Hepatitis b disease and prevention：乙型肝炎疾病预防.pptVIP

Up date on malaria vaccine Mark R. Withers, M.D., MPH, Director, WRP Kombewa Clinic Dr Walter OtienoMBChB, M. Med (Paeds), PhD Walter Reed Project-Centre for Clinical Research Kenya Medical Research Institute * * WRP-Kisumu * WRP-Kisumu: 4 main campuses Kisumu HQ (“Kondele”) Administration Basic science: ELISA, PCR, flow cyt, RDTs New Nyanza Provincial General Hospital (PGH, Russian) Children’s Hospital: 65 bed facility Ward 8: dedicated in-out patient clinical research center “Center of Excellence” for malaria microscopy KEMRI “Center for Global Health” (Kisian town) Entomology malaria culture lab (monitors drug resistance patterns) Kombewa Clinical Research Center Dedicated unit for large clinical trials Why is malaria so important? Severe disease burden 300 - 500 million cases 575 000 CM (19% mortality) 1.42–5.66 million Anemia (13% mortality) 1.12–1.99 million RDS (18% mortality) In Kombewa 62% of admissions in children due to malaria Malaria Vaccine Development  Ongoing for P. falciparum P. vivax Theoretical Concepts: Pregnant women protect newborns Living in endemic areas develop immunity Malaria vaccines target the life cycle: Pre-erythrocytic stage (sporozoite/hepatic) Erythrocytic (asexual) stage Sexual stage (transmission blocking) TARGETS OF MALARIA VACCINES Pre-erythrocytic -Prevent infection -Reduce disease Blood-stage -Prevent disease Transmission blocking -Prevent transmission RTS,S Program History Circumsporozoite protein Most abundant protein covering entire sporozoite surface Also expressed by malaria liver stages Structure of CS protein: Of all malaria species has a central domain with several amino acid repetitions Amino acid sequence that composes each repetition is completely different for each plasmodium species Circumsporozoite protein Structure of CS protein: P. falciparum CS protein has limited variability therefore ideal for vaccines P. vivax isolates display enormous variation-therefore n