Coverage and cost of a large oral cholera vaccination program in a high-risk cholera endemic urban population in Dhaka, Bangladesh
Coverage and cost of a large oral cholera vaccination program in a high-risk cholera endemic urban population in Dhaka, Bangladesh
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DOI：
10.1016/j.vaccine.2013.10.021
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发表时间：
2013-12-09
期刊：
影响因子：
5.5
通讯作者：
Qadri, Firdausi
中科院分区：
文献类型：
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作者：
Khan, Iqbal Ansary;Saha, Amit;Qadri, Firdausi
进行了口服霍乱疫苗的可行性研究，以测试为孟加拉国达卡米尔布尔城市高危人群提供疫苗的策略。这项研究是随机分组的，有三组：疫苗，疫苗加安全饮用水和洗手习惯，没有干预。来自两个干预组的一岁及以上高危人群（孕妇除外）接受了两剂口服霍乱疫苗Shanchol（TM）。2011年2月17日至4月16日期间进行疫苗接种，两次接种之间至少间隔14天。在接种疫苗之前进行人际交流，以提高目标人群的认识。记录了所用疫苗剂量、接种人口、遗漏、辍学、疫苗浪费和所需资源。接种方式采用定点外展接种策略。此外，还为目标社区建立了移动的疫苗接种点，并开展了扫荡活动。在172，754名目标人群中，分别有141，839人（82%）和123，666人（72%）接种了完整的第一剂和第二剂疫苗。从第一剂到第二剂的脱落率为13%。123，661名参与者接受了两次完整剂量。儿童疫苗接种率为81%。女性的覆盖率明显高于男性（77%对66%，P < 0.001）。提供完整剂量的疫苗浪费率为1.2%。政府免费为该项目提供冷链相关支持。每人两剂疫苗的费用为3.93美元，其中1.63美元用于运送。单次注射的费用为0.76美元。我们没有观察到严重的不良事件。通过政府现有的国家免疫接种系统，大规模接种口服霍乱疫苗是可行的，可以覆盖高危流行人群。(C)2013作者由爱思唯尔有限公司出版。保留所有权利。
A feasibility study of an oral cholera vaccine was carried out to test strategies to reach high-risk populations in urban Mirpur, Dhaka, Bangladesh. The study was cluster randomized, with three arms: vaccine, vaccine plus safe water and hand washing practice, and no intervention. High risk people of age one year and above (except pregnant woman) from the two intervention arms received two doses of the oral cholera vaccine, Shanchol (TM). Vaccination was conducted between 17th February and 16th April 2011, with a minimum interval of fourteen days between two doses. Interpersonal communication preceded vaccination to raise awareness amongst the target population. The number of vaccine doses used, the population vaccinated, left-out, drop out, vaccine wastage and resources required were documented. Fixed outreach site vaccination strategy was adopted as the mode of vaccine delivery. Additionally, mobile vaccination sites and mop-up activities were carried out to reach the target communities. Of the 172,754 target population, 141,839 (82%) and 123,666 (72%) received complete first and second doses of the vaccine, respectively. Dropout rate from the first to the second dose was 13%. Two complete doses were received by 123,661 participants. Vaccine coverage in children was 81%. Coverage was significantly higher in females than in males (77% vs. 66%, P < 0.001). Vaccine wastage for delivering the complete doses was 1.2%. The government provided cold-chain related support at no cost to the project. Costs for two doses of vaccine per-person were US$3.93, of which US$1.63 was spent on delivery. Cost for delivering a single dose was US$0.76. We observed no serious adverse events. Mass vaccination with oral cholera vaccine is feasible for reaching high risk endemic population through the existing national immunization delivery system employed by the government. (C) 2013 The Authors. Published by Elsevier Ltd. All rights reserved.