Effectiveness of two doses of Euvichol-plus oral cholera vaccine in response to the 2017/2018 outbreak: a matched case–control study in Lusaka, Zambia
Introduction Zambia experienced a major cholera outbreak in 2017–2018, with more than 5905 cases reported countrywide, predominantly from the peri-urban slums of Lusaka city. The WHO recommends the use of oral cholera vaccines (OCVs) together with traditional control measures, including health promo...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/11/e066945.full |
| _version_ | 1797988426126983168 |
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| author | Victor M Mukonka Modest Mulenga C Michelo Khozya Zyambo Cephas Sialubanje Muzala Kapina Orbrie Chewe Belem Blamwell Matapo Albertina Moraes Ngomah Brittany Gianetti William Ngosa Mpanga Kasonde Kunda Musonda Nyambe Sinyange Patricia Bobo Lucy Mazyanga Nathan Bakyaita |
| author_facet | Victor M Mukonka Modest Mulenga C Michelo Khozya Zyambo Cephas Sialubanje Muzala Kapina Orbrie Chewe Belem Blamwell Matapo Albertina Moraes Ngomah Brittany Gianetti William Ngosa Mpanga Kasonde Kunda Musonda Nyambe Sinyange Patricia Bobo Lucy Mazyanga Nathan Bakyaita |
| author_sort | Victor M Mukonka |
| collection | DOAJ |
| description | Introduction Zambia experienced a major cholera outbreak in 2017–2018, with more than 5905 cases reported countrywide, predominantly from the peri-urban slums of Lusaka city. The WHO recommends the use of oral cholera vaccines (OCVs) together with traditional control measures, including health promotion, provision of safe water and improving sanitation, in cholera endemic areas and during cholera outbreaks. In response to this outbreak, the Zambian government implemented the OVC campaign and administered the Euvichol-plus vaccine in the high-risk subdistricts of Lusaka. Although OCVs have been shown to be effective in preventing cholera infection in cholera endemic and outbreak settings, the effectiveness of the Euvichol-plus vaccine has not yet been evaluated in Zambia. This study aimed to determine the effectiveness of two doses of OCV administered during the 2017/2018 vaccination campaign.Methods We conducted a matched case–control study involving 79 cases and 316 controls following the mass vaccination campaign in the four subdistricts of Lusaka (Chawama, Chipata, Kanyama and Matero). Matching of controls was based on the place of residence, age and sex. Conditional logistic regression was used for analysis. Adjusted OR (AOR), 95% CI and vaccine effectiveness (1-AOR) for two doses of Euvichol-plus vaccine and any dose were estimated (p<0.05).Results The AOR vaccine effectiveness for two doses of Euvichol-plus OCV was 81.0% (95% CI 66.0% to 78.0%; p<0.01). Secondary analysis showed that vaccine effectiveness for any dose was 74.0% (95% CI 50.0% to 86.0%; p<0.01).Conclusion These findings show that two doses of Euvichol-plus OCV are effective in a cholera outbreak setting in Lusaka, Zambia. The findings also indicate that two doses are more effective than a single dose and thus support the use of two doses of the vaccine as part of an integrated intervention to cholera control during outbreaks. |
| first_indexed | 2024-04-11T08:04:02Z |
| format | Article |
| id | doaj.art-b473a0520c5c437ba95db57b8e0b519b |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-11T08:04:02Z |
| publishDate | 2022-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-b473a0520c5c437ba95db57b8e0b519b2022-12-22T04:35:38ZengBMJ Publishing GroupBMJ Open2044-60552022-11-01121110.1136/bmjopen-2022-066945Effectiveness of two doses of Euvichol-plus oral cholera vaccine in response to the 2017/2018 outbreak: a matched case–control study in Lusaka, ZambiaVictor M Mukonka0Modest Mulenga1C Michelo2Khozya Zyambo3Cephas Sialubanje4Muzala Kapina5Orbrie Chewe6Belem Blamwell Matapo7Albertina Moraes Ngomah8Brittany Gianetti9William Ngosa10Mpanga Kasonde11Kunda Musonda12Nyambe Sinyange13Patricia Bobo14Lucy Mazyanga15Nathan Bakyaita16Zambia National Public Health Institute, Lusaka, ZambiaTropical Diseases Research Centre, Ndola, ZambiaUniversity of Zambia School of Public Health, Lusaka, ZambiaZambia Ministry of Health, Lusaka, ZambiaSchool of Public Health, Levy Mwanawasa Medical University, Lusaka, ZambiaZambia National Public Health Institute, Lusaka, ZambiaSurveillance and Disease Intelligence, Zambia National Public Health Institute, Lusaka, ZambiaWorld Health Organization, Lusaka, ZambiaCommunication Information & Research, Zambia National Public Health Institute, Lusaka, ZambiaUniversity of California Berkeley, Berkeley, California, USACommunication Information & Research, Zambia National Public Health Institute, Lusaka, ZambiaLaboratory System and Networks, Zambia National Public Health Institute, Lusaka, ZambiaMinistry of health Zambia, Lusaka, ZambiaEpidemic Preparedness & Response, Zambia National Public Health Institute, Lusaka, ZambiaMinistry of health Zambia, Lusaka, ZambiaZambia National Public Health Institute, Lusaka, ZambiaWorld Health Organization, Lusaka, ZambiaIntroduction Zambia experienced a major cholera outbreak in 2017–2018, with more than 5905 cases reported countrywide, predominantly from the peri-urban slums of Lusaka city. The WHO recommends the use of oral cholera vaccines (OCVs) together with traditional control measures, including health promotion, provision of safe water and improving sanitation, in cholera endemic areas and during cholera outbreaks. In response to this outbreak, the Zambian government implemented the OVC campaign and administered the Euvichol-plus vaccine in the high-risk subdistricts of Lusaka. Although OCVs have been shown to be effective in preventing cholera infection in cholera endemic and outbreak settings, the effectiveness of the Euvichol-plus vaccine has not yet been evaluated in Zambia. This study aimed to determine the effectiveness of two doses of OCV administered during the 2017/2018 vaccination campaign.Methods We conducted a matched case–control study involving 79 cases and 316 controls following the mass vaccination campaign in the four subdistricts of Lusaka (Chawama, Chipata, Kanyama and Matero). Matching of controls was based on the place of residence, age and sex. Conditional logistic regression was used for analysis. Adjusted OR (AOR), 95% CI and vaccine effectiveness (1-AOR) for two doses of Euvichol-plus vaccine and any dose were estimated (p<0.05).Results The AOR vaccine effectiveness for two doses of Euvichol-plus OCV was 81.0% (95% CI 66.0% to 78.0%; p<0.01). Secondary analysis showed that vaccine effectiveness for any dose was 74.0% (95% CI 50.0% to 86.0%; p<0.01).Conclusion These findings show that two doses of Euvichol-plus OCV are effective in a cholera outbreak setting in Lusaka, Zambia. The findings also indicate that two doses are more effective than a single dose and thus support the use of two doses of the vaccine as part of an integrated intervention to cholera control during outbreaks.https://bmjopen.bmj.com/content/12/11/e066945.full |
| spellingShingle | Victor M Mukonka Modest Mulenga C Michelo Khozya Zyambo Cephas Sialubanje Muzala Kapina Orbrie Chewe Belem Blamwell Matapo Albertina Moraes Ngomah Brittany Gianetti William Ngosa Mpanga Kasonde Kunda Musonda Nyambe Sinyange Patricia Bobo Lucy Mazyanga Nathan Bakyaita Effectiveness of two doses of Euvichol-plus oral cholera vaccine in response to the 2017/2018 outbreak: a matched case–control study in Lusaka, Zambia BMJ Open |
| title | Effectiveness of two doses of Euvichol-plus oral cholera vaccine in response to the 2017/2018 outbreak: a matched case–control study in Lusaka, Zambia |
| title_full | Effectiveness of two doses of Euvichol-plus oral cholera vaccine in response to the 2017/2018 outbreak: a matched case–control study in Lusaka, Zambia |
| title_fullStr | Effectiveness of two doses of Euvichol-plus oral cholera vaccine in response to the 2017/2018 outbreak: a matched case–control study in Lusaka, Zambia |
| title_full_unstemmed | Effectiveness of two doses of Euvichol-plus oral cholera vaccine in response to the 2017/2018 outbreak: a matched case–control study in Lusaka, Zambia |
| title_short | Effectiveness of two doses of Euvichol-plus oral cholera vaccine in response to the 2017/2018 outbreak: a matched case–control study in Lusaka, Zambia |
| title_sort | effectiveness of two doses of euvichol plus oral cholera vaccine in response to the 2017 2018 outbreak a matched case control study in lusaka zambia |
| url | https://bmjopen.bmj.com/content/12/11/e066945.full |
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