• Effectiveness of oral cholera vaccine in preventing cholera among fishermen in Lake Chilwa, Malawi: A case-control study

      Grandesso, F; Kasambara, W; Page, AL; Debes, AK; M'bang'ombe, M; Palomares, A; Lechevalier, P; Pezzoli, L; Alley, I; Salumu, L; et al. (Elsevier, 2019-06-19)
      Background: In response to a cholera outbreak among mobile, difficult-to-reach fishermen on Lake Chilwa, Malawi in 2016, a novel vaccine distribution strategy exploited the proven vaccine thermostability. Fishermen, while taking the first vaccine dose under supervision, received the second dose in a sealed bag, and were told to drink it two weeks later. This study assessed short-term vaccine protection of this strategy. Methods: Patients with diarrhoea admitted to health facilities around lake were interviewed and a stool sample collected for PCR testing. Vaccine effectiveness was assessed in a case-control test-negative design by comparing cases (PCR-positive for V. cholerae O1) and controls (patients with diarrhoea but PCR-negative) and with the screening method that compared the proportions of vaccinated among cholera cases versus the general fishermen population. Results: Of 145 study participants, 120 were fishermen living on the lake. Vaccine effectiveness at three-months was 90.0% [95%CI:38.8;98.4] among fishermen and 83.3% [95%CI: 20.8; 96.5] among all participants in the case-control test-negative design, and 97.5% [95%CI: 90.9;99.3] with the screening method. Conclusion: This strategy was effective in providing short-term protection in fishermen against cholera. Further research is needed to determine the adding value of the second dose and to identify the optimal vaccination strategies for different contexts.
    • Oral cholera vaccination in hard-to-reach communities, Lake Chilwa, Malawi

      Grandesso, F; Rafael, F; Chipeta, S; Alley, I; Saussier, C; Nogareda, F; Burns, M; Lechevalier, P; Page, AL; Salumu, L; et al. (The World Health Organization, 2018-12-01)
      To evaluate vaccination coverage, identify reasons for non-vaccination and assess satisfaction with two innovative strategies for distributing second doses in an oral cholera vaccine campaign in 2016 in Lake Chilwa, Malawi, in response to a cholera outbreak.
    • Oral cholera vaccination in hard-to-reach communities, Lake Chilwa, Malawi

      Grandesso, F; Rafael, F; Chipeta, S; Alley, I; Saussier, C; Nogareda, F; Burns, M; Lechevalier, P; Page, AL; Salumu, L; et al. (World Health Organization, 2018-09-27)