Ivory Coast becomes first country to launch new malaria vaccine

News brief

Ivory Coast yesterday became the first country to launch the new R21 malaria vaccine, which was codeveloped by Oxford University and the Serum Institute of India (SII). It contains the Matrix M adjuvant—an immune-booster—made by Novavax.

baby behind mosquito net — USAID/Wendy Stone/Flickr cc

R21 is the second malaria vaccine to enter the market, the first being RTS,S. The new vaccine was prequalified by the World Health Organization (WHO) in December 2023, a step that ensures quality and safety and paves the way for lower- and middle-income countries to receive doses.

The first R21 dose was administered yesterday in Abidjan, Ivory Coast's largest city, according to a news release from Novavax. R21 will be rolled out to 38 districts across the country.

Under $4 a dose

Though malaria deaths in Ivory Coast have been trending downward since 2017, the disease still kills about four people each day, mainly young children, according to the country's health minister.

Ahead of the rollout, SII has manufactured 25 million doses and said it will scale up production to 100 million doses annually, Oxford University said in a statement. SII is offering the vaccine for less than $4 a dose.

Ivory Coast has received 656,600 doses, which will initially be used to vaccinate 250,000 children across 16 regions.

Fifteen African countries are slated introduce malaria vaccines in 2024 with support from Gavi, the Vaccine Alliance. The goal is to reach 6.6 million children in 2024 and 2025.

COVID tied to faster progression from preclinical to clinical type 1 diabetes in kids

News brief

Mary Van Beusekom, MS

Girl checking insulin — *Antonio_Diaz / iStock*

A study of German youth with presymptomatic type 1 diabetes links COVID-19 infection to accelerated progression to clinical diabetes.

For the study, published yesterday in JAMA, researchers in Munich and Dresden followed up with 509 children aged 1 to 16 years with presymptomatic type 1 diabetes participating in a screening program from February 2015 to October 2023.

The team collected blood samples every 3 to 6 months and confirmed parent-reported COVID-19 infections through the detection of SARS-CoV-2 antibodies. Information on infection severity was unavailable.

Of 509 participants, 358 were followed before March 2020 (prepandemic), and 396 were followed amid the pandemic. The median participant age was 4.1 years, and 46.2% were girls.

"The incidence of type 1 diabetes increased during the COVID-19 pandemic," the study authors noted, and they sought to determine if COVID-19 contributed to the rise.

Faster progression only among infected youth

Fifty-seven of 358 participants (15.9%) progressed to clinical type 1 diabetes before the pandemic, while 113 of 396 (28.5%) did so after the pandemic began. The incidence of clinical type 1 diabetes was 6.4 per 100 person-years prepandemic and 12.1 per 100 after March 2020.

The COVID-19 pandemic was associated with an accelerated progression to clinical disease and that this acceleration was confined to those with COVID-19.

Of the 353 participants with COVID-19 information, 236 (66.9%) were infected. Type 1 diabetes incidence was 8.6 per 100 person-years during, versus before, the pandemic among uninfected participants and 14.0 among the infected. The rate of type 1 diabetes was 15.3 among participants with a parent-reported infection and 13.7 among those who had SARS-CoV-2 antibodies but no report of infection.

The results "demonstrated that the COVID-19 pandemic was associated with an accelerated progression to clinical disease and that this acceleration was confined to those with COVID-19," the researchers concluded. "Further studies are required to determine whether COVID-19 also accelerates progression to type 1 diabetes in adults and whether vaccination and monitoring for COVID-19 symptoms should be considered for individuals with presymptomatic type 1 diabetes."

Backyard chicken flocks have higher rate of Campylobacter than those on farms, study finds

News brief

Jim Wappes

backyard chickens — *Karen Jackson / Flickr cc*

A new prevalence study of the common foodborne bacterium Campylobacter in North Carolina chickens shows it is almost twice as common in backyard flocks than on commercial farms, and isolates are often resistant to antibiotics.

The authors say the findings are significant because chicken is the top consumed meat worldwide, and backyard poultry production is increasing in the United States. The results were published in JAC - Antimicrobial Resistance.

22% samples positive in backyard flocks, 12% on farms

North Carolina State investigators obtained samples from 10 backyard and 10 commercial broiler farms in North Carolina to follow flocks throughout production. They collected fecal and environmental samples at days 10, 31, and 52 days post-hatch in backyard flocks and on days 10, 24, and 38 on commercial farms. Environmental samples were collected from the soil, litter/compost, and feeders and waterers.

Of samples collected from backyard flocks, 21.9% tested positive for Campylobacter, compared with 12.2% of the farm samples. Most of the isolates were identified as C jejuni (70.8%), with the rest C coli (29.2%). The breakdown of positive sample locations in backyard farms was 70.2% from fecal samples, 6.4% from soil, 3.5% from litter/compost, and 19.9% from swabs of feeders and waterers. For commercial farms, the rates were 84.2%, 0%, 12.6%, and 3.2%, respectively.

We found a higher proportion of resistant isolates in commercial farms, with unprecedented higher levels in C. jejuni versus C. coli.

Antimicrobial susceptibility testing revealed phenotypic resistance to ciprofloxacin (40.2%), an important treatment drug for Campylobacter, and tetracycline (46.6%). The researchers found a higher proportion of resistance in C jejuni isolates and on the commercial farms.

The authors concluded, "Despite higher prevalence in backyard farms, we found a higher proportion of resistant isolates in commercial farms, with unprecedented higher levels in C. jejuni versus C. coli."