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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Use of Vibrio cholerae vaccine in an outbreak in Guinea
New England Journal of Medicine, Volume 370, No. 22, Year 2014
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Description
BACKGROUND: The use of vaccines to prevent and control cholera is currently under debate. Shanchol is one of the two oral cholera vaccines prequalified by the World Health Organization; however, its effectiveness under field conditions and the protection it confers in the first months after administration remain unknown. The main objective of this study was to estimate the short-term effectiveness of two doses of Shanchol used as a part of the integrated response to a cholera outbreak in Africa. METHODS: We conducted a matched case-control study in Guinea between May 20 and October 19, 2012. Suspected cholera cases were confirmed by means of a rapid test, and controls were selected among neighbors of the same age and sex as the case patients. The odds of vaccination were compared between case patients and controls in bivariate and adjusted conditional logistic-regression models. Vaccine effectiveness was calculated as (1 - odds ratio) x 100. RESULTS: Between June 8 and October 19, 2012, we enrolled 40 case patients and 160 controls in the study for the primary analysis. After adjustment for potentially confounding variables, vaccination with two complete doses was associated with significant protection against cholera (effectiveness, 86.6%; 95% confidence interval, 56.7 to 95.8; P = 0.001). CONCLUSIONS: In this study, Shanchol was effective when used in response to a cholera outbreak in Guinea. This study provides evidence supporting the addition of vaccination as part of the response to an outbreak. It also supports the ongoing efforts to establish a cholera vaccine stockpile for emergency use, which would enhance outbreak prevention and control strategies. Copyright © 2014 Massachusetts Medical Society.
Authors & Co-Authors
Luquero, Francisco Javier
France, Paris
Epicentre
Grout, Lise
France, Paris
Epicentre
Switzerland, Geneva
Medecins Sans Frontieres
Ciglenečki, Iza
Switzerland, Geneva
Medecins Sans Frontieres
Sakoba, Keita
France, Paris
Agency of Preventive Medicine
Guinea, Guinea
Ministry of Health
Traore, Bala
Guinea
Direction Préfectorale de la Santé
Heile, Melat
Switzerland, Geneva
Medecins Sans Frontieres
Diallo, Alpha Amadou Sanck
Guinea, Guinea
Ministry of Health
Itama, Christian
Switzerland, Geneva
Organisation Mondiale de la Santé
Page, Anne Laure
France, Paris
Epicentre
Quilici, Marie Laure
France, Paris
Institut Pasteur, Paris
Mengel, Martin A.
France, Paris
Agency of Preventive Medicine
Eiros-Bouza, José María
Spain, Valladolid
Universidad de Valladolid
Serafini, Micaela
Switzerland, Geneva
Medecins Sans Frontieres
Legros, Dominique
Switzerland, Geneva
Medecins Sans Frontieres
Grais, Rebecca Freeman
France, Paris
Epicentre
Statistics
Citations: 141
Authors: 15
Affiliations: 8
Identifiers
Doi:
10.1056/NEJMoa1312680
ISSN:
00284793
e-ISSN:
15334406
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Case-Control Study
Study Locations
Guinea