Effectiveness of one dose of oral cholera vaccine in response to an outbreak: a case-cohort study
| Autor: | David A. Sack, Lucy Anne Parker, Augusto E. Llosa, Lul Deng, Michael Lasuba, Justin Lessler, Sandra Cohuet, Anne Laure Page, Dossou Vincent Sodjinou, Richard Laku Lino, Abdinasir Abubakar, Lameck Ontweka, Marie Laure Quilici, Francesco Grandesso, Bior K. Bior, Fisseha Tadesse, Amanda K. Debes, John Rumunu, Lorenzo Pezzoli, Iza Ciglenecki, Andrew S. Azman, Christine Jamet, Joseph F. Wamala, Francisco J. Luquero, Allan M. Mpairwe |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent 030231 tropical medicine Administration Oral India Drug Administration Schedule Disease Outbreaks Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine Cholera Epidemiology medicine Humans 030212 general & internal medicine Child business.industry Public health lcsh:Public aspects of medicine Vaccination Vibrio cholerae O1 Outbreak lcsh:RA1-1270 Cholera Vaccines General Medicine Middle Aged medicine.disease Child Preschool Cohort Immunology Female business Cholera vaccine Cohort study |
| Zdroj: | The Lancet Global Health, Vol 4, Iss 11, Pp e856-e863 (2016) |
| ISSN: | 2214-109X |
| Popis: | Summary Background Oral cholera vaccines represent a new effective tool to fight cholera and are licensed as two-dose regimens with 2–4 weeks between doses. Evidence from previous studies suggests that a single dose of oral cholera vaccine might provide substantial direct protection against cholera. During a cholera outbreak in May, 2015, in Juba, South Sudan, the Ministry of Health, Medecins Sans Frontieres, and partners engaged in the first field deployment of a single dose of oral cholera vaccine to enhance the outbreak response. We did a vaccine effectiveness study in conjunction with this large public health intervention. Methods We did a case-cohort study, combining information on the vaccination status and disease outcomes from a random cohort recruited from throughout the city of Juba with that from all the cases detected. Eligible cases were those aged 1 year or older on the first day of the vaccination campaign who sought care for diarrhoea at all three cholera treatment centres and seven rehydration posts throughout Juba. Confirmed cases were suspected cases who tested positive to PCR for Vibrio cholerae O1. We estimated the short-term protection (direct and indirect) conferred by one dose of cholera vaccine (Shanchol, Shantha Biotechnics, Hyderabad, India). Findings Between Aug 9, 2015, and Sept 29, 2015, we enrolled 87 individuals with suspected cholera, and an 898-person cohort from throughout Juba. Of the 87 individuals with suspected cholera, 34 were classified as cholera positive, 52 as cholera negative, and one had indeterminate results. Of the 858 cohort members who completed a follow-up visit, none developed clinical cholera during follow-up. The unadjusted single-dose vaccine effectiveness was 80·2% (95% CI 61·5–100·0) and after adjusting for potential confounders was 87·3% (70·2–100·0). Interpretation One dose of Shanchol was effective in preventing medically attended cholera in this study. These results support the use of a single-dose strategy in outbreaks in similar epidemiological settings. Funding Medecins Sans Frontieres. |
| Databáze: | OpenAIRE |
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