Unmasking herd protection by an oral cholera vaccine in a cluster-randomized trial
| Autor: | Ali, Mohammad, Qadri, Firdausi, Kim, Deok Ryun, Islam, Taufiqul, Im, Justin, Ahmmed, Faisal, Chon, Yun, Islam Khan, Ashraful, Zaman, Khalequ, Marks, Florian, Clemens, John D |
|---|---|
| Přispěvatelé: | Marks, Florian [0000-0002-6043-7170], Apollo - University of Cambridge Repository |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Immunity Herd Male Adolescent Urban Population fried-egg design Administration Oral Infectious Disease Young Adult Cholera Poverty Areas Cluster Analysis Humans Child Aged Proportional Hazards Models Bangladesh vaccine effectiveness Vaccination Infant Cholera Vaccines cluster-randomized trial Middle Aged Treatment Outcome Vaccines Inactivated Child Preschool Female |
| Zdroj: | International Journal of Epidemiology |
| DOI: | 10.17863/cam.39044 |
| Popis: | BACKGROUND: Several studies have shown that inactivated, whole-cell oral cholera vaccines (OCVs) confer both direct protection on vaccinees and herd protection on populations. Because our earlier cluster-randomized effectiveness trial (CRT) in urban Bangladesh failed to detect OCV herd protection, we reanalysed the trial to assess whether herd effects were masked in our original analysis. METHODS: A total of 267 270 persons were randomized to 90 approximately equal-sized clusters. In 60 clusters persons aged 1 year and older were eligible to receive OCV and in 30 clusters persons received no intervention and served as controls. We analysed OCV protection against severely dehydrating cholera for the entire clusters, as in our original analysis, and for subclusters consisting of residents of innermost households. We hypothesized that if OCV herd protection was attenuated by cholera transmission into the clusters from the outside in this densely populated setting, herd protection would be most evident in the innermost households. RESULTS: During 2 years of follow-up of all residents of the clusters, total protection (protection of OCV recipients relative to control residents) was 58% [95% confidence interval (CI): 43%, 70%; P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|