Use of <i>Vibrio cholerae</i> Vaccine in an Outbreak in Guinea

Luquero, Francisco J.; Grout, Lise; Ciglenečki, Iza; Кейта, Сакоба; Traore, Balla; Heile, Melat; Diallo, Alpha; Itama, Christian; Page, Anne‐Laure; Quilici, Marie‐Laure; Mengel, Martin; Eirós, José María; Serafini, Micaela; Legros, Dominique; Grais, Rebecca F.

doi:10.1056/nejmoa1312680

Cited by 144 publications

(152 citation statements)

References 25 publications

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“…It was feasible to mount a campaign in Guinea in a short time after cholera cases appear with >75% two-dose vaccine coverage Luquero et al 2013Luquero et al , 2014.…”

Section: Resultsmentioning

confidence: 99%

“…Kolkata, India, 2006-2010[Sur et al 2009Bhattacharya et al 2013] • Cluster-randomized trial • Two doses of killed whole cell bivalent (O1 and O139) OCV • No. of subjects: nonpregnant individuals aged 1 year and older: 66,900 • Follow up: 5 years 2 years: all age groups: PE = 67% 1 to <5 years old: PE = 49%; 5 to < 15 years old: PE = 87%; 15+ years old: PE = 63% 3 years: cumulative PE = 66%; 1 to <5 years, cumulative PE = 43%; PE on the third year was 65% for all ages 5 years: cumulative PE = 65%; 1 to <5 years, cumulative PE = 42% (p = 0.07 for difference in PE in age groups) Forecariah and Boffa prefectures in Guinea, 2012 [Luquero et al 2014 [Trach et al 1997]. In 1992, following the emergence of O139 in India and Bangladesh, the vaccine was modified to include killed V. cholerae O139 cells.…”

Section: Bs-wc or Rbs-wc (Dukoral)mentioning

confidence: 94%

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Killed oral cholera vaccines: history, development and implementation challenges

Lopez

Gonzales

Aldaba

et al. 2014

Therapeutic Advances in Vaccines

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Cholera is still a major global health problem, affecting mainly people living in unsanitary conditions and who are at risk for outbreaks of cholera. During the past decade, outbreaks are increasingly reported from more countries. From the early killed oral cholera vaccine, rapid improvements in vaccine development occurred as a result of a better understanding of the epidemiology of the disease, pathogenesis of cholera infection and immunity. The newer-generation oral killed cholera vaccines have been shown to be safe and effective in field trials conducted in cholera endemic areas. Likewise, they have been shown to be protective when used during outbreak settings. Aside from providing direct protection to vaccinated individuals, recent studies have demonstrated that these killed oral vaccines also confer indirect protection through herd immunity. Although new-generation oral cholera vaccines should not be considered in isolation from other preventive approaches in countries where they are most needed, especially improved water quality and sanitation, these vaccines serve as immediately available public health tools for preventing further morbidity and mortality from cholera. However, despite its availability for more than two decades, use of these vaccines has not been optimized. Although there are limitations of the currently available oral cholera vaccines, recent data show that the vaccines are safe, feasible to use even in difficult circumstances and able to provide protection in various settings. Clear identification of the areas and target population groups who will benefit from the use of the cholera vaccines will be required and strategies to facilitate accessibility and usage of these vaccines in these areas and population groups will need to be developed.

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“…It was feasible to mount a campaign in Guinea in a short time after cholera cases appear with >75% two-dose vaccine coverage Luquero et al 2013Luquero et al , 2014.…”

Section: Resultsmentioning

confidence: 99%

Section: Bs-wc or Rbs-wc (Dukoral)mentioning

confidence: 94%

Killed oral cholera vaccines: history, development and implementation challenges

Lopez

Gonzales

Aldaba

et al. 2014

Therapeutic Advances in Vaccines

View full text Add to dashboard Cite

show abstract

“…In another example, several VE case-control studies for cholera vaccines have used confirmed cholera diarrhea as cases and chose as controls persons who did not seek treatment for diarrhea -a conventional design (65)(66)(67). They then did a parallel "bias-indicator" analysis using those who sought treatment for diarrhea but did not test positive for cholera as cases and conventional controls, showing that the study design did not find measurable VE for a noncholera outcome.…”

Section: Discussionmentioning

confidence: 99%

“…• Showed that the vaccine-preventable burden of influenza mortality has been overestimated due to confounding (6,14,15) • Added confidence to several studies of cholera VE in outbreaks by showing that VE was estimated to be not statistically different from zero for non-cholera diarrhea (65)(66)(67) Substantive insights from test-negative designs…”

Section: Discussionmentioning

confidence: 99%

Observational studies and the difficult quest for causality: lessons from vaccine effectiveness and impact studies

2016

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Although randomized placebo-controlled trials (RCT) are critical to establish efficacy of vaccines at the time of licensure, important remaining questions about vaccine effectiveness (VE) -used here to include individual-level measures and population-wide impact of vaccine programs --can only be answered once the vaccine is in use, from observational studies. However, such studies are inherently at risk for bias. Using a causal framework and illustrating with examples we review newer approaches to detecting and avoiding confounding and selection bias in three major classes of observational study design: cohort, case-control, and ecological studies. Studies of influenza VE, especially in seniors, are an excellent demonstration of the challenges of detecting and reducing such bias, and so we use influenza VE as a running example. We take a fresh look at the time-trend studies often dismissed as "ecological." Such designs are the only observational study design that can measure the overall effect of a vaccination program (indirect (herd) as well as direct effects), and are in fact already an important part of the evidence base for several vaccines currently in use. Despite the great strides towards more robust observational study designs, challenges lie ahead for evaluating best practices for achieving robust unbiased results from observational studies. This is critical for evaluation of national and global vaccine program effectiveness.

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“…While immediate availability has been a major reason behind increased interest, other important factors include the observed feasibility of mass OCV campaigns and ability to confer protection to underserved populations in complex situations. [47][48][49] The increased use and experience with OCV adds multidimensional values to the established control measures. In the past, OCV and traditional measures of cholera response (water, sanitation, hygiene), surveillance, community education, and access to treatment had been viewed as competitive, if not mutually exclusive.…”

Section: Ocv For Emergency Use Is Released After Review Of Country Apmentioning

confidence: 99%

Achievements and challenges for the use of killed oral cholera vaccines in the global stockpile era

Desai

Pezzoli

Alberti

et al. 2016

Human Vaccines & Immunotherapeutics

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Cholera remains an important but neglected public health threat, affecting the health of the poorest populations and imposing substantial costs on public health systems. Cholera can be eliminated where access to clean water, sanitation, and satisfactory hygiene practices are sustained, but major improvements in infrastructure continue to be a distant goal. New developments and trends of cholera disease burden, the creation of affordable oral cholera vaccines (OCVs) for use in developing countries, as well as recent evidence of vaccination impact has created an increased demand for cholera vaccines. The global OCV stockpile was established in 2013 and with support from Gavi, has assisted in achieving rapid access to vaccine in emergencies. Recent WHO prequalification of a second affordable OCV supports the stockpile goals of increased availability and distribution to affected populations. It serves as an essential step toward an integrated cholera control and prevention strategy in emergency and endemic settings.

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Use of Vibrio cholerae Vaccine in an Outbreak in Guinea

Cited by 144 publications

References 25 publications

Killed oral cholera vaccines: history, development and implementation challenges

Killed oral cholera vaccines: history, development and implementation challenges

Observational studies and the difficult quest for causality: lessons from vaccine effectiveness and impact studies

Achievements and challenges for the use of killed oral cholera vaccines in the global stockpile era

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