Continuing the fight against childhood diarrhoeal disease

11 May 2015
Diarrhoea is a leading cause of illness and death among children aged less than five years in developing countries. The WHO ranks diarrhoeal disease as the second (after pneumonia) leading killer of children under five years of age in developing countries, accounting for 18 per cent of the 10.6 million children deaths each year in this age group.

Musical group in Basse

Musical group in Basse

At three community sensitization events held at Mansajang, Fatoto and Bakadagi in the Upper River Region of The Gambia in March, Dr Jahangir Hossain and his team presented results of the Global Enteric Multicentre study (GEMS), thanked all participants who took part, and introduced the new Vaccine Impact on Diarrhoea in Africa (VIDA) study which started in April 2015.

Fatoto community

Fatoto community

Attended by over 900 people, the events included a drama presentation from the MRC Basse Drama group and speeches by distinguished representatives from the Gambian Government, health officials and MRC staff.




Getting research into practice

The GEMS was the largest study ever conducted on diarrhoeal diseases in developing countries, enrolling more than 20,000 children from seven sites across Asia and Africa. The study was coordinated by the Centre for Vaccine Development (CVD), University of Maryland, Baltimore, and funded by the Bill and Melinda Gates Foundation. The study confirmed rotavirus – for which a vaccine already exists – as the leading cause of severe diarrhoea among infants and young children.

GEMS provided important data that initiated policymakers, donors, international public health agencies and advocates to make evidence-based decisions about the global burden of diarrhoeal diseases. The results influenced introduction of the rotavirus vaccine in developing countries where diarrhoeal burden and child mortality are high, with the support of GAVI, WHO, UNICEF and other international donor agencies. The Ministry of Health and Social Welfare of The Gambian Government introduced rotavirus vaccine into its EPI in August 2013.

Assessing rotavirus vaccine impact

The new Vaccine Impact on Diarrhoea in Africa (VIDA) study will assess the impact of rotavirus vaccine introduction in The Gambia on overall burden of rotavirus-specific moderate-to-severe diarrhoea, and determine the effectiveness of the rotavirus vaccine.

There is much data available about diarrhoea pre-introduction of the rotavirus vaccine however there is little or no data on diarrhoea post-introduction of the rotavirus vaccine in routine immunization programmes in Africa. The VIDA study will run for four years and will complement the Gambian Government’s efforts to improve child health and to prevent diseases. The study is being run in collaboration with the CVD, University of Maryland, Baltimore.

Introducing the new study at the community sensitization event, Dr Jahangir Hossain explained: “It is vital to understand how rotavirus vaccine works in children in a routine immunization programme to assess the impact on overall diarrhoeal illness, common germs causing diarrhoea, rotavirus-specific diarrhoea, nutritional status and risk of death after an episode of moderate-to-severe diarrhoea.”

Kanilia musical group in Bakadagi

Kanilia musical group in Bakadagi

“To understand healthcare practices, field staff will collect information from the community about diarrhoeal illness in children, finding out information about where and how the child was treated. Working in seven health centres in the Upper River Region and three health centres in the Central River Region of The Gambia, the team will identify and recruit cases of moderate-to-severe diarrhoea for the study and assist management of diarrhoea cases.”

In his speech, Dr Jahangir Hossain addressed the communities directly, saying: “We will provide our continuous support to work with you and the Government of The Gambia to improve child health and to prevent diarrhoea.”

Thanking the community

During the community event at Mansajang, Professor Umberto D’Alessandro, expressed gratitude to the community for their support in the GEMS, and said: “The MRC aims to fight diseases affecting the Gambian community. The Unit is committed in the fight against preventable diseases across the country to aid vaccine development across the developing world”.

Regional Health Director representative Momodou Lamin emphasised the importance of research to fight against vaccine-preventable disease to improve health. He also expressed thanks to the MRC for giving feedback to the community.

The vote of thanks was delivered by Mamady Sidebeh who stated: “We have a unique relationship which we need to guard as we co-exist for the advancement of Africa and the world at large”. He concluded by thanking the community for their willingness to join the study, the Government for their continued support and the field workers for their hard work.