Indian J Med Res
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Review Meta Analysis
Efficacy of leprosy vaccines across the globe: A systematic review & meta-analysis of randomized controlled trials.
Background & objectives Although multi-drug therapy has decreased the burden of disease, leprosy is yet to be eliminated. Accelerating progress requires optimal use of existing tools, advanced diagnostic tests, newer drugs, and vaccines. The search for a vaccine with therapeutic and preventive potential is ongoing, but evidence on effectiveness and safety is lacking. ⋯ In subgroup analysis among the eight prophylactic vaccine studies, pooled relative risk was found to be 0.61 (95% CI: 0.41 - 0.91). Interpretation & conclusions The findings of this meta-analysis suggest that both prophylactic and therapeutic leprosy vaccines were significantly better compared to the placebo. Leprosy vaccine in the form of Mw/Mycobacterium welchii/MIP along with combination of World Health Organization (WHO) multi-drug therapy (MDT) or Bacillus Calmette-Guerin (BCG) vaccine along with second line treatment with rifampicin were found to be protective among the recipients.
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Tuberculosis continues to be among the leading causes of morbidity as well as mortality. It is appreciated that our aim of eliminating TB in the foreseeable future will not be realized until we have a new vaccine with significant efficacy among diverse populations and all age-groups. Although impressive strides have been made in more refined development of new TB vaccines based on learnings from past experiences, the substitute or a booster vaccine for the BCG vaccine is not available yet. This article puts in perspective the recent efforts in re-positioning BCG, development of newer vaccines based on novel approaches, the current TB vaccine pipeline, yet unmet challenges in vaccine development, exploring newer ideas in vaccine development and what the future holds.
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Background & objectives The expanded programme on immunization launched in India in 1978, with its focus on preventing six diseases in children (tetanus, diphtheria, pertussis, poliomyelitis, typhoid, and childhood tuberculosis), was widened in its scope in 1985-86. This new avtaar, the Universal Immunization Programme (UIP), incorporated measles vaccine for children and rubella and adult diphtheria vaccines for pregnant women. We conducted this rapid review on adult immunization relevant for India, as recent COVID-19 experience revealed how newly emergent or re-emergent pathogens could have their onslaughts on the elderly and adults with comorbidities. ⋯ Both qualitative and quantitative investigations explored vaccine hesitancy, which was studied more during the COVID-19 pandemic than earlier. Interpretation & conclusions Vaccination programmes in India would require (i) increasing awareness around vaccine-preventable diseases among adults and HCWs; (ii) actively engaging health care systems and community-based organizations; and (iii) developing and producing affordable, safe, and country-appropriate vaccines. Effective communication strategies and tools will be the key to the success of such interventions.
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Leishmaniasis is a parasitic disease caused by various species of the Leishmania parasite, manifesting in visceral (VL), cutaneous (CL), and mucocutaneous (MCL) forms. To combat this debilitating disease, various vaccines candidates including proteins, DNA, vectors, adjuvants, and recombinant whole parasites have been developed and tested experimentally and preclinically against several Leishmania species. Some vaccines have already entered human clinical trials. ⋯ This review examines all efforts to develop recombinant vaccines against the parasite, analyzing successes including commercially available canine vaccines and the overall challenges faced in the quest to eradicate the disease. Additionally, recent advances in vaccine delivery systems, such as viral vectors and non-pathogenic bacteria, offer promising avenues to enhance immunogenicity and improve the targeted delivery of antigens, potentially leading to more effective and long-lasting immune responses. By understanding past and current efforts, future strategies can be refined to create more effective vaccines and ultimately control or eradicate this parasitic disease.
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Vaccination is one of the most successful and cost-effective interventions designed by science which has helped in preventing millions of deaths, especially in children. The Expanded Programme on Immunization (EPI) was established by World Health Organization (WHO) in 1974 to develop immunization programmes throughout the world with polio, measles, diphtheria, tetanus, tuberculosis and whooping cough. ⋯ The story of vaccines in South-East Asia is a testament to scientific progress, global collaboration, and unwavering commitment to public health. This article aims to discuss the journey of EPI in the WHO SEAR.