Impact, Challenges, and Future Projections of Vaccine Trials in Africa

Abstract

Abstract. Immunization remains the most cost effective method for the control of infectious diseases. Therefore, there is a global effort to deploy new vaccines for disease control and eradication. These new vaccines must be tested in the settings in which they will be used. This necessity has required the conduct of many vaccine trials in Africa, where several infectious diseases with significant public health impact are prevalent. However, these areas have peculiarities and are just beginning to gain expertise in the conduct of such trials. The vaccine developers and sponsors of these trials may also not be conversant with some issues unique to the trial site. The understanding gap from both partners can result in challenges if not addressed during the planning phase of the trial. This review seeks to highlight the issues surrounding the conduct of clinical trials in resource-constrained settings and suggests some ways of circumventing them.

Engagement of the Community, Traditional Leaders, and Public Health System in the Design and Implementation of a Large Community-Based, Cluster-Randomized Trial of Umbilical Cord Care in Zambia

“…Understanding and addressing community belief systems before initiation of a clinical trial is important for ensuring successful recruitment and retention and high levels of participant follow-up. 17 The baseline formative research was critically important to determine appropriate visitors and their timing in the first 24 hours of a child's life. Collaborating with the community on the FM selection helped foster a sense of ownership and participation from traditional leaders, village headmen, and other community members.…”

“…Community belief systems and the need to obtain informed consent from stakeholders ranging from traditional leaders to individual pregnant women and guardians/husbands of pregnant minors also present challenges to the conduct of clinical trials. 16,17 We developed our approach to the implementation of the Zambia Chlorhexidine Application Trial (ZamCAT) with these issues in mind. The primary goal of this manuscript is to describe the process of community engagement and how this influenced the quality of study implementation.…”

Suboptimal vaccination rates in rural Ghana despite positive caregiver attitudes towards vaccination

“…Immunization is a proven and cost effective tool for control of infectious diseases [6,7]. Vaccine preventable infections includes diphtheria, Haemophilus influenzae type B, hepatitis A, hepatitis B, human papilloma virus, influenza, measles, meningococcus, mumps, pertussis, pneumococcus, polio, rotavirus, rubella, smallpox, and tetanus.…”

Clinical Research in Neglected Tropical Diseases: The Challenge of Implementing Good Clinical (Laboratory) Practices

“…The challenges of implementing GC(L)P in LMICs have been described by different groups in sub-Saharan Africa, for instance in the fields of a multi-country malaria trial [8] and of vaccine research, respectively [9]. More recently, they have been discussed in the frame of the Ebola outbreak in West Africa [10].…”