Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-27T10:03:38.986Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  10 January 2018

Patricia Schwerdtle ,
Coretta-Kings Onekon  and
Katrina Recoche
Patricia Schwerdtle*
Affiliation:
Nursing and Midwifery, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia Medecins Sans Frontieres, Sydney, Australia
Coretta-Kings Onekon
Affiliation:
Cameroon Ministry for Health, Cameroon, Africa
Katrina Recoche
Affiliation:
Nursing and Midwifery, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
*
Correspondence: Patricia Schwerdtle, MPH Monash University Nursing and Midwifery Faculty of Medicine, Nursing, and Health Sciences Melbourne, Victoria, Australia E-mail: patricia.schwerdtle@monash.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

The efficacy of oral cholera vaccines (OCVs) in laboratory conditions has been established, and the World Health Organization (WHO; Geneva, Switzerland) has recommended their preventative use in high-risk settings. The WHO recommendation has not been fully operationalized, nor has it been extended to apply to the reactive use of OCVs in real field epidemic conditions due to concerns about potential resource diversion, feasibility, cost, and acceptability. The purpose of this study is to assess and synthesize existing evidence of OCV effectiveness when used reactively in real field conditions.

Methods

A systematic review and meta-analysis was conducted involving studies that investigated vaccine effectiveness when used as a reactive measure; that is, cases had reached epidemic threshold and a cholera epidemic was declared in real field epidemic conditions. OVID Medline (US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA), CINAHL (EBSCO Information Services; Ipswich, Massachusetts USA), and EMBASE (Elsevier; Amsterdam, Netherlands), along with grey literature, were systematically searched using pre-determined criteria. Two independent reviewers identified studies that met the selection criteria and data were extracted using validated tools. Pooled estimates were obtained using fixed effect models.

Results

Of the 347 articles that met the inclusion criteria, four studies were retrieved for meta-analysis (three were case-control studies and one was a case-cohort study) involving a total of 1,509 participants and comprising 175 cases and 1,334 case controls. The effectiveness of one or two doses of either Shanchol (Shantha Biotechnics; India) or ORC-Vax (Vabiotech; Vietnam) OCVs showed a combined vaccine effectiveness of 75% (95% CI, 61-84).

Conclusion

A positive association was demonstrated between the reactive use of OCVs and protection against cholera. This supported the WHO recommendation to utilize OCVs reactively as an additional measure to the standard cholera epidemic response package.

SchwerdtleP, OnekonCK, RecocheK. A Quantitative Systematic Review and Meta-Analysis of the Effectiveness of Oral Cholera Vaccine as a Reactive Measure in Cholera Outbreaks. Prehosp Disaster Med. 2018;33(1):2–6.

Keywords

choleraeffectivenessepidemicsmeta-analysisoral cholera vaccinationsystematic review
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 33 , Issue 1 , February 2018 , pp. 2 - 6
Copyright
© World Association for Disaster and Emergency Medicine 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Conflicts of interest: none.

References

1. Verma, R, Khanna, P, Chawla, S. Cholera vaccine: new preventive tool for endemic countries. Hum Vaccin Immunother. 2012;8(5):682-684.Google Scholar
2. Weinberg, GA, Szilagyi, PG. Vaccine epidemiology: efficacy, effectiveness, and the translational research roadmap. J Infect Dis. 2010;201(11):1607-1610.Google Scholar
3. Luquero, FJ, Grout, L, Ciglenecki, I, et al. Use of Vibrio cholerae vaccine in an outbreak in Guinea. N Engl J Med. 2014;370(22):2111-2120.Google Scholar
4. World Health Organization. Cholera vaccines: WHO position paper-recommendations. Vaccine. 2010;28(30):4687-4688.CrossRefGoogle Scholar
5. Date, KA, Vicari, A, Hyde, TB, et al. Considerations for oral cholera vaccine use during outbreak after earthquake in Haiti, 2010-2011. Emerging Infectious Diseases. 2011;17(11):2105-2112.CrossRefGoogle ScholarPubMed
6. Deen, J, Ali, M, Sack, D. Methods to assess the impact of mass oral cholera vaccination campaigns under real field conditions. PLoS ONE. 2014;9(2):e88139.Google Scholar
7. Ciglenecki, I, Sakoba, K, Luquero, FJ, et al. Feasibility of mass vaccination campaign with oral cholera vaccines in response to an outbreak in Guinea. PLoS Med. 2013;10(9):e1001512.Google Scholar
8. Clemens, J, Shin, S, Sur, D, Nair, GB, Holmgren, J. New-generation vaccines against cholera. Nat Rev Gastroenterol Hepatol. 2011;8(12):701-710.Google Scholar
9. Ali, M, Lopez, AL, You, YA, et al. The global burden of cholera. Bull World Health Org. 2012;90(3):209-218A.CrossRefGoogle ScholarPubMed
10. World Health Organization. Cholera Fact sheet no. 107. 2015. http://www.who.int/mediacentre/factsheets/fs107/en/. Accessed February 17, 2017.Google Scholar
11. World Health Organization. WHO technical working group on creation of an oral cholera vaccine stockpile: meeting report; Geneva, Switzerland: April 26-27, 2012.Google Scholar
12. CDC. Principles of Epidemiology in Public Health practice, Third Edition. An Introduction to Applied Epidemiology and Biostatistics. 2012. http://www.cdc.gov/ophss/csels/dsepd/SS1978/Lesson1/Section1.html. Accessed February 17, 2017.Google Scholar
13. Calain, P, Chaine, JP, Johnson, E, et al. Can oral cholera vaccination play a role in controlling a cholera outbreak? Vaccine. 2004;22(19):2444-2451.Google Scholar
14. Kim, SY, Choi, Y, Mason, PR, Rusakaniko, S, Goldie, SJ. Potential impact of reactive vaccination in controlling cholera outbreaks: an exploratory analysis using a Zimbabwean experience. South African Medical Journal. 2011;101(9):659-664.Google ScholarPubMed
15. von Seidlein, L, Jiddawi, M, Grais, RF, Luquero, F, Lucas, M, Deen, J. The value of and challenges for cholera vaccines in Africa. J Infect Dis. 2013;208(Suppl 1):S8-S14.Google Scholar
16. OXFAM. Cholera Outbreak Guidelines. 2014. https://www.unicef.org/cholera_toolkit/Annexes/Supporting_Resources/Annex_6B/OXFAM_Cholera_guidelines.pdf. Accessed February 17, 2017.Google Scholar
17. Ivers, LC, Hilaire, IJ, Teng, JE, et al. Effectiveness of reactive oral cholera vaccination in rural Haiti: a case-control study and bias-indicator analysis. Lancet Glob Health. 2015;3(3):e162-e168.Google Scholar
18. The Joanna Briggs Institute. New JBI levels of evidence. 2014. http://joannabriggs.org/assets/docs/approach/JBI-Levels-of-evidence_2014.pdf. Accessed February 17, 2017.Google Scholar
19. The Joanna Briggs Institute. Joanna Briggs Institute Reviewers’ Manual: 2016 Edition. Adelaide, Australia: The Joanna Briggs Institute; 2016.Google Scholar
20. Buttner, P, Muller, R. Epidemiology. Melbourne, Australia: Oxford Press; 2011.Google Scholar
21. Azman, A, Parker, L, Rumunu, J, et al. The effectiveness of one dose of oral cholera vaccine in response to an outbreak: a case-cohort study. Lancet Glob Health. 2016;4(11):e856-e863.Google Scholar
22. Cochrane Community, Review Manager (RevMan). http://community.cochrane.org/editorial-and-publishing-policy-resource/information-technology/review-manager-revman. Accessed February 17, 2017.Google Scholar
23. Borenstein, M. Introduction to Meta-Analysis. Chichester, England: John Wiley and Sons; 2009.Google Scholar
24. Oliviera, SC, Fonseca, CT, Cardoso, FC, Farias, LP, Leite, LC. Recent advances in vaccine research against schistosomiasis in Brazil. Acta Trop. 2008;108(2-3):256-262.CrossRefGoogle Scholar
25. Anh, DD, Lopez, AL, Thiem, VD, et al. Use of oral cholera vaccines in an outbreak in Vietnam: a case control study. PLoS Negl Tropl Dis. 2011;5(1):e1006.Google Scholar
26. Taylor, DL, Kahawita, TM, Cairncross, S, Ensink, JHJ. The impact of water, sanitation, and hygiene interventions to control cholera: a systematic review. PLOS One. 2015;10(8):e0135676.Google Scholar
Supplementary material: File

Schwerdtle et al. supplementary material

Schwerdtle et al. supplementary material 1

Download Schwerdtle et al. supplementary material(File)
File 37.4 KB