First Outbreak Response Using an Oral Cholera Vaccine in Africa

Vaccine Coverage, Acceptability and Surveillance of Adverse Events, Guinea, 2012

Francisco J. Luquero, Lise Grout, Iza Ciglenecki, Keita Sakoba, Bala Traore, Melat Heile, Alpha Amadou Dialo, Christian Itama, Micaela Serafini, Dominique Legros, Rebecca F. Grais

Research output: Contribution to journalArticle

Abstract

Background:Despite World Health Organization (WHO) prequalification of two safe and effective oral cholera vaccines (OCV), concerns about the acceptability, potential diversion of resources, cost and feasibility of implementing timely campaigns has discouraged their use. In 2012, the Ministry of Health of Guinea, with the support of Médecins Sans Frontières organized the first mass vaccination campaign using a two-dose OCV (Shanchol) as an additional control measure to respond to the on-going nationwide epidemic. Overall, 316,250 vaccines were delivered. Here, we present the results of vaccination coverage, acceptability and surveillance of adverse events.Methodology/Principal Findings:We performed a cross-sectional cluster survey and implemented adverse event surveillance. The study population included individuals older than 12 months, eligible for vaccination, and residing in the areas targeted for vaccination (Forécariah and Boffa, Guinea). Data sources were household interviews with verification by vaccination card and notifications of adverse events from surveillance at vaccination posts and health centres. In total 5,248 people were included in the survey, 3,993 in Boffa and 1,255 in Forécariah. Overall, 89.4% [95%CI:86.4-91.8%] and 87.7% [95%CI:84.2-90.6%] were vaccinated during the first round and 79.8% [95%CI:75.6-83.4%] and 82.9% [95%CI:76.6-87.7%] during the second round in Boffa and Forécariah respectively. The two dose vaccine coverage (including card and oral reporting) was 75.8% [95%CI: 71.2-75.9%] in Boffa and 75.9% [95%CI: 69.8-80.9%] in Forécariah respectively. Vaccination coverage was higher in children. The main reason for non-vaccination was absence. No severe adverse events were notified.Conclusions/Significance:The well-accepted mass vaccination campaign reached high coverage in a remote area with a mobile population. Although OCV should not be foreseen as the long-term solution for global cholera control, they should be integrated as an additional tool into the response.

Original languageEnglish (US)
Article numbere2465
JournalPLoS Neglected Tropical Diseases
Volume7
Issue number10
DOIs
StatePublished - Oct 2013
Externally publishedYes

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Cholera Vaccines
Guinea
Disease Outbreaks
Vaccination
Vaccines
Mass Vaccination
Immunization Programs
Cholera
Information Storage and Retrieval
Health
Population
Cross-Sectional Studies
Interviews
Costs and Cost Analysis

ASJC Scopus subject areas

  • Infectious Diseases
  • Public Health, Environmental and Occupational Health
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

First Outbreak Response Using an Oral Cholera Vaccine in Africa : Vaccine Coverage, Acceptability and Surveillance of Adverse Events, Guinea, 2012. / Luquero, Francisco J.; Grout, Lise; Ciglenecki, Iza; Sakoba, Keita; Traore, Bala; Heile, Melat; Dialo, Alpha Amadou; Itama, Christian; Serafini, Micaela; Legros, Dominique; Grais, Rebecca F.

In: PLoS Neglected Tropical Diseases, Vol. 7, No. 10, e2465, 10.2013.

Research output: Contribution to journalArticle

Luquero, FJ, Grout, L, Ciglenecki, I, Sakoba, K, Traore, B, Heile, M, Dialo, AA, Itama, C, Serafini, M, Legros, D & Grais, RF 2013, 'First Outbreak Response Using an Oral Cholera Vaccine in Africa: Vaccine Coverage, Acceptability and Surveillance of Adverse Events, Guinea, 2012', PLoS Neglected Tropical Diseases, vol. 7, no. 10, e2465. https://doi.org/10.1371/journal.pntd.0002465
Luquero, Francisco J. ; Grout, Lise ; Ciglenecki, Iza ; Sakoba, Keita ; Traore, Bala ; Heile, Melat ; Dialo, Alpha Amadou ; Itama, Christian ; Serafini, Micaela ; Legros, Dominique ; Grais, Rebecca F. / First Outbreak Response Using an Oral Cholera Vaccine in Africa : Vaccine Coverage, Acceptability and Surveillance of Adverse Events, Guinea, 2012. In: PLoS Neglected Tropical Diseases. 2013 ; Vol. 7, No. 10.
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abstract = "Background:Despite World Health Organization (WHO) prequalification of two safe and effective oral cholera vaccines (OCV), concerns about the acceptability, potential diversion of resources, cost and feasibility of implementing timely campaigns has discouraged their use. In 2012, the Ministry of Health of Guinea, with the support of M{\'e}decins Sans Fronti{\`e}res organized the first mass vaccination campaign using a two-dose OCV (Shanchol) as an additional control measure to respond to the on-going nationwide epidemic. Overall, 316,250 vaccines were delivered. Here, we present the results of vaccination coverage, acceptability and surveillance of adverse events.Methodology/Principal Findings:We performed a cross-sectional cluster survey and implemented adverse event surveillance. The study population included individuals older than 12 months, eligible for vaccination, and residing in the areas targeted for vaccination (For{\'e}cariah and Boffa, Guinea). Data sources were household interviews with verification by vaccination card and notifications of adverse events from surveillance at vaccination posts and health centres. In total 5,248 people were included in the survey, 3,993 in Boffa and 1,255 in For{\'e}cariah. Overall, 89.4{\%} [95{\%}CI:86.4-91.8{\%}] and 87.7{\%} [95{\%}CI:84.2-90.6{\%}] were vaccinated during the first round and 79.8{\%} [95{\%}CI:75.6-83.4{\%}] and 82.9{\%} [95{\%}CI:76.6-87.7{\%}] during the second round in Boffa and For{\'e}cariah respectively. The two dose vaccine coverage (including card and oral reporting) was 75.8{\%} [95{\%}CI: 71.2-75.9{\%}] in Boffa and 75.9{\%} [95{\%}CI: 69.8-80.9{\%}] in For{\'e}cariah respectively. Vaccination coverage was higher in children. The main reason for non-vaccination was absence. No severe adverse events were notified.Conclusions/Significance:The well-accepted mass vaccination campaign reached high coverage in a remote area with a mobile population. Although OCV should not be foreseen as the long-term solution for global cholera control, they should be integrated as an additional tool into the response.",
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N2 - Background:Despite World Health Organization (WHO) prequalification of two safe and effective oral cholera vaccines (OCV), concerns about the acceptability, potential diversion of resources, cost and feasibility of implementing timely campaigns has discouraged their use. In 2012, the Ministry of Health of Guinea, with the support of Médecins Sans Frontières organized the first mass vaccination campaign using a two-dose OCV (Shanchol) as an additional control measure to respond to the on-going nationwide epidemic. Overall, 316,250 vaccines were delivered. Here, we present the results of vaccination coverage, acceptability and surveillance of adverse events.Methodology/Principal Findings:We performed a cross-sectional cluster survey and implemented adverse event surveillance. The study population included individuals older than 12 months, eligible for vaccination, and residing in the areas targeted for vaccination (Forécariah and Boffa, Guinea). Data sources were household interviews with verification by vaccination card and notifications of adverse events from surveillance at vaccination posts and health centres. In total 5,248 people were included in the survey, 3,993 in Boffa and 1,255 in Forécariah. Overall, 89.4% [95%CI:86.4-91.8%] and 87.7% [95%CI:84.2-90.6%] were vaccinated during the first round and 79.8% [95%CI:75.6-83.4%] and 82.9% [95%CI:76.6-87.7%] during the second round in Boffa and Forécariah respectively. The two dose vaccine coverage (including card and oral reporting) was 75.8% [95%CI: 71.2-75.9%] in Boffa and 75.9% [95%CI: 69.8-80.9%] in Forécariah respectively. Vaccination coverage was higher in children. The main reason for non-vaccination was absence. No severe adverse events were notified.Conclusions/Significance:The well-accepted mass vaccination campaign reached high coverage in a remote area with a mobile population. Although OCV should not be foreseen as the long-term solution for global cholera control, they should be integrated as an additional tool into the response.

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