a bacteria known as Salmonella Typhi that causes a gastrointestinal infection, leading to typhoid fever. This bacteria transfers from person to person and is spread due to lack of access to adequate sanitation and clean water. Typhoid continues to afflict many countries across the world in regions lacking access to sanitation. In 2016, an estimated 130,000 people died from typhoid fever across the world. One of the countries where typhoid continues to be a serious problem is the southeastern African country of Malawi.

Symptoms and Effects of Typhoid

Those affected by typhoid fever often struggle with symptoms such as extreme fatigue, rashes and a loss of appetite. In severe cases, typhoid can cause hemorrhaging or a perforation in the intestines.  Even after patients recover from typhoid or stop showing symptoms, they may continue to carry and spread the bacteria. Typhoid also affects more than just physical health; illness can impact people’s lives by impeding their ability to work or even to go to school. This results in a loss of wages or education for the duration a person suffers from typhoid. In recent years, typhoid has become more dangerous, as the bacteria grows increasingly resistant to antibiotic treatment.

The New Vaccine Against Typhoid in Malawi

Due to the severe prevalence of typhoid in Malawi, there has been a push for the use of vaccinations to prevent, or at least reduce, the effect of typhoid. In February of 2018, a conjugate vaccine trial was launched in Malawi. This vaccine is called Typbar-TCV. Young children are particularly vulnerable to typhoid, and Typbar-TCV is the first vaccine against the disease that can be given to children younger than two years old. Roughly 24,000 children in Malawi will participate in the trial.

Typbar-TCV was developed by Bharat Biotech, an Indian biotechnology company. Several studies have been conducted since 2005, and the vaccine was first launched in 2013. This vaccine has a wide range of effectiveness, from children as young as six months old to adults. Tests have shown that the vaccine to be 87 percent effective in preventing the contraction of typhoid. It also lasts longer than previously used vaccines, providing greater protection for a longer period of time.

Benefits of Typbar-TCV

The cost of treating typhoid can be a significant burden on people living in poverty, but the new vaccine takes steps to alleviate this burden. A study in 2016 reported that almost 70 percent of people living in Malawi were surviving on $1.90 USD or less per day. In the majority of developing countries, treatment for typhoid can be between $50 and $5,000. In contrast, the new Typbar-TCV vaccine costs $1.50 per dose to GAVI eligible countries. Through the vaccine’s affordability, the prohibitive cost burden that typhoid places on those who are the most vulnerable can be avoided.

Over the span of four years leading up to 2014, the appearance of multidrug-resistant typhoid increased by 90 percent in Malawi. Because of inadequate sanitation, people in the country remain vulnerable to typhoid while the disease itself becomes more difficult to treat. This antibiotic resistance increases the urgency for methods to prevent the spread of typhoid so that antibiotics become unnecessary. The Typbar-TCV vaccine is a step in the direction of reducing this danger by hindering the growth of increasingly deadly and untreatable forms of typhoid.

The use of Typbar-TCV in Malawi is a great achievement. The vaccine provides a method of preventing the spread of typhoid among those who need it, including infants who are most vulnerable to the dangers of the disease. Typbar-TCV will reduce the need for the antibiotics required after a person has contracted typhoid; this reduces the prevalence of multidrug-resistant strains of typhoid as well as protecting people from becoming infected in the first place. This vaccine against typhoid keeps the most vulnerable populations of Malawi safe.

– Lindabeth Doby
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