Use of oral cholera vaccine as a vaccine probe to determine the burden of culture-negative cholera

by Justin Im, Md. Taufiqul Islam, Faisal Ahmmed, Deok Ryun Kim, Yun Chon, K Zaman, Ashraful Islam Khan, Mohammad Ali, Florian Marks, Firdausi Qadri, John D. Clemens Analyses of stool from patients with acute watery diarrhea (AWD) using sensitive molecular diagnostics have challenged whether fecal microbiological cultures have acceptably high sensitivity for cholera diagnosis. If true, these findings imply that current estimates of the global burden of cholera , which rely largely on culture-confirmation, may be underestimates. We conducted a vaccine probe study to evaluate this possibility, assessing whether an effective killed oral cholera vaccine (OCV) tested in a field trial in a cholera-endemic population conferred protection against cholera culture- negative AWD, with the assumption that if cultures are indeed insensitive, OCV protection in such cases should be detectable. We re-analysed the data of a Phase III individually-randomized placebo-controlled efficacy trial of killed OCVs conducted in Matlab, Bangladesh in 1985. We calculated the pro tective efficacy (PE) of a killed whole cell-only (WC-only) OCV against first-episodes of cholera culture-negative AWD during two years of post-dosing follow-up. In secondary analyses, we evaluated PE against cholera culture-negative AWD by age at vaccination, season of onset, and disease severity. In this trial 50,770 people received at least 2 complete doses of either WC-only OCV or placebo, and 791 first episodes of AWD were r...
Source: PLoS Neglected Tropical Diseases - Category: Tropical Medicine Authors: Source Type: research

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We described how the vaccination program was planned, prepared and implemented using different strategies to deliver oral cholera vaccine to a high-risk urban population in Dhaka, Bangladesh based on administrative data and observations made during the program. The objective of this study is to evaluate the organization, implementation and effectiveness of different oral cholera vaccine delivery strategies in the endemic urban setting in Bangladesh. OCV administration by trained local volunteers through outreach sites and mop-up activities yielded high coverage of 82% and 72% of 172,754 targeted individuals for the first a...
Source: Global Health Action - Category: International Medicine & Public Health Tags: Glob Health Action Source Type: research
AbstractCholera remains a major public health problem in many countries. Poor sanitation and inappropriate clean water supply, insufficient health literacy and community mobilization, absence of national plans and cross-border collaborations are major factors impeding optimal control of cholera in endemic countries.In March 2017, a group of experts from 10 Asian cholera-prone countries that belong to the Initiative against Diarrheal and Enteric Diseases in Africa and Asia (IDEA), together with representatives from the World Health Organization, the US National Institutes of Health, International Vaccine Institute, Agence d...
Source: BMC Proceedings - Category: Biomedical Science Source Type: research
Tents set up at Alsabeen hospital in Sana'a Yemen for screening suspected cholera cases.By Anna KucirkovaTEXAS, USA, Nov 2 2018 (IPS)Cholera outbreaks across history regularly killed a hundred thousand or more. It isn’t well known today because it was essentially eliminated in the Western world. It last erupted in the U.S. in the 1800s, eradicated by water and sewage treatment systems that prevented it from spreading via contaminated water. However, cholera is making a comeback around the globe, and it could again become a major killer.Cholera is caused by eating or drinking something contaminated with the Vibrio cho...
Source: IPS Inter Press Service - Health - Category: International Medicine & Public Health Authors: Tags: Environment Featured Global Headlines Health Humanitarian Emergencies IPS UN: Inside the Glasshouse Population Poverty & SDGs TerraViva United Nations Water & Sanitation Source Type: news
Conclusion The results obtained from this research shows, in general, the fragility in the social and political infrastructure necessary to improve the living conditions of populations, particularly those that depend on family agriculture in drought prone areas. The conditions of social, economic and environmental vulnerabilities presented in the region can be amplified by the drought process, and can aggravate the impacts resulting drought events, thus disadvantaging the population of this region, as shown in the Fig. 1. The general perception of the interviewees of the health sector shows an agreement with what is found...
Source: PLOS Currents Disasters - Category: International Medicine & Public Health Authors: Source Type: research
Publication date: Available online 22 August 2018Source: Saudi Journal of Biological SciencesAuthor(s): Essam H. Ibrahim, Ramadan Taha, Hamed A. Ghramh, Mona Kilany, Khalid Ali KhanAbstractOne of the mosquito-borne zoonotic diseases is the Rift Valley fever virus (RVFV). Currently, there is no completely licensed vaccine that can be used to vaccinate animals or humans outside endemic areas. The aim of this work was to use the RVFV glycoprotein (Gn) and the subunit B of cholera toxin (CTB) at gene level and build up fused recombinant vaccine. The gene of CTB was joined to the gene Gn to work as an adjuvant in the resulting ...
Source: Saudi Journal of Biological Sciences - Category: Biology Source Type: research
Publication date: September 2018Source: The Lancet Global Health, Volume 6, Issue 9Author(s): Molly F Franke, Ralph Ternier, J Gregory Jerome, Wilfredo R Matias, Jason B Harris, Louise C IversSummaryBackgroundNo study of long-term protection following killed oral cholera vaccination has been done outside of the historically cholera-endemic areas of south Asia, or has examined protection after a single-dose vaccination regimen. To address this, we examined the duration of protection of the standard two-dose regimen and an incomplete regimen of one dose up to 4 years after vaccination in Haiti.MethodsIn the setting of two-do...
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research
Background: Cholera is still a public health issue in developing countries. Rehydration and sanitary improvements are the main prevention strategies, though antibiotics could shorten infection-spans. Given antibiotic resistance and the lack of widespread vaccinations, bacteriophage (phage) therapy could be a solution. In the past ten years, more than 60% of reported cholera cases occur in Africa, with the largest percentage in the DRC, where cholera has been endemic since the seventies.
Source: International Journal of Infectious Diseases - Category: Infectious Diseases Authors: Tags: UMP. 429 Source Type: research
AbstractPurpose of ReviewThis review describes the basic epidemiologic, clinical, and microbiologic aspects of cholera, highlights new developments within these areas, and presents strategies for applying currently available tools and knowledge more effectively.Recent FindingsFrom 1990 to 2016, the reported global burden of cholera fluctuated between 74,000 and 595,000 cases per year; however, modeling estimates suggest the real burden is between 1.3 and 4.0 million cases and 95,000 deaths yearly. In 2018, the World Health Assembly endorsed a new initiative to reduce cholera deaths by 90% and eliminate local cholera transm...
Source: Current Epidemiology Reports - Category: Epidemiology Source Type: research
Publication date: February 2019Source: Nonlinear Analysis: Real World Applications, Volume 45Author(s): Eric Kokomo, Yves EmvuduAbstractIn this paper, we formulate a deterministic, nonlinear model of cholera with age structure which integrates the direct transmission and the indirect transmission of the disease. The vaccination and the demographic movements are also taken into account in this model. The propounded model is an initial/boundary-value problem constituted of four partial differential equations of first order describing the transmission dynamics of human hosts and of two ordinary differential equations represen...
Source: Nonlinear Analysis: Real World Applications - Category: Research Source Type: research
AbstractCholera is a secretory diarrhoeal disease caused by infection withVibrio cholerae, primarily theV. cholerae O1 El Tor biotype. There are approximately 2.9 million cases in 69 endemic countries annually, resulting in 95 000 deaths. Cholera is associated with poor infrastructure and lack of access to sanitation and clean drinking water. The current cholera epidemic in Yemen, linked to spread ofV. cholerae O1 (Ogawa serotype), is associated with the ongoing war. This has devastated infrastructure and health services. The World Health Organization had estimated that 172 286 suspected cases arose between 27th April and ...
Source: Frontiers of Medicine - Category: General Medicine Source Type: research
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