Tag Archives: Medicalxpress

Microbiology

Increased adenoma detection rate may significantly reduce post-colonoscopy colorectal cancer risk

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A cohort study from the Italian Colorectal Cancer screening program including more than 49,000 colonoscopies found a significant inverse association between endoscopists’ proficiency as measured by adenoma detection rate (ADR) and post-colonoscopy colorectal cancer (PCCRC). These finding suggest that targeting only poor performing endoscopists with measures to increase ADR may significantly reduce PCCRC risk. The findings are published in Annals of Internal Medicine.

Colorectal cancer (CRC) population screening programs based on fecal testing (FITs) represent the standard of care for CRC prevention in many Western countries. The ultimate effectiveness of these screening procedures relies on the accurate detection and removal of precancerous lesions and early invasive cancer in colonoscopies of persons with positive FIT results. However, it is known that there are high miss rates and high rates of performance variability among endoscopists.

Researchers from Veneto Tumor Registry, Azienda Zero, Padova, “Sapienza” University of Rome and Humanitas University in Milan, Italy, conducted a population-based of 49,626 colonoscopies done by 113 endoscopists between 2012 and 2017 after a positive FIT result.

They report that 277 cases of PCCRC were diagnosed with a mean ADR of 48.3%. They noted a 2.35-fold cancer risk increase in the lowest performing endoscopists group compared to the highest performing group. According to the authors, endoscopist competence is key to screening effectiveness.

These results strongly suggest tailored targeting of low performing endoscopists with interventions aimed at helping them increase their ADR and consequently help their patients by reducing their PCCRC risk.

More information:
Manuel Zorzi et al, Adenoma Detection Rate and Colorectal Cancer Risk in Fecal Immunochemical Test Screening Programs, Annals of Internal Medicine (2023). DOI: 10.7326/M22-1008

Journal information:
Annals of Internal Medicine

American College of Physicians

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Microbiology

Cold snare polypectomy significantly reduces bleeding risk compared to hot snare polypectomy

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A randomized controlled trial (RCT) of more than 4,000 people found that the risk for delayed bleeding after polypectomy was significantly reduced among persons who received a cold snare polypectomy. The findings are published in Annals of Internal Medicine.

More than 16 million colonoscopies are performed annually in the U.S., and polypectomy during colonoscopy plays a pivotal role in preventing . Hot snare polypectomy (HSP) has been conventionally used to remove polyps but is associated with a higher risk of delayed bleeding, post-polypectomy syndrome, or perforation. Previous research on cold snare polypectomy (CSP) demonstrated that CSP was as effective as HSP but more efficient in removing small polyps, but its effect on reducing delayed bleeding has been shown only in high-risk patients.

Researchers from National Taiwan University Hospital conducted an RCT of 4,270 participants who were undergoing polypectomy in six centers in Taiwan. They report that only 8 out of 2,137 persons, or 0.4%, experienced delayed bleeding after CSP. In comparison, 31 out of 2,133 persons, or 1.5%, experienced delayed bleeding after HSP. They also report that only 0.2% of CSP group had emergency service visits compared with 0.6% of the HSP group. The authors show that CSP was also more efficient, with the study’s results showing that the time required for polypectomy is reduced by 26.9%.

According to the authors, the findings support the superior safety of CSP over HSP in managing colorectal sized 10 mm or smaller in the .

More information:
Li-Chun Chang et al, Cold Versus Hot Snare Polypectomy for Small Colorectal Polyps, Annals of Internal Medicine (2023). DOI: 10.7326/M22-2189

Journal information:
Annals of Internal Medicine

American College of Physicians

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Microbiology

How do parents decide if they should vaccinate their kids against SARS-CoV-2?

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For parents, the decision to vaccinate their kids against SARS-CoV-2 is complex, influenced by scientific evidence, political and social pressures, and views about individual versus collective benefits of vaccination, according to a new study published in CMAJ (Canadian Medical Association Journal).

Researchers conducted a qualitative study with in-depth interviews of 20 parents to understand their views about SARS-CoV-2 vaccination, with a goal to support future vaccination initiatives.

“Given the observed discrepancy between parental intention and decision to vaccinate their children against SARS-CoV-2, it is important to understand how and why parents make their decisions,” said Dr. Jonathon Maguire, a pediatrician at St. Michael’s Hospital, a site of Unity Health Toronto, and the University of Toronto. “Understanding the factors that influence parents’ decisions about SARS-CoV-2 vaccination for their children would help improve and interventions as well as inform about parents’ perspectives and concerns.”

Few previous studies have explored how parents make decisions to vaccinate, or not vaccinate, their children once eligible for vaccination.

The decision was challenging for most parents in the study. Parents’ considerations related to the following:

These findings have implications for communicating information on SARS-CoV-2 vaccination.

“Future guidance should highlight both individual and collective benefits of SARS-CoV-2 vaccination for children; however, health care providers should prioritize individualized discussions with parents to help interpret evidence, consider their understanding of risks and benefits, and provide tailored recommendations,” said Dr. Janet Parsons, a research scientist at St. Michael’s Hospital, a site of Unity Health Toronto, and an associate professor at the University of Toronto.

Health care providers have a key role to play in supporting parents in decision making.

“It is important for health care providers to understand that parents who seem hesitant to vaccinate their children may have a variety of reasons for feeling this way and may be reticent to ask questions to for fear of stigma,” said Dr. Parsons. The authors recommend that these conversations be approached with empathy and openness.

More information:
Parents’ perspectives on SARS-CoV-2 vaccinations for children: a qualitative analysis, Canadian Medical Association Journal (2023). DOI: 10.1503/cmaj.221401

Journal information:
Canadian Medical Association Journal

Canadian Medical Association Journal

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Microbiology

Three doses of COVID-19 mRNA vaccine associated with better outcomes for patients with cancer

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Breakthrough SARS-CoV-2 infections following vaccination against COVID-19 are of international concern and patients with cancer are highly vulnerable and susceptible to poor outcomes.

It is recommended that with receive a 3-dose COVID-19 vaccination series but it is noted that their immunological response to the vaccine series may be lessened, notably among those with hematologic malignancies.

Utilizing data from the multi-institutional COVID-19 and Cancer Consortium (CCC19) scientists found vaccination with 2 or 3 doses of an mRNA vaccine prior to infection was associated with improved outcomes for patients with cancer diagnosed with COVID-19 in 2021 or 2022. Across all endpoints, including 30-day morality, ICU admission and hospitalization, the vaccine benefit was most pronounced for those patients receiving 3 doses.

This study shows vaccination against COVID-19 is an essential strategy to improve outcomes in this high-risk population. The results support guidelines that patients with cancer should receive at least 3 COVID-19 vaccine doses.

This analysis represents one of the largest cohorts with comprehensive clinical and on vaccinated patients with cancer and breakthrough COVID-19 to date and is one of the first studies to evaluate breakthrough infections following the receipt of 3 doses of mRNA vaccines among patients with cancer.

The findings are published in The Lancet Regional Health—Americas.

More information:
Toni K. Choueiri et al, Breakthrough SARS-CoV-2 infections among patients with cancer following two and three doses of COVID-19 mRNA vaccines: a retrospective observational study from the COVID-19 and Cancer Consortium, The Lancet Regional Health—Americas (2023). DOI: 10.1016/j.lana.2023.100445

Dana-Farber Cancer Institute

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Microbiology

Flu vaccination rate holds steady but misinformation about flu and COVID-19 persists

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Although the public had been alerted that this winter could be a potentially bad flu season, barely half of Americans said in January that they had received a flu shot, a vaccination level unchanged in a representative national panel from the comparable period last year, according to a new Annenberg Science Knowledge (ASK) survey by the Annenberg Public Policy Center of the University of Pennsylvania.

The panel survey, fielded with over 1,600 U.S. adults, finds that many have a base of knowledge about the flu but there is a reservoir of uncertainty about other consequential information about the flu, COVID-19, and vaccination. Among the findings of the ASK survey, which also inquired more broadly about attitudes toward mandates and the continuing “return to normal”:

“Although the CDC indicated that seasonal flu activity is now low nationally, the fact that the level of reported flu vaccination in our panel was roughly the same in January of this year as a year before is concerning,” said Kathleen Hall Jamieson, director of the Annenberg Public Policy Center. “Because this has been a more severe flu season than the one a year ago, we expected an increase in the reported vaccination rate.”

The nationally representative panel of 1,657 U.S. adults surveyed by SSRS for the Annenberg Public Policy Center (APPC) of the University of Pennsylvania from January 10-16, 2023, was the tenth wave of an Annenberg Science Knowledge survey whose respondents were first empaneled in April 2021. The margin of sampling error (MOE) is ± 3.2 percentage points at the 95% confidence level. See the Appendix and Methodology for question wording and additional information.

What the public knows: The flu and flu shot

The latest wave of the ASK survey finds that many people know the basics about the flu:

A majority of the public knows that the following claims are false:

But there are important claims about the flu that substantial parts of the public are confused about:

The ASK survey in January 2023 finds that 49% of respondents say they have had a seasonal flu shot, statistically unchanged from 47% in our January 2022 survey and 50% in April 2021. According to the Centers for Disease Control and Prevention (CDC), nearly 46% of U.S. adults 18 and older had a as of December 31, 2022.

The CDC actively promoted flu vaccination amid concerns that the 2022-23 season would be severe.

When the 49% of survey respondents who said they got the flu vaccine were asked in January why they got the shot (multiple responses were permitted):

Worries about family members contracting flu, COVID, or RSV: About a third of those surveyed say they are somewhat or very worried about family members contracting COVID-19 (36%), the seasonal flu (35%), or RSV, respiratory syncytial virus (33%). Only 11% say they are somewhat/very worried about a family member contracting polio, which reemerged as a public health threat in July 2022 after a case was reported in New York State.

Myocarditis: Rare cases of myocarditis, an inflammation of the heart muscle, have been reported among those who have had mRNA COVID-19 vaccines, particularly young males following a second vaccine dose. The connection between myocarditis and the vaccine has drawn attention on and in news media.

The survey found that over a third of respondents (37%) think that COVID-19 poses a higher risk for myocarditis than the vaccine against COVID-19. But 17% think that is false and nearly half of those surveyed (47%) are not sure which poses a higher risk.

Much of the public rejects the notion that Damar Hamlin’s collapse during an NFL game had anything to do with the vaccine against COVID-19. But the survey finds that many people are uncertain about the broader unsupported claim that more young athletes are dying of heart problems these days.

Hamlin, a safety on the Buffalo Bills, suffered a cardiac arrest during the Jan. 2, 2023, game against the Cincinnati Bengals, triggering a spate of unfounded, anti-vaccine conspiracy theories on social media about the cause. The overwhelming majority of those in our survey (87%) said they had heard, read, or seen reports of his collapse.

But those respondents overwhelmingly reject the idea that a COVID-19 vaccine caused Hamlin’s injury. Only 10% of those who had heard of the incident attribute it to factors connected with the vaccine. Nearly half (49%) say that based on what they had heard of it, Hamlin’s cardiac arrest was most likely caused by being hit hard in the chest; 17% say an underlying heart condition; and 21% say they are not sure.

While social media posts with millions of views quickly associated Hamlin’s collapse with vaccination, mainstream media sources noted the lack of evidence for such claims or dismissed them as misinformation.

However, 26% of those surveyed say they think that the number of young athletes dying of heart problems increased over the past three years, and nearly half (49%) are not sure whether the number has increased or decreased. Only 23% say that the numbers of deaths have remained virtually unchanged.

Schools and military: The ASK survey finds stronger support for a COVID-19 vaccine mandate in the military than in public schools, with over half supporting a military mandate:

MMR vaccine: Asked their views on the childhood vaccines for measles, mumps, and rubella (MMR), 63% agree that healthy children should be required to get the MMR vaccine in order to attend public schools, while 22% say parents should be able to decide whether to vaccinate their children who attend public schools and 15% are not sure.

Getting back to ‘normal’

The return to normal: Asked when they expect to be able to return to “your normal, pre-COVID-19 life,” more than half of Americans (52%) say they already have—up from 47% in October 2022. More than 1 in 5 Americans (22%) continue to say “never,” which is statistically unchanged since July 2022.

Mask-wearing: Six in 10 people (61%) say they never or rarely wear masks, statistically unchanged from the 60% who said this in October 2022. And 18% say they always or often wear a mask, also statistically unchanged from the 17% who said so in October.

More information:
Survey site: www.annenbergpublicpolicycente … e-communication/ask/

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Microbiology

Scabies: What it is, symptoms, treatment and more

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Talk about the stuff of nightmares. You have extremely itchy skin at bedtime, not to mention a pimple-like rash. What is it?

Those are fairly clear signs of scabies, a microscopic parasitic infestation where burrow under your and lay eggs there.

Scabies infection comes from prolonged contact, not just a quick brush against someone else’s skin. It can also be passed through bedding or clothing.

“Anyone who is diagnosed with scabies, as well as his or her sexual partners and other contacts who have had prolonged skin-to- with the infested person, should be treated,” the U.S. Centers for Disease Control and Prevention advises.

This “human itch mite” lives and lays eggs in the upper layer of the skin, according to the CDC.

About 200 million people worldwide have scabies at any one time, including up to 10% of children in , according to the World Health Organization.

Once the eggs hatch, the larvae can travel to the skin’s surface, spreading to other areas or other people, according to the Mayo Clinic.

What does scabies look like? It may resemble hives, tiny bites, knots under the skin or even eczema-like scaly patches, according to the American Academy of Dermatology (AAD). Sores may develop from scratching.

Under magnification, the mite is creamy-white, has eight legs and a round body. It is roughly the size of a needle tip, according to the Cleveland Clinic.

A doctor can best do this, but signs can include the rash and intense itching that worsens at night.

Mites are most commonly found between the fingers, around the fingernails, on elbows, wrists, at the belt line, in the genital area and around the nipples, according to the AAD.

Sometimes children will have an all-over rash, including their scalp. Infants typically have it on the palms and soles, according to the AAD.

Although scabies is contagious, children can typically return to school the day after treatment, according to an article recently published by HealthDay.

A severe form called crusted scabies, or Norwegian scabies, leads to widespread crusts on skin with hundreds or thousands of mites, instead of 15 or 20. It can impact someone with a weakened immune system, according to the AAD.

Scabies is commonly spread between or among members of the same household.

Crowded conditions can also contribute, according to the CDC. Outbreaks are common in nursing homes, prisons and child care facilities.

What causes scabies? It’s a mite known as Sarcoptes scabiei var hominis.

Incubation time ranges from just one to four days if you’ve had scabies before to four to eight weeks, the CDC said.

Scabies cause an “intense, unbearable itch,” according to a report published recently in the journal Frontiers in Medicine. This is caused directly by the mites and the body’s immune response to them.

A later rash can look like lines on the skin that are grayish or skin-colored, according to the Cleveland Clinic.

Scratching too much can cause a skin infection, such as impetigo, according to Mayo Clinic. Untreated scabies can even lead to complications such as chronic kidney disease, according to the Frontiers in Medicine report.

Scabies medications include creams and pills, according to the Mayo Clinic. The condition won’t resolve without treatment.

What is a good treatment for scabies? Apply a prescription cream that contains permethrin to clean skin on the entire body, including palms and soles of the feet. Children may also need it on the scalp.

Leave the cream on for eight to 14 hours before washing it off, the Cleveland Clinic advised.

The veterinary drug ivermectin, which gained fame during the pandemic as a failed treatment for COVID-19, can be used in small doses to treat parasites, according to a recent HealthDay story.

Just last summer, in the Solomon Islands initiated a mass rollout of ivermectin to treat an outbreak of scabies among children there.

“Scabies affects everyone, especially ,” Sarah Andersson, program manager of the rollout, said in a Murdoch Children’s Research Institute news release. “Rolling out the treatment for scabies to all communities in the Solomon Islands at the same time will contribute significantly to stopping the spread of scabies and preventing this debilitating condition.”

Ivermectin is given in two doses separated by a week or two under a doctor’s guidance. It shouldn’t be used by someone who is pregnant or lactating or in children weighing less than 35 pounds, according to the Cleveland Clinic.

Bumps and itching may persist for up to four weeks even though the mites are dead. Antihistamines can help with the itching, the Cleveland Clinic noted. Anyone who has had close contact with a person infected with scabies should also be treated.

Wash clothing and bedding in hot water followed by a hot dryer. Vacuum carpets and furniture well, especially if someone has had crusted scabies, the CDC recommends.

Copyright © 2023 HealthDay. All rights reserved.

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Microbiology

New drug target to treat pain from visceral organs

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An approved drug for chronic constipation also relieves the pain associated with that condition. New research by Scott Waldman, MD, Ph.D., chair of pharmacology, physiology and cancer biology at Jefferson, demonstrates that the drug’s two actions can be separated biologically—a finding that may offer ways to precisely target visceral pain syndromes beyond constipation.

Here’s what was known: A called GUCY2C, present in the lining of the intestines, regulates water and salt balance, and therefore, the looseness of stools. The constipation medicine, called linaclotide, acts on this receptor to increase water secretion. However, the drug’s -relieving action does not appear to be a simple consequence of constipation relief, and hypotheses abounded as to how it all worked.

Dr. Waldman and his MD-Ph.D. student Joshua Barton sought to explore how the drug produced analgesia. The study, published in the Journal of Clinical Investigation focused on the GUCY2C receptor in a newly discovered intestinal cell type called neuropods, which can sense stimulation and communicate closely with neurons that send pain messages to the brain. The team partnered with neuroscientist Manuel Covarrubias, MD, Ph.D., who co-directed the study.

The researchers used molecular tools to delete GUCY2C receptors from neuropods in mice, but not from other intestinal cells. The altered animals experienced spontaneous visceral pain that the drug linaclotide did not relieve; meanwhile water secretion was unaffected. This finding, Dr. Waldman says, means that neuropod receptors are regulating sensory tone in the intestine and that they mediate the drug effect on pain.

What was most surprising, he says, is how stark the delineation was. Biological functions are known for redundancies and exploratory scientific research doesn’t often yield such clear results—in this case, separating two seemingly connected functions, pain relief and water secretion.

Dr. Waldman envisions therapies that directly target neuropod cells. “We may be able to side-step a major side effect—diarrhea—in other visceral pain conditions,” he says, such as with diarrhea or endometriosis. Visceral pain regulation by neuropods may represent “a final common pathway,” he says.

More information:
Joshua R. Barton et al, Intestinal neuropod cell GUCY2C regulates visceral pain, Journal of Clinical Investigation (2022). DOI: 10.1172/JCI165578

Journal information:
Journal of Clinical Investigation

Thomas Jefferson University

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Microbiology

Depression, anxiety tied to higher health care use with inflammatory bowel disease

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Worsening or persistently high anxiety or depression symptoms are tied to significantly higher use of health care among patients with inflammatory bowel disease (IBD), according to a study published in the February issue of the American Journal of Gastroenterology.

Keeley Fairbrass, M.B.Ch.B., from University of Leeds in the United Kingdom, and colleagues assessed trajectories of mental health symptoms in IBD. The analysis included self-reported and health care utilization data from 1,031 adult outpatients with IBD.

The researchers found that patients with worsening or persistently abnormal anxiety or depression scores had increased antidepressant (28.6 versus 12.3 percent and 35.8 versus 10.1 percent for anxiety and depression, respectively) and opiate use (19.0 versus 7.8 percent and 34.0 versus 7.4 percent for anxiety and depression, respectively) compared with patients with persistently normal or improving scores.

Individuals with worsening or persistent symptoms were also more likely to have been diagnosed with IBD in the last 12 months and to have clinically active disease at baseline and lower quality-of-life scores. Furthermore, significantly more outpatient appointments, radiological investigations, and endoscopic procedures for IBD-related symptoms were required for individuals with worsening or persistently abnormal trajectories of anxiety or depression.

“Based on our findings, there is a clear need to offer formal psychological support to a subgroup of with IBD, through a defined referral pathway, to reduce health care utilization and, potentially, improve disease prognosis,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.

Copyright © 2023 HealthDay. All rights reserved.

More information:
Keeley M. Fairbrass et al, Characteristics and Effect of Anxiety and Depression Trajectories in Inflammatory Bowel Disease, American Journal of Gastroenterology (2022). DOI: 10.14309/ajg.0000000000002063

Journal information:
American Journal of Gastroenterology

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Microbiology

AI model differentiates scalp psoriasis from seborrheic dermatitis

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A deep learning (DL) model based on dermatoscopic images can differentiate scalp psoriasis from seborrheic dermatitis, according to a study recently published in Frontiers in Medicine.

Zhang Yu, from Inner Mongolia Medical University in Hohhot, China, and colleagues developed a new diagnostic method for discriminating scalp psoriasis and seborrheic dermatitis based on a DL model. A total of 1,358 pictures from 617 with pathological and diagnostic confirmed (508 cases of psoriasis; 850 cases of seborrheic dermatitis) were randomly allocated into training, validation, and testing datasets (1,088, 134, and 136, respectively). The transfer learning technique was used to establish and train a DL model for differentiating the two diseases.

The researchers found that the DL model exhibited good sensitivity and specificity (96.1 and 88.2 percent), with an area under the curve (AUC) of 0.922. Compared with five dermatologists with various levels of experience, the DL model outperformed them for diagnosis of scalp psoriasis and seborrheic dermatitis. Comparable diagnostic performance can be achieved for nonproficient doctors with the assistance of the DL model and dermatologists proficient in dermoscopy.

Diagnostic performance was improved for one dermatology graduate student and two , with the AUC values increasing from 0.600, 0.537, and 0.575 to 0.849, 0.778, and 0.788, respectively; consistency of diagnosis was also improved with the kappa values increasing from 0.191, 0.071, and 0.143 to 0.679, 0.550, and 0.568, respectively.

“The DL can prevent the delay of patients’ treatment, tackle the development of the disease course, and improve the prognosis when encountering patients with ambiguous diagnoses,” the authors write.

Copyright © 2023 HealthDay. All rights reserved.

More information:
Zhang Yu et al, A deep learning-based approach toward differentiating scalp psoriasis and seborrheic dermatitis from dermoscopic images, Frontiers in Medicine (2022). DOI: 10.3389/fmed.2022.965423

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Microbiology

More than 100 years after the first TB vaccine, why are we still waiting for a second?

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It has been more than 100 years since the first and only tuberculosis (TB) vaccine—the Bacillus Calmette–Guérin (BCG) vaccine—was used for the first time medically in 1921. With an estimated 1.6 million people dying from TB in 2021, there is an urgent need for new vaccines to help stem the never-ending pandemic.

There are more than 10 TB vaccines currently in development, with some now in the later stages of the clinical trials process. In a presentation in one of the preliminary pre-ECCMID days of this year’s European Congress on Clinical Microbiology & Infectious Diseases (ECCMID 2023, Copenhagen, April 15-19) Frank Cobelens, Professor of Global Health at the University of Amsterdam and the Amsterdam Institute for Global Health and Development (AIGHD), Netherlands, will discuss the frontrunners among the , and the challenges facing TB development.

“In order to reach the WHO’s target of ending TB as a global health problem, we desperately need an effective and safe vaccine for use in adults and adolescents,” explains Prof Cobelens.

“However, TB vaccine research and development is hampered by our limited knowledge of protective immune responses, poor prediction of efficacy in humans by animal models and lack of correlates of protection (the immune response required to give protection), all leading to a high-risk pipeline that includes large trials of long duration. Essentially, we don’t know if vaccines will work until they are at the end of the clinical trials process—meaning high-risk, high cost.”

Despite this, for the first time since decades there are several promising new TB vaccine candidates entering phase 3 trials (efficacy testing in humans), even though 2 of the 4 (VPM1002 and MTBVAC) are still live-attenuated vaccines just as BCG is– and for which the added value in terms of protection and safety over BCG is yet to be established.

“However, the current need for long trials implies that licensure of any of these candidates will take at least several years,” says Prof Cobelens. He adds that a key issue for WHO in licensing any new TB vaccine is evidence of prevention of disease (POD)—however many of the current trials are looking at prevention of infection (POI) or prevention of recurrence (POR) in those with latent infection—which are not quite the same as POD.

Prof Cobelens will highlight that, for the first time in decades there is a different platform candidate that has shown protection in adults and adolescents in a phase II trial: M72/ASO1E (an adjuvanted subunit vaccine). This is also important because it allows the field to identify correlates of protection. In a trial of some 3500 participants in Kenya, South Africa, and Zambia, the vaccine demonstrated 50% protection against TB infection after three years follow-up. It was also safely tested in 400 people living with HIV.

This vaccine, licensed by pharmaceutical company GlaxoSmithKline to the Bill & Melinda Gates Medical Research Institute, is now going to enter a phase III trial in high-incidence settings across Africa, with an estimated 26,000 participants. It will include people never infected with TB and those with latent TB to see if they are protected from TB disease. But as the trial will require three years for recruitment and five for follow up, it is unlikely to provide results until the start of the 2030s.

Other vaccines considered frontrunners include the Russian Vaccine GamTBVac, currently in a phase 3 trial with 7000 participants expected to report in or around 2025. Also considered promising is the VPM1002 (live recombinant BCG), which is about report on trials on prevention of infection in babies and prevention of recurrence in adults in the next two years (delayed due to COVID pandemic)–while a further phase 3 trial, to test prevention of infection in adult household contacts of primary infected persons, is currently underway.

Another genetically modified live-attenuated vaccine, MTBVAC, has just begun a BCG-controlled phase 3 trial in babies in South Africa and Madagascar, while a phase 3 trial in BCG-vaccinated and unvaccinated adults is in its planning stages. Results from these trials are likely to be announced at the end of this decade.

“We have waited more than a century for a new effective TB vaccine, and unfortunately that wait is set to last at least several more years,” concludes Prof Cobelens.

“However, there are promising new approaches that include alternative routes of delivery for BCG-vectored vaccines that will hopefully enter the development pipeline soon. We are also in the early stages of harnessing the vaccine innovation that emerged during the COVID pandemic—which could open the door on other new routes to a successful TB vaccine.”

More information:
2022 Global TB report

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