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Matias WR, Guillaume Y, Cene Augustin G, Vissieres K, Ternier R, Slater DM, Harris JB, Franke MF, Ivers LC. Effectiveness of the Euvichol® oral cholera vaccine at 2 years: A case-control and bias-indicator study in Haiti. Int J Infect Dis 2024; 139:153-158. [PMID: 38000510 PMCID: PMC10784151 DOI: 10.1016/j.ijid.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/21/2023] [Accepted: 11/19/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVES The World Health Organization recommends the use of oral cholera vaccine (OCV) in cholera control efforts. Euvichol®, pre-qualified in 2015, is the leading component of the Global OCV stockpile, but data on its field effectiveness are limited. To evaluate Euvichol® vaccine effectiveness (VE), we conducted a case-control study between September 2018 to March 2020 following an OCV campaign in November 2017 in Haiti. METHODS Cases were individuals with acute watery diarrhea. Stool samples were tested by culture and real-time polymerase chain reaction of the Vibrio cholerae ctxA gene. Cases were matched to four community controls without diarrhea by residence, enrollment time, age, and gender, and interviewed for sociodemographics, risk factors, and self-reported vaccination. Cholera cases were analyzed by conditional logistic regression in the VE study. Non-cholera diarrhea cases were analyzed in a bias-indicator study. RESULTS We enrolled 15 cholera cases matched to 60 controls, and 63 non-cholera diarrhea cases matched to 249 controls. In the VE analysis, eight (53%) cases reported vaccination with any number of doses compared to 43 (72%) controls. Adjusted two-dose OCV VE was 69% (95% CI -71 to 94%). CONCLUSIONS Between 10-27 months after vaccination, Euvichol® was effective and similar to Shanchol™, suggesting that it can serve as one component of multi-sectoral comprehensive cholera control.
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Affiliation(s)
- Wilfredo R Matias
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, USA; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, USA; Center for Global Health, Massachusetts General Hospital, Boston, USA.
| | | | | | | | | | - Damien M Slater
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, USA; Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Jason B Harris
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, USA; Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Molly F Franke
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA
| | - Louise C Ivers
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, USA; Center for Global Health, Massachusetts General Hospital, Boston, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA; Harvard Global Health Institute, Cambridge, USA
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Mukonka VM, Sialubanje C, Matapo BB, Chewe O, Ngomah AM, Ngosa W, Hamoonga R, Sinyange N, Mzyece H, Mazyanga L, Bakyaita N, Kapata N. Euvichol-plus vaccine campaign coverage during the 2017/2018 cholera outbreak in Lusaka district, Zambia: a cross-sectional descriptive study. BMJ Open 2023; 13:e070796. [PMID: 37798024 PMCID: PMC10565249 DOI: 10.1136/bmjopen-2022-070796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 09/24/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE To determine the coverage for the oral cholera vaccine (OCV) campaign conducted during the 2017/2018 cholera outbreak in Lusaka, Zambia. STUDY DESIGN A descriptive cross-sectional study employing survey method conducted among 1691 respondents from 369 households following the second round of the 2018 OCV campaign. STUDY SETTING Four primary healthcare facilities and their catchment areas in Lusaka city (Kanyama, Chawama, Chipata and Matero subdistricts). PARTICIPANTS A total of 1691 respondents 12 months and older sampled from 369 households where the campaign was conducted. A satellite map-based sampling technique was used to randomly select households. DATA MANAGEMENT AND ANALYSIS A pretested electronic questionnaire uploaded on an electronic tablet (ODK V.1.12.2) was used for data collection. Descriptive statistics were computed to summarise respondents' characteristics and OCV coverage per dose. Bivariate analysis (χ2 test) was conducted to stratify OCV coverage according to age and sex for each round (p<0.05). RESULTS The overall coverage for the first, second and two doses were 81.3% (95% CI 79.24% to 83.36%), 72.1% (95% CI 69.58% to 74.62%) and 66% (95% CI 63.22% to 68.78%), respectively. The drop-out rate was 18.8% (95% CI 14.51% to 23.09%). Of the 81.3% who received the first dose, 58.8% were female. Among those who received the second dose, the majority (61.0%) were females aged between 5 and 14 years (42.6%) and 15 and 35 years (27.7%). Only 15.5% of the participants aged between 36 and 65 and 2.5% among those aged above 65 years received the second dose. CONCLUSION These findings confirm the 2018 OCV campaign coverage and highlight the need for follow-up surveys to validate administrative coverage estimates using population-based methods. Reliance on health facility data alone may mask low coverage and prevent measures to improve programming. Future public health interventions should consider sociodemographic factors in order to achieve optimal vaccine coverage.
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Affiliation(s)
- Victor M Mukonka
- School of Public Health, Levy Mwanawasa Medical University, Lusaka, Zambia
- School of Medicine, The Copperbelt University, Kitwe, Zambia
| | - Cephas Sialubanje
- School of Public Health, Levy Mwanawasa Medical University, Lusaka, Zambia
| | | | - Orbrie Chewe
- Surveillance and Disease Intelligence, Zambia National Public Health Institute, Lusaka, Zambia
- Public Health, Zambia Ministry of Health, Lusaka, Zambia
| | - Albertina Moraes Ngomah
- Communication Information & Research, Zambia National Public Health Institute, Lusaka, Zambia
| | - Willaim Ngosa
- Communication Information & Research, Zambia National Public Health Institute, Lusaka, Zambia
| | - Raymond Hamoonga
- Surveillance and Disease Intelligence, Zambia National Public Health Institute, Lusaka, Zambia
| | - Nyambe Sinyange
- Surveillance and Disease Intelligence, Zambia National Public Health Institute, Lusaka, Zambia
| | - Hannah Mzyece
- Surveillance and Disease Intelligence, Zambia National Public Health Institute, Lusaka, Zambia
| | - Lucy Mazyanga
- Communication Information & Research, Zambia National Public Health Institute, Lusaka, Zambia
| | | | - Nathan Kapata
- Epidemic Preparedness and Response, Zambia National Public Health Institute, Lusaka, Zambia
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A scoping review of facilitators and barriers influencing the implementation of surveillance and oral cholera vaccine interventions for cholera control in lower- and middle-income countries. BMC Public Health 2023; 23:455. [PMID: 36890476 PMCID: PMC9994404 DOI: 10.1186/s12889-023-15326-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 02/27/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Cholera still affects millions of people worldwide, especially in lower- and middle-income countries (LMICs). The Global Task Force on Cholera Control (GTFCC) has identified surveillance and oral cholera vaccines as two critical interventions to actualise the global roadmap goals-reduction of cholera-related deaths by 90% and decreasing the number of cholera endemic countries by half by 2030. Therefore, this study aimed to identify facilitators and barriers to implementing these two cholera interventions in LMIC settings. METHODS A scoping review using the methods presented by Arksey and O'Malley. The search strategy involved using key search terms (cholera, surveillance, epidemiology and vaccines) in three databases (PubMed, CINAHL and Web of Science) and reviewing the first ten pages of Google searches. The eligibility criteria of being conducted in LMICs, a timeline of 2011-2021 and documents only in English were applied. Thematic analysis was performed, and the findings were presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension. RESULTS Thirty-six documents met the predefined inclusion criteria, covering 2011 to 2021. There were two themes identified regarding the implementation of surveillance: timeliness and reporting (1); and resources and laboratory capabilities (2). As for oral cholera vaccines, there were four themes identified: information and awareness (1); community acceptance and trusted community leaders (2); planning and coordination (3); and resources and logistics (4). Additionally, adequate resources, good planning and coordination were identified to be operating at the interface between surveillance and oral cholera vaccines. CONCLUSION Findings suggest that adequate and sustainable resources are crucial for timely and accurate cholera surveillance and that oral cholera vaccine implementation would benefit from increased community awareness and engagement of community leaders.
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Zeng W, Cui Y, Jarawan E, Avila C, Li G, Turbat V, Bouey J, Farag M, Mutasa R, Ahn H, Sun D, Shen J. Optimizing immunization schedules in endemic cholera regions: cost-effectiveness assessment of vaccination strategies for cholera control in Bangladesh. Vaccine 2021; 39:6356-6363. [PMID: 34579976 DOI: 10.1016/j.vaccine.2021.09.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/06/2021] [Accepted: 09/16/2021] [Indexed: 10/20/2022]
Abstract
This study is to examine the cost-effectiveness of deployment strategies of oral cholera vaccines (OCVs) in controlling cholera in Bangladesh. We developed a dynamic compartment model to simulate costs and health outcomes for 12 years for four OCVs deployment scenarios: (1) vaccination of children aged one and above with two doses of OCVs, (2) vaccination of population aged 5 and above with a single dose of OCVs, (3) vaccination of children aged 1-4 with two doses of OCVs; and (4) combined strategy of (2) and (3). We obtained all parameters from the literature and performed a cost-effectiveness analysis from both health systems and societal perspectives, in comparison with the base scenario of no vaccination.The incremental cost-effectiveness ratios (ICERs) for the four strategies from the societal perspective were $2,236, $2,250, $1,109, and $2,112 per DALY averted, respectively, with herd immunity being considered. Without herd immunity, the ICERs increased substantially for all four scenarios except for the scenario that vaccinates children aged 1-4 only. The major determinants of ICERs were the case fatality rate and the incidence of cholera, as well as the efficacy of OCVs. The projection period and frequency of administering OCVs would also affect the cost-effectiveness of OCVs. With the cut-off of 1.5 times gross domestic product per capita, the four OCVs deployment strategies are cost-effective. The combined strategy is more efficient than the strategy of vaccinating the population aged one and above with two doses of OCVs and could be considered in the resource-limited settings.
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Affiliation(s)
- Wu Zeng
- Department of International Health, School of Nursing and Health Studies, Georgetown University, Washington, DC, USA.
| | - Yujie Cui
- Shanghai Jiao Tong University School of Medicine, Shanghai, China; China Hospital Management Institute, Shanghai Jiao Tong University, Shanghai, China.
| | - Eva Jarawan
- Department of International Health, School of Nursing and Health Studies, Georgetown University, Washington, DC, USA.
| | | | - Guohong Li
- Shanghai Jiao Tong University School of Medicine, Shanghai, China; China Hospital Management Institute, Shanghai Jiao Tong University, Shanghai, China.
| | - Vincent Turbat
- Department of International Health, School of Nursing and Health Studies, Georgetown University, Washington, DC, USA.
| | - Jennifer Bouey
- Department of International Health, School of Nursing and Health Studies, Georgetown University, Washington, DC, USA.
| | - Marwa Farag
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada School of Public Administration and Development Economics, Doha Institute for Graduate Studies, Doha, Qatar.
| | | | - Haksoon Ahn
- School of Social Work, University of Maryland, Baltimore, MD, USA.
| | - Daxin Sun
- College of Transportation and Civil Engineering, Fujian Agriculture and Forestry University, Fuzhou, China.
| | - Jie Shen
- Shanghai Jiao Tong University School of Medicine, Shanghai, China; China Hospital Management Institute, Shanghai Jiao Tong University, Shanghai, China.
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Moise K, Achille AM, Batumbo D, Bourdeau B, Rebaudet S, Lerebours G, Henrys JH, Raccurt C. Impact of patron saint festivities on cholera in three communes in Haiti. BMC Public Health 2020; 20:1490. [PMID: 33004021 PMCID: PMC7528476 DOI: 10.1186/s12889-020-09601-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Religious pilgrimages are among the anthropogenic factors known to be associated with the transmission of diarrheal diseases, such as cholera. This ecological study aimed to describe the evolution of cholera and assess the relationship between the implementation of the 'coup de poing' strategy during the patron saint festivities and the incidence of cholera in the three communes of Cabaret, Carrefour, and Croix-des-Bouquets in Haiti in 2017. METHODS An epidemiological curve was produced to illustrate the evolution of cholera at the communal level. Generalized linear models assuming a Poisson distribution were used to weight the annual cholera incidence of communal sections against variables such as the number of patronal festivities, population density and annual precipitation rates. The number of cases in the week of the festivity as well as one and 2 weeks later was weighted against patronal festivities and weekly precipitation rates. RESULTS In total, 3633 suspected cholera cases were continuously reported in three communes in Haiti (Cabaret, Carrefour, Croix-des-bouquets) during the 52-epidemiological week period in 2017. After controlling for rainfall and population density, the implementation of the 'coup de poing' strategy during the patron saint festivities was associated with a significant reduction in cholera incidence of 57.23% [PR = 0.4277 (97.5% CI: 0.2798-0.6193), p = 0.0000244]. The implementation of the strategy was associated with a reduction in cholera incidence of 25.41% 1 week following patronal festivities. CONCLUSION This study showed a continuous presence of cholera in three communes in Haiti in 2017 and an association between the implementation of the 'coup de poing' strategy during patronal festivities and a reduction in cholera incidence. The findings imply that the multi-partner 'coup de poing' strategy may have contributed to the reduced cholera incidence following patron saint festivities and in Ouest department in Haiti in 2017.
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Affiliation(s)
- Kenny Moise
- Equipe de Recherche sur les Maladies Infectieuses, Parasitaires et Tropicales, Université Quisqueya, 218 Avenue Jean-Paul II, Port-au-Prince, 6110, Haiti.
| | - Aude Mélody Achille
- Equipe de Recherche sur les Maladies Infectieuses, Parasitaires et Tropicales, Université Quisqueya, 218 Avenue Jean-Paul II, Port-au-Prince, 6110, Haiti
| | - Doudou Batumbo
- Unité de Formation et de Recherche sur l'Eco-épidémiologie des Maladies Infectieuses, Université de Kinshasa, Kinshasa, République Démocratique du Congo
| | - Bertiny Bourdeau
- Equipe de Recherche sur les Maladies Infectieuses, Parasitaires et Tropicales, Université Quisqueya, 218 Avenue Jean-Paul II, Port-au-Prince, 6110, Haiti
| | - Stanislas Rebaudet
- APHM, Aix Marseille Univ, INSERM, IRD, Hôpital Européen, SESSTIM, Marseille, France
| | - Gérald Lerebours
- Equipe de Recherche sur les Maladies Infectieuses, Parasitaires et Tropicales, Université Quisqueya, 218 Avenue Jean-Paul II, Port-au-Prince, 6110, Haiti
| | - Jean Hugues Henrys
- Equipe de Recherche sur les Maladies Infectieuses, Parasitaires et Tropicales, Université Quisqueya, 218 Avenue Jean-Paul II, Port-au-Prince, 6110, Haiti
| | - Christian Raccurt
- Equipe de Recherche sur les Maladies Infectieuses, Parasitaires et Tropicales, Université Quisqueya, 218 Avenue Jean-Paul II, Port-au-Prince, 6110, Haiti
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Froelich BA, Daines DA. In hot water: effects of climate change on Vibrio-human interactions. Environ Microbiol 2020; 22:4101-4111. [PMID: 32114705 DOI: 10.1111/1462-2920.14967] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/25/2020] [Accepted: 02/27/2020] [Indexed: 02/06/2023]
Abstract
Sea level rise and the anthropogenic warming of the world's oceans is not only an environmental tragedy, but these changes also result in a significant threat to public health. Along with coastal flooding and the encroachment of saltwater farther inland comes an increased risk of human interaction with pathogenic Vibrio species, such as Vibrio cholerae, V. vulnificus and V. parahaemolyticus. This minireview examines the current literature for updates on the climatic changes and practices that impact the location and duration of the presence of Vibrio spp., as well as the infection routes, trends and virulence factors of these highly successful pathogens. Finally, an overview of current treatments and methods for the mitigation of both oral and cutaneous exposures are presented.
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Affiliation(s)
- Brett A Froelich
- Department of Biology, George Mason University, 10900 University Boulevard, Manassas, VA, 20110
| | - Dayle A Daines
- College of Sciences, Office of the Dean, Old Dominion University, Norfolk, VA, 23529
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