The Public and Community Engagement group at OUCRU has a strong commitment to community engagement, particularly in the field of vaccine research. Let’s look at some featured projects in all OUCRU’s local offices, spreading out from typhoid in Nepal to TB in Vietnam.
Nepal: Tackling Typhoid
Typhoid is a public health problem in Nepal(1). With its high incidence, Kathmandu, the capital city of Nepal, has been labelled the enteric fever capital of the world.(2) To reduce the morbidity and mortality, the Typhoid Vaccine Acceleration Consortium (TyVAC) supported the introduction of typhoid conjugate vaccine (TCV) for Gavi eligible countries with a typhoid disease burden(3) using a World Health Organization (WHO) prequalified vaccine.
However, in Nepal, clinical research is often met with distrust and negative opinions. Therefore, when the TyVAC-Nepal study was conducted, a continuous public engagement strategy had been used to gain and maintain community trust.
The strategy involved three tiers of engagement with various stakeholders, including parents/guardians of vaccinated children, before, during, and after vaccination.
Before vaccination, initial engagement involved Lalitpur Metropolitan City’s elected representatives. The second engagement level was carried out in all 17 municipal wards, attended by various local stakeholders, including ward chairpersons and elected members. The third level involved engaging with mothers’ groups and schools before vaccination, and subsequently with parents of vaccinated children and non-vaccinated community members. School engagement with students and teachers was also part of this third level.
Access full paper about public engagement to support typhoid vaccine in Nepal here.
Despite challenges such as misinformation, skepticism, and logistical issues, the study achieved its target of vaccinating 20,019 children. The study found that using community-friendly language, involving locals in the consent process, and adapting to community needs and expectations were crucial in overcoming hurdles and building trust.
Indonesia: Battling Malaria
Over 150 million Indonesians are at risk of malaria from five Plasmodium species. Malaria is particularly severe in rural and impoverished areas.
The Indonesian Army deployment of malaria-naïve (or minimally malaria-exposed) infantry soldiers to Papua are highly exposed and vulnerable to severe forms of clinical malaria. Therefore, they view the development of a vaccine as an ideal solution. They believe it could serve as a powerful tool for both the prevention of new cases and the eventual elimination of the disease within their ranks.
The Indonesia trial is being performed as a collaboration between the Indonesian Army, the Eijkman Institute, the University of Indonesia School of Medicine, and OUCRU Indonesia (formerly EOCRU).
This is the first time a malaria vaccine has been tested in a real-world setting outside Africa in many years. It’s also the first time the vaccines have been tested against natural strains of P. falciparum and P. vivax outside of Africa.
Vietnam: Working towards #EndTB Goal
Tuberculosis (TB) is a leading cause of death from infectious diseases and antimicrobial resistance, affecting about a quarter of the world’s population. The Global tuberculosis report 2018 estimated Viet Nam had 124.000 new TB cases and 12.000 TB-related deaths in 2017. Despite advances in diagnosis and treatment, TB still causes significant human suffering and economic burden. The current BCG vaccine, developed over 100 years ago, only offers partial protection and does not protect adults and adolescents, who are the majority of TB transmitters. Achieving the WHO’s End TB Strategy targets by 2035 will require a new vaccine effective across all age groups, and vaccines are the best chance to contain the spread of multi-drug resistant tuberculosis.(4)
One of OUCRU’s initial steps towards new TB vaccine and other TB prevention approaches is consulting with the community through the Public and Community Engagement Group’s initiative, the Health Research Advisory Board. Through several meetings and discussions, researchers expect to have opportunities to understand the awareness, concerns, perspectives, and TB vaccine readiness of several communities represented in the board.
Read more about Health Research Advisory Board here.
Watch the interview with the TB vaccine project’s two OUCRU researchers
The work of the PCE group at OUCRU highlights the importance of public and community engagement in vaccine research, from encouraging two-way dialogues, dispelling misconceptions, and promoting the benefits of vaccination.
References:
(1) Shakya M, Colin-Jones R, Theiss-Nyland K, Voysey M, Pant D, Smith N, Liu X, Tonks S, Mazur O, Farooq YG, et al. Phase 3 efficacy analysis of a typhoid conjugate vaccine trial in Nepal. N Engl J Med. 2019;381(123):2209–18. doi:10.1056/NEJMoa1905047. – DOI – PMC – PubMed
(2) Karkey A, Aryjal A, Basnyat B, Baker S.. Kathmandu, Nepal: still an enteric fever capital of the world. J Infect Dev Ctries. 2005;2(6):461–65. doi:10.3855/jidc.162. – DOI – PubMed
(3) Karkey A, Aryjal A, Basnyat B, Baker S.. Kathmandu, Nepal: still an enteric fever capital of the world. J Infect Dev Ctries. 2005;2(6):461–65. doi: 10.3855/jidc.162. [PubMed] [CrossRef] [Google Scholar]
(4) https://www.who.int/teams/global-tuberculosis-programme/research-innovation/vaccines and https://www.who.int/vietnam/health-topics/tuberculosis
