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Randomized Controlled Trial
. 2016 May 4;94(5):1136-42.
doi: 10.4269/ajtmh.15-0700. Epub 2016 Feb 29.

Effectiveness of Oral Cholera Vaccine in Haiti: 37-Month Follow-Up

Karine Sévère  1 , Vanessa Rouzier  1 , Stravinsky Benedict Anglade  2 , Claudin Bertil  2 , Patrice Joseph  2 , Alexandra Deroncelay  2 , Marie Marcelle Mabou  2 , Peter F Wright  2 , Florence Duperval Guillaume  2 , Jean William Pape  2
Affiliations
Randomized Controlled Trial

Effectiveness of Oral Cholera Vaccine in Haiti: 37-Month Follow-Up

Karine Sévère et al. Am J Trop Med Hyg. .

Abstract

The first oral cholera vaccine (OCV) campaign, since its prequalification by the World Health Organization, in response to an ongoing cholera epidemic (reactive vaccination) was successfully conducted in a poor urban slum of approximately 70,000 inhabitants in Port-au-Prince, Haiti, in 2012. Vaccine coverage was 75% of the target population. This report documents the impact of OCV in reducing the number of culture-confirmed cases of cholera admitted to the Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) cholera treatment center from that community in the 37 months postvaccination (April 2012-April 30, 2015). Of 1,788 patients with culture-confirmed cholera, 1,770 (99%) were either from outside the vaccine area (1,400 cases) or from the vaccinated community who had not received OCV (370 cases). Of the 388 people from the catchment area who developed culture-confirmed cholera, 370 occurred among the 17,643 people who had not been vaccinated (2.1%) and the remaining 18 occurred among the 52,357 people (0.034%) who had been vaccinated (P < 0.001), for an efficacy that approximates 97.5%. Despite not being designed as a randomized control trial, the very high efficacy is a strong evidence for the effectiveness of OCV as part of an integrated package for the control of cholera in outbreak settings.

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Figures

Figure 1.
Figure 1.
Proximity of the Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes cholera treatment center (GHESKIO CTC) in relation to the target vaccination area.
Figure 2.
Figure 2.
Distribution of patients with acute watery diarrhea admitted to the Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) cholera treatment center: October 2010–April 2015.
Figure 3.
Figure 3.
Rate of culture-confirmed cholera among patients with acute diarrhea in the Port-au-Prince area—Haiti National Laboratory (January 2012–November 2014).
Figure 4.
Figure 4.
Impact of different interventions on acute watery diarrhea cases seen at the Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes cholera treatment center (GHESKIO CTC).
Figure 6.
Figure 6.
Distribution of patients with culture-confirmed cholera within the Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes cholera treatment center (GHESKIO) oral cholera vaccine catchment area: April 2012–April 2015.
Figure 5.
Figure 5.
Rate of culture-confirmed cholera in National Laboratory specimens compared with Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) oral cholera vaccine (OCV) catchment area vaccine and nonvaccine recipients.
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References

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