Stemming cholera tides in Zimbabwe through mass vaccination.
Basic reproductive number
Cholera
Mathematical model
Prevention
Vaccination
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
21
02
2020
revised:
25
03
2020
accepted:
26
03
2020
pubmed:
7
5
2020
medline:
17
9
2020
entrez:
7
5
2020
Statut:
ppublish
Résumé
In 2018, Zimbabwe declared another major cholera outbreak a decade after recording one of the worst cholera outbreaks in Africa. A mathematical model for cholera was used to estimate the magnitude of the cholera outbreak and vaccination coverage using cholera cases reported data. A Markov chain Monte Carlo method based on a Bayesian framework was used to fit the model in order to estimate the basic reproductive number and required vaccination coverage for cholera control. The results showed that the outbreak had a basic reproductive number of 1.82 (95% credible interval [CrI] 1.53-2.11) and required vaccination coverage of at least 58% (95% Crl 45-68%) to be contained using an oral cholera vaccine of 78% efficacy. Sensitivity analysis demonstrated that a vaccine with at least 55% efficacy was sufficient to contain the outbreak but at higher coverage of 75% (95% Crl 58-88%). However, high-efficacy vaccines would greatly reduce the required coverage, with 100% efficacy vaccine reducing coverage to 45% (95% Crl 35-53%). These findings reinforce the crucial need for oral cholera vaccines to control cholera in Zimbabwe, considering that the decay of water reticulation and sewerage infrastructure is unlikely to be effectively addressed in the coming years.
Sections du résumé
BACKGROUND
BACKGROUND
In 2018, Zimbabwe declared another major cholera outbreak a decade after recording one of the worst cholera outbreaks in Africa.
METHODS
METHODS
A mathematical model for cholera was used to estimate the magnitude of the cholera outbreak and vaccination coverage using cholera cases reported data. A Markov chain Monte Carlo method based on a Bayesian framework was used to fit the model in order to estimate the basic reproductive number and required vaccination coverage for cholera control.
RESULTS
RESULTS
The results showed that the outbreak had a basic reproductive number of 1.82 (95% credible interval [CrI] 1.53-2.11) and required vaccination coverage of at least 58% (95% Crl 45-68%) to be contained using an oral cholera vaccine of 78% efficacy. Sensitivity analysis demonstrated that a vaccine with at least 55% efficacy was sufficient to contain the outbreak but at higher coverage of 75% (95% Crl 58-88%). However, high-efficacy vaccines would greatly reduce the required coverage, with 100% efficacy vaccine reducing coverage to 45% (95% Crl 35-53%).
CONCLUSIONS
CONCLUSIONS
These findings reinforce the crucial need for oral cholera vaccines to control cholera in Zimbabwe, considering that the decay of water reticulation and sewerage infrastructure is unlikely to be effectively addressed in the coming years.
Identifiants
pubmed: 32371191
pii: S1201-9712(20)30210-1
doi: 10.1016/j.ijid.2020.03.077
pii:
doi:
Substances chimiques
Cholera Vaccines
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
222-227Subventions
Organisme : NIAID NIH HHS
ID : R01 AI097405
Pays : United States
Informations de copyright
Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.