Four year old Golden Kondowe with his dad, Christopher, after receiving his vaccine.

History was made in the fight against typhoid fever today, as the first child in Africa was vaccinated in a clinical trial using a new generation of typhoid vaccines.

The clinical trial in Malawi is being led by Professor Melita Gordon of the University of Liverpool and the Malawi-Liverpool-Wellcome Trust (MLW) Clinical Research Programme. The goal of the trial is to assess the efficacy and cost-effectiveness of a new typhoid conjugate vaccine (TCV) in African children. In the densely-populated low-income urban townships of Blantyre, Malawi, 24,000 children aged 9 months to 12 years will be enrolled as part of the Typhoid Vaccine Acceleration Consortium (TyVAC) study, funded by the Bill & Melinda Gates Foundation.

Substantial public health problem

Typhoid fever, a bacterial bloodstream infection cause by Salmonella Typhi, causes fever, abdominal pain and, in severe cases, jaundice and bleeding or perforation of the bowel. There are an estimated 12 million cases and more than 128,000 deaths due to typhoid each year.

Four year-old Golden Kondowe is the first child to be vaccinated in the trial. His mother was out at work, and he was brought by his father Christopher, who said: “We decided we want our child to be protected against this serious disease – it will help him and other children in Malawi, too. We are humbled to have this chance.”

The recent emergence of the global multidrug-resistant ‘H58’ strain has resulted in an increase in cases across Africa. A Malawi-based team of researchers from the University of Liverpool and the Liverpool School of Tropical Medicine identified new epidemics of typhoid peaking in young and school-age children. They see at first hand the impact typhoid has on hard-pressed health services and hospitals, and how the circumstances of poverty mitigate against good sanitation in these urban townships.