Be in the Know: Malawi study shows new typhoid vaccine protects children long term


By: Adebowale Bello, Freelance Health Writer. With medical review and editorial support by the Datelinehealth Africa Team





With the increase in environmental pollution, food and water sources around the world are becoming contaminated and this has led to an increase in life-threatening diseases such as cholera, hepatitis A and typhoid.


Typhoid is caused by a bacterium known as Salmonella typhi and this microorganism primarily affects the intestines, hence some of the major symptoms of typhoid include fever, abdominal pains, fatigue and headaches. In severe cases, typhoid could cause bodily shock, tears/holes in the intestines and a disruption in normal brain function.


Typhoid fever is common in areas with limited access to clean water supply and unhygienic sanitation practices. Regions like Southeast Asia and sub-Saharan Africa have higher numbers of typhoid cases when compared to other areas. (2)


According to a 2019 report by the World Health Organisation (WHO), there were 9 million typhoid cases worldwide with a significant amount of those numbers in sub-Saharan Africa and with the increase in global urbanization, typhoid fever cases are on the rise. (3)


However, vaccines have been developed to combat this prevalent disease and this blog post would spotlight the African country Malawi and the effects of the nationwide typhoid vaccination program on its most vulnerable population; children.



Typhoid in Malawi


With more than half of its estimated 20 million citizens living in poverty, residents face a daily struggle to survive and with one in five persons in extreme poverty, hygiene and sanitation practices take a back seat. 


In 2016, there were at least 16,000 new cases of people suffering from the effects of typhoid. 67% of these cases occurred in children who were 15 years of age and younger highlighting the susceptibility of this age group.


Efforts to minimize typhoid have led to the initial development of two typhoid vaccines namely an oral capsule vaccine and an inactivated typhoid vaccine, although these vaccines are effective for adults, children remain at risk. This led to further research and the typhoid conjugate vaccine (TCV) was developed.


The TCV has been approved by the WHO for use by persons of all ages and apart from the longer protection duration, TCV gives adequate protection to children against typhoid fever. This vaccine has undergone controlled trials in several countries including Malawi with resounding success.



Typhoid vaccination in Malawi


28,130 children were selected for a nationwide controlled study in Malawi and these children were within the ages of 9 months to 12 years. For the purpose of this study, they were distributed into 2 groups by researchers. 


The first group received a single dose of the typhoid conjugate vaccine while the other group received a meningococcal vaccine. After 4 years, both groups of children were tested for typhoid fever and in the first group 24 children tested positive while 110 children tested positive in the second group.


With a 78% efficacy, this study showed in clear terms that even after 4 years, a single dose of TCV still provided adequate protection against typhoid in young children.


Further trials in Nepal and Bangladesh showed that the single dose TCV had an efficacy range of 79-85% and this showed consistency in the safety and efficacy of TCV. 



Why is Vaccination Crucial?


Vaccination is a preventive measure that boosts your body's defenses against diseases through the administering of a vaccine. Vaccination is crucial for several reasons:

1. Vaccines protect you from developing serious illnesses by stimulating your immune system to recognize and fight off specific pathogens.

2. Apart from protecting you, vaccination protects the people around you because when a significant amount of the population is vaccinated against a particular disease, the disease is not as widespread as it could have been and it becomes easier to control.

3. Some vaccines can last a lifetime while others last for a limited period but they fulfill the objectives of protecting you against infectious diseases.



Implications of the Study


The implications of the study on the new typhoid vaccine in Malawi is significant for the following reasons:


1. There is a significant decrease in the amount of typhoid cases among children in Malawi, resulting in improved health outcomes and reduced mortality rates.


2. Family resources can be channeled into other more productive endeavours and children would miss fewer school days as a result of illness. 


3. The successful deployment of the new typhoid vaccine in Malawi could serve as a model for other African countries facing similar challenges with typhoid fever therefore contributing to global efforts to control and eliminate the disease.





In conclusion, the findings from the study on the new typhoid conjugate vaccine demonstrate promising long-term protection for children in Malawi and mark a significant step forward in the fight against this debilitating disease.


Therefore, it is essential to continue advocating for the widespread adoption of effective vaccines and investing in public health initiatives to ensure a healthier future for all.




  • World Health Organisation. Typhoid fever. [Internet. N.d.] Accessed February 5,2023
  • Marchello CS, Hong CY, Crump JA. Global Typhoid Fever Incidence: A Systematic Review and Meta-analysis. Clin Infect Dis. 2019 Mar 7;68(Suppl 2):S105-S116. doi: 10.1093/cid/ciy1094. Abstract, Available from:
  • World Health Organisation. Typhoid. [Internet,. 30 March 2023]. Accessed February 5, 2024.



Published: February 6, 2024

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