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WITHDRAWN: Vaccines for preventing malaria.

P Graves1, H Gelband

  • 1EpiVec Consulting, 606 Kimberly Lane NE, Atlanta, GA 30306, USA. epivec@comcast.net

The Cochrane Database of Systematic Reviews
|July 20, 2007
PubMed
Summary
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Malaria vaccines SPf66, CS-NANP, RTS,S, and MSP/RESA were evaluated. SPf66 showed limited efficacy in Africa, while RTS,S demonstrated promising results, warranting further investigation.

Area of Science:

  • Malariology
  • Vaccinology
  • Infectious Diseases

Background:

  • Four malaria vaccines, SPf66, MSP/RESA, CS-NANP, and RTS,S, targeting different Plasmodium parasite stages, have undergone randomized controlled trials.
  • These trials were conducted in areas endemic for malaria.

Purpose of the Study:

  • To assess the efficacy of malaria vaccines against Plasmodium falciparum, P. vivax, P. malariae, and P. ovale.
  • The primary outcomes evaluated were prevention of infection, disease, and death.

Main Methods:

  • A systematic review of randomized controlled trials was performed, searching multiple databases up to April 2004.
  • Trials compared malaria vaccines against placebo or routine antimalarial treatments in participants of all ages.
  • Data extraction and quality assessment were conducted independently by two reviewers.

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Main Results:

  • Eighteen trials involving 10,971 participants were included. SPf66 vaccine efficacy was heterogeneous, showing no protection in African trials but a reduction in malaria attacks outside Africa.
  • CS-NANP vaccines showed no evidence of protection against P. falciparum malaria. RTS,S vaccine provided strong protection in non-immune adults and showed 66% efficacy against clinical malaria in semi-immune individuals in The Gambia.
  • MSP/RESA vaccine demonstrated no protective effect against clinical malaria episodes, though it influenced parasite density and reduced prevalence of a specific MSP2 subtype.

Conclusions:

  • SPf66 vaccines offer no protection against P. falciparum in Africa but show modest efficacy elsewhere, suggesting potential for further research with new formulations.
  • Insufficient evidence exists to evaluate CS-NANP vaccines. RTS,S shows promise, and MSP/RESA may be effective if it includes other MSP2 allelic forms.
  • Concomitant chemotherapy during vaccine trials can reduce vaccine efficacy, necessitating careful consideration in trial design.