Abstract：
BACKGROUND:In response to a cholera outbreak among mobile, difficult-to-reach fishermen on Lake Chilwa, Malawi in 2016, a novel vaccine distribution strategy exploited the proven vaccine thermostability. Fishermen, while taking the first vaccine dose under supervision, received the second dose in a sealed bag, and were told to drink it two weeks later. This study assessed short-term vaccine protection of this strategy. METHODS:Patients with diarrhoea admitted to health facilities around lake were interviewed and a stool sample collected for PCR testing. Vaccine effectiveness was assessed in a case-control test-negative design by comparing cases (PCR-positive for V. cholerae O1) and controls (patients with diarrhoea but PCR-negative) and with the screening method that compared the proportions of vaccinated among cholera cases versus the general fishermen population. RESULTS:Of 145 study participants, 120 were fishermen living on the lake. Vaccine effectiveness at three-months was 90.0% [95%CI:38.8;98.4] among fishermen and 83.3% [95%CI: 20.8; 96.5] among all participants in the case-control test-negative design, and 97.5% [95%CI: 90.9;99.3] with the screening method. CONCLUSION:This strategy was effective in providing short-term protection in fishermen against cholera. Further research is needed to determine the adding value of the second dose and to identify the optimal vaccination strategies for different contexts.
journal_name
Vaccinejournal_title
Vaccineauthors
Grandesso F,Kasambara W,Page AL,Debes AK,M'bang'ombe M,Palomares A,Lechevalier P,Pezzoli L,Alley I,Salumu L,Msyamboza K,Sack D,Cohuet S,Luquero FJdoi
10.1016/j.vaccine.2019.05.044subject
Has Abstractpub_date
2019-06-19 00:00:00pages
3668-3676issue
28eissn
0264-410Xissn
1873-2518pii
S0264-410X(19)30668-1journal_volume
37pub_type
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