A Quantitative Systematic Review and Meta-Analysis of the Effectiveness of Oral Cholera Vaccine as a Reactive Measure in Cholera Outbreaks

Schwerdtle, Patricia Nayna; Onekon, Coretta Kings; Récoché, Katrina

doi:10.1017/s1049023x17007166

Cited by 12 publications

(13 citation statements)

References 17 publications

(34 reference statements)

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“…The current WHO position paper on cholera vaccines offers general advice in four sentences on which factors to consider regarding the use of OCVs for cholera control in humanitarian emergencies [ 79 ], while the available draft of the 2018 Sphere Handbook offers further general advice on this [ 76 ]. In the end, the decision has to be made on a case-by-case basis by the people involved in a given humanitarian response, leaving room for a degree of arbitrary in the decision-making process that should at least be sought to be minimized through the development of more specific, comprehensive and actionable frameworks based on the accumulating and promising evidence from mass OCV campaigns in humanitarian emergencies [ 26 , 29 , 60 , 71 , 80 – 84 ].…”

Section: Main Textmentioning

confidence: 99%

The cholera outbreak in Yemen: lessons learned and way forward

Federspiel

Ali

2018

BMC Public Health

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The Yemen cholera outbreak has been driven by years of conflict and has now become the largest in epidemiologically recorded history with more than 1.2 million cases since the beginning of the outbreak in April, 2017. In this report we review and discuss the cholera management strategies applied by the major international humanitarian health organizations present in Yemen. We find the response by the organizations examined to have been more focused on case management than on outbreak prevention. Oral Cholera Vaccines (OCVs) were not delivered until nearly 16 months into the outbreak. A recent scale-up of the global OCV stockpile will hopefully allow for rapid mass deployment of the OCV in future humanitarian emergencies. Continuous funding to this stockpile will be crucial to maintain this option for prevention and control of cholera outbreaks. Of equal importance will be the timely recognition of the need for mass OCV deployment and development of more specific, comprehensive and actionable evidence-based frameworks to help guide this decision, however difficult this may be. The outbreak highlights the importance for international humanitarian health organizations to have a continuous discussion about whether and to what extent they should increase their focus on pre-emptively addressing the environmental determinants of communicable diseases in humanitarian emergencies. Strong advocacy from the public health community for peace and the protection of human health, by bringing to attention the public health impacts of armed conflict and keeping the world’s political leaders accountable to their actions, will remain crucial.

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Section: Main Textmentioning

confidence: 99%

The cholera outbreak in Yemen: lessons learned and way forward

Federspiel

Ali

2018

BMC Public Health

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“…It is characterized by dehydration due to a rigorous form of acute, severe watery diarrhea, which may lead patients to deathbed. [37] Two-third of the patients will be asymptomatic, but 80%–90% of symptomatic patients develop acute-onset diarrhea. If it is untreated, the fatality may raise up to 40%.…”

Section: Choleramentioning

confidence: 99%

“…If it is untreated, the fatality may raise up to 40%. [3738] Recently, massive outbreaks of cholera, killed more than one lakh people. [37] Diagnosis depends on the isolation of Vibrio cholerae from feces.…”

Section: Choleramentioning

confidence: 99%

“…According to WHO, the patient aged 5 or more and develops severe dehydration or watery diarrhea or vomiting in the cholera epidemic area should suspect infection. [37] The majority of patients may be treated for dehydration. Antibiotic therapy for 3–5 days will suffice.…”

Section: Choleramentioning

confidence: 99%

“…Currently, whole-cell-cholera toxin recombinant B subunit vaccine and bivalent killed whole-cell vaccine are available with trade names Dukoral, Shanchol, and Morcvax. [37] In the global scenario, the WHO recommends available cholera vaccine can be considered at risk areas for outbreaks and should be utilized as compliments to traditional control and preventive measures. [3839] Vietnam has incorporated cholera vaccine in public health program.…”

Section: Choleramentioning

confidence: 99%

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Adult immunization – Need of the hour

Jairaj

Shirisha

Abdul

et al. 2018

J Int Soc Prevent Communit Dent

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Immunization is the process of making individuals immune. Childhood immunization is a common process for various aliments, but adult immunization in the Indian scenario is obscure. Officially, India has been declared polio-free, which is an achievement despite cultural, political, economic, geographic, and so many other factors. The changing demographics of adult, geriatric population and growing cost of health-care maintenance are a concern in developing countries like India. Thus, promoting healthy lifestyle needs prevention, early detection, and management of various diseases and disorders. Certainly, prevention in adults is yet to be tapped completely, so that goal of 100% prevention can be achieved. Various fraternities of medical association have come up with guidelines for adult immunization schedules in India. The present paper reviews infectious diseases such as anthrax, chikungunya, cholera, dengue, influenza, and malaria in this section of the review. We humbly request all health-care professionals and educators to educate the mass for adult immunization. So that, cost involved for treatment and workforce for the management of diseases can be better utilized in some other needed areas.

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Oral killed cholera vaccines for preventing cholera

Saif-Ur-Rahman,

Mamun,

Hasan

et al. 2024

Cochrane Database of Systematic Reviews

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Background Cholera causes acute watery diarrhoea and death if not properly treated. Outbreaks occur in areas with poor sanitation, including refugee camps. Several vaccines have been developed and tested over the last 50 years. This is an update of a Cochrane review, originally published in 1998, which explored the effects of all vaccines for preventing cholera. This review examines oral vaccines made from killed bacteria. Objectives To assess the effectiveness and safety of the available World Health Organization (WHO)‐prequalified oral killed cholera vaccines among children and adults. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register; CENTRAL, MEDLINE; Embase; LILACS; and two trials registers (February 2023). Selection criteria We included randomized controlled trials (RCTs), including cluster‐RCTs. There were no restrictions on the age and sex of the participants or the setting of the study. We considered any available WHO‐prequalified oral killed cholera vaccine as an intervention. The control group was given a placebo, another vaccine, or no vaccine. The outcomes were related to vaccine effectiveness and safety. We included articles published in English only. Data collection and analysis Two review authors independently applied the inclusion criteria and extracted data from included studies. We assessed the risk of bias using the Cochrane ROB 1 assessment tool. We used the generic inverse variance and a random‐effects model meta‐analysis to estimate the pooled effect of the interventions. We assessed the certainty of the evidence using the GRADE approach. For vaccine effectiveness (VE), we converted the overall risk ratio (RR) to vaccine effectiveness using the formula: VE = (1 ‐ RR) x 100%. Main results Five RCTs, reported in 12 records, with 462,754 participants, met the inclusion criteria. We identified trials on whole‐cell plus recombinant vaccine (WC‐rBS vaccine (Dukoral)) from Peru and trials on bivalent whole‐cell vaccine (BivWC (Shanchol)) vaccine from India and Bangladesh. We did not identify any trials on other BivWC vaccines (Euvichol/Euvichol‐Plus), or Hillchol. Two doses of Dukoral with or without a booster dose reduces cases of cholera at two‐year follow‐up in a general population of children and adults, and at five‐month follow‐up in an adult male population (overall VE 76%; RR 0.24, 95% confidence interval (CI) 0.08 to 0.65; 2 trials, 16,423 participants; high‐certainty evidence). Two doses of Shanchol reduces cases of cholera at one‐year follow‐up (overall VE 37%; RR 0.63, 95% CI 0.47 to 0.85; 2 trials, 241,631 participants; high‐certainty evidence), at two‐year follow‐up (overall VE 64%; RR 0.36, 95% CI 0.16 to 0.81; 2 trials, 168,540 participants; moderate‐certainty evidence), and at five‐year follow‐up (overall VE 80%; RR 0.20, 95% CI ...

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A Quantitative Systematic Review and Meta-Analysis of the Effectiveness of Oral Cholera Vaccine as a Reactive Measure in Cholera Outbreaks

Cited by 12 publications

References 17 publications

The cholera outbreak in Yemen: lessons learned and way forward

The cholera outbreak in Yemen: lessons learned and way forward

Adult immunization – Need of the hour

Oral killed cholera vaccines for preventing cholera

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