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Review
. 2024 Jul 12;79(Suppl 1):S20-S32.
doi: 10.1093/cid/ciae194.

Comprehensive Review on the Use of Oral Cholera Vaccine (OCV) in Ethiopia: 2019 to 2023

Moti Edosa  1 , Yeonji Jeon  2 , Abel Gedefaw  2   3 , Dejene Hailu  2   4 , Edlawit Mesfin Getachew  5 , Ondari D Mogeni  2 , Geun Hyeog Jang  6 , David Mukasa  6 , Biruk Yeshitela  7 , Tomas Getahun  5 , Julia Lynch  8 , Malika Bouhenia  9 , Yeshambel Worku Demlie  1 , Mukemil Hussen  1 , Mesfin Wossen  1 , Mekonnen Teferi  5 , Se Eun Park  2   10
Affiliations
Review

Comprehensive Review on the Use of Oral Cholera Vaccine (OCV) in Ethiopia: 2019 to 2023

Moti Edosa et al. Clin Infect Dis. .

Abstract

Background: Cholera outbreaks in Ethiopia necessitate frequent mass oral cholera vaccine (OCV) campaigns. Despite this, there is a notable absence of a comprehensive summary of these campaigns. Understanding national OCV vaccination history is essential to design appropriate and effective cholera control strategies. Here, we aimed to retrospectively review all OCV vaccination campaigns conducted across Ethiopia between 2019 and 2023.

Methods: The OCV request records from 2019 to October 2023 and vaccination campaign reports for the period from 2019 to December 2023 were retrospectively accessed from the Ethiopia Public Health Institute (EPHI) database. Descriptive analysis was conducted using the retrospective data collected.

Results: From 2019 to October 2023, Ethiopian government requested 32 044 576 OCV doses (31 899 576 doses to global stockpile; 145 000 doses to outside of stockpile). Around 66.3% of requested doses were approved; of which 90.4% were received. Fifteen OCV campaigns (12 reactive and 3 pre-emptive) were conducted, including five two-dose campaigns with varying dose intervals and single-dose campaigns partially in 2019 and entirely in 2021, 2022 and 2023. Overall vaccine administrative coverage was high; except for Tigray region (41.8% in the 1st round; 2nd round didn't occur). The vaccine administrative coverage records were documented, but no OCV coverage survey data was available.

Conclusions: This study represents the first comprehensive review of OCV campaigns in Ethiopia spanning the last five years. Its findings offer valuable insights into informing future cholera control strategies, underscoring the importance of monitoring and evaluation despite resource constraints. Addressing the limitations in coverage survey data availability is crucial for enhancing the efficacy of future campaigns.

Keywords: Cholera; Ethiopia; OCV; OCV dosing schedules; global OCV stockpile.

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Conflict of interest statement

Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
OCV doses made available in Ethiopia from 2019 to October 2023. The figure shows OCV doses requested, approved, and received in Ethiopia from 2019 to October 2023, and doses used in last 5 years. “Request number” refers to each OCV request made by the Ethiopian government to the ICG (A1-A11) and non-stockpile requests (Bilateral, ECCP). “Bilateral” represents the Ethiopian government's bilateral request to the government of the Republic of Korea for OCV doses for cholera outbreak control in 2019. “ECCP” represents “Ethiopia Cholera Control and Prevention” project. “Afar” and “Amhara” represent preventive vaccination campaigns conducted in Afar and Amhara region, respectively using remaining OCV doses from other vaccination campaigns. Abbreviation: OCV, oral cholera vaccine.
Figure 2.
Figure 2.
Map of OCV vaccination campaign areas. The map comprehensively shows woredas where OCV vaccination campaigns have been conducted from 2019 to 2023. Number of vaccination rounds conducted in each woreda is represented as either R1 or R2. Abbreviations: ECCP, Ethiopia Cholera Control and Prevention; OCV, oral cholera vaccine.
Figure 3.
Figure 3.
Age group and sex-stratified OCV vaccinated populations from 2019 to 2023. Panels A–D show age groups and sex of OCV vaccinated populations in each vaccination campaigns. “Request number” refers to each OCV request made by the Ethiopian government to the ICG (A1–A11) and non-stockpile requests (Bilateral, ECCP). “Bilateral” represents the Ethiopian government's bilateral request to the government of the Republic of Korea for OCV doses for cholera outbreak control in 2019. “ECCP” represents “Ethiopia Cholera Control and Prevention” project. “Afar” and “Amhara” represent preventive vaccination campaigns conducted in Afar and Amhara region respectively using remaining OCV doses from other vaccination campaigns. Age and sex stratified data of OCV vaccinated populations from Bilateral and A4 were not available. Afar, Amhara, and A6–A11 administered single dose (SD) strategy; there was no second round information. Panels A and B exhibit age group and sex stratifications of populations vaccinated respectively in the 1st round; Panels C and D exhibit age group and sex stratifications of populations vaccinated respectively in the 2nd round. Abbreviation: OCV, oral cholera vaccine.
Figure 3.
Figure 3.
Age group and sex-stratified OCV vaccinated populations from 2019 to 2023. Panels A–D show age groups and sex of OCV vaccinated populations in each vaccination campaigns. “Request number” refers to each OCV request made by the Ethiopian government to the ICG (A1–A11) and non-stockpile requests (Bilateral, ECCP). “Bilateral” represents the Ethiopian government's bilateral request to the government of the Republic of Korea for OCV doses for cholera outbreak control in 2019. “ECCP” represents “Ethiopia Cholera Control and Prevention” project. “Afar” and “Amhara” represent preventive vaccination campaigns conducted in Afar and Amhara region respectively using remaining OCV doses from other vaccination campaigns. Age and sex stratified data of OCV vaccinated populations from Bilateral and A4 were not available. Afar, Amhara, and A6–A11 administered single dose (SD) strategy; there was no second round information. Panels A and B exhibit age group and sex stratifications of populations vaccinated respectively in the 1st round; Panels C and D exhibit age group and sex stratifications of populations vaccinated respectively in the 2nd round. Abbreviation: OCV, oral cholera vaccine.
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References

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