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High cholera vaccination coverage following emergency campaign in Haiti: Results from a cluster survey in three rural Communes in the South Department, 2017
- Source :
- PLoS Neglected Tropical Diseases, PLoS Neglected Tropical Diseases, Vol 14, Iss 1, p e0007967 (2020)
- Publication Year :
- 2020
- Publisher :
- Public Library of Science (PLoS), 2020.
-
Abstract
- Oral cholera vaccine (OCV) has increasingly been used as an outbreak control measure, but vaccine shortages limit its application. A two-dose OCV campaign targeting residents aged over 1 year was launched in three rural Communes of Southern Haiti during an outbreak following Hurricane Matthew in October 2016. Door-to-door and fixed-site strategies were employed and mobile teams delivered vaccines to hard-to-reach communities. This was the first campaign to use the recently pre-qualified OCV, Euvichol. The study objective was to estimate post-campaign vaccination coverage in order to evaluate the campaign and guide future outbreak control strategies. We conducted a cluster survey with sampling based on random GPS points. We identified clusters of five households and included all members eligible for vaccination. Local residents collected data through face-to-face interviews. Coverage was estimated, accounting for the clustered sampling, and 95% confidence intervals calculated. 435 clusters, 2,100 households and 9,086 people were included (99% response rate). Across the three communes respectively, coverage by recall was: 80.7% (95% CI:76.8–84.1), 82.6% (78.1–86.4), and 82.3% (79.0–85.2) for two doses and 94.2% (90.8–96.4), 91.8% (87–94.9), and 93.8% (90.8–95.9) for at least one dose. Coverage varied by less than 9% across age groups and was similar among males and females. Participants obtained vaccines from door-to-door vaccinators (53%) and fixed sites (47%). Most participants heard about the campaign through community ‘criers’ (58%). Despite hard-to-reach communities, high coverage was achieved in all areas through combining different vaccine delivery strategies and extensive community mobilisation. Emergency OCV campaigns are a viable option for outbreak control and where possible multiple strategies should be used in combination. Euvichol will help alleviate the OCV shortage but effectiveness studies in outbreaks should be done.<br />Author summary After Hurricane Matthew hit Southern Haiti on October 4, 2016, there was an outbreak of Cholera. The Government launched a campaign to vaccinate residents using an oral vaccine, which has been proven to protect people against the disease. MSF supported the campaign in three rural areas, offering the vaccine in local clinics and going from door to door. We didn’t know how many people were living there at the time so we couldn’t say for sure if we had vaccinated enough people. To find out how many people were vaccinated we did a survey, choosing households at random and asking them if and where they received the vaccine. This showed that on average around 90% of people were vaccinated, which is a very high proportion. We can take encouragement from this that mass vaccination campaigns like this can work well, even in rural settings. Our survey showed that about half of people got their vaccine from a clinic and the other half from door-to-door vaccinators, so it’s probably important to use both approaches. Most people heard about the campaign through members of the local community called ‘criers’. This shows how important it is to engage with the local community during a vaccination campaign.
- Subjects :
- Bacterial Diseases
Male
Rural Population
0301 basic medicine
Vaccination Coverage
RC955-962
Surveys
Geographical locations
Disease Outbreaks
0302 clinical medicine
Cholera
Arctic medicine. Tropical medicine
Medicine and Health Sciences
Cluster Analysis
Public and Occupational Health
Child
Response rate (survey)
Vaccines
Family Characteristics
Data Collection
Vaccination and Immunization
Vaccination
Infectious Diseases
Geography
Research Design
Child, Preschool
Female
Cluster sampling
Public aspects of medicine
RA1-1270
Research Article
Neglected Tropical Diseases
Adult
Infectious Disease Control
Adolescent
Clinical Research Design
Immunology
030231 tropical medicine
Research and Analysis Methods
Mass Vaccination
03 medical and health sciences
Environmental health
parasitic diseases
medicine
Humans
Caribbean
Survey Research
Data collection
Public Health, Environmental and Occupational Health
Biology and Life Sciences
Infant
Outbreak
Cholera Vaccines
Tropical Diseases
medicine.disease
Haiti
Confidence interval
030104 developmental biology
Age Groups
North America
Population Groupings
Preventive Medicine
Adverse Events
People and places
Cholera vaccine
Subjects
Details
- ISSN :
- 19352735
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- PLOS Neglected Tropical Diseases
- Accession number :
- edsair.doi.dedup.....69577bc293f09e3af2921bc76fa99ecb