Use of vaccines reduces or control disease and hospitalizations, stated Dr. Gagandeep Kang, executive director, Translational Health Science and Technology Institute (THSTI), Faridabad and winner of Infosys Prize 2016 Laureate for Life Sciences.
“While vaccine efficacy is higher in richer countries, the absolute reduction in severe disease per hundred children annually is much greater in poorer countries because of increased disease burden,” she added.
“Therefore, until better vaccines are made and available, we should use the vaccines we have, because it would prevent children from succumbing to diarrheal disease among others”, Dr Kang told Pharmabiz in an email.
“Under these circumstances, the focus of my research is nutrition, safe water, sanitation and vaccines to improve the health of India’s children in addition to understand the biology of disease. Globally and India being a special case, we evaluated natural rotavirus infection and vaccines. As expected, the vaccines work less well in poorer environmental settings, with the least access to health care,” she said.
Emerging data from Africa shows that in non-malnourished children the vaccine performance is >70% efficacy which is comparable to Latin America. In India, among middle-class and rich children, report a higher vaccine performance. Evidence shows that in national vaccination programs across the US and Africa, does reduce disease and hospitalizations, noted Dr. Kang.
Globally, rotavirus is the most common cause of severe diarrhoea in children where vaccines are not used. In India, rotavirus causes around 50,000 fatalities and over half a million hospitalizations annually. “In studies with ICMR, we have shown that 2 of 5 hospitalizations for diarrhea in India are due to rotavirus. India has finally introduced rotavirus vaccination in 4 states and expansion is planned in phases. We have started to monitor its impact and expect results in about 2 years”, she said.
“Although children in India are infected at the same rates globally, but those in poor environmental setting are repeatedly infected with rotavirus. Usually children in the West would have complete protection from this diarrhea after being infected twice, but in India even after three infections, the protection is only 80%. We do not completely understand why this happens, but we think it has a lot to do with multiple exposures to intestinal infections and the effect of the environment on intestinal function”, explained Dr. Kang.
There are no specific drugs to treat rotavirus. “We tested racecadotril, which was a helpful drug for acute watery diarrhea and not for severe cases. Nitazoxanide was reported to be good in one study, but there were no further successful independent studies. For rotavirus, there are many areas for exploration. The need of the hour is to identify an antibody to protect children from the disease. But with close to 20 years of research, it has been difficult to find one,” she said.
Delving on the interest among young scientists in India and abroad to research on infectious diseases, Dr. Kang said their comfort to technologies and computational tools was critical for translational research in the future. “THSTI has the capability to address public health problems in India with conventional and new tools to understand the disease mechanisms and design interventions for prevention and treatment,” she said.