Evaluation of oral cholera vaccine (Euvichol-Plus) effectiveness against Vibrio cholerae in Bangladesh: an interim analysis
Introduction Millions of Euvichol-Plus doses have been deployed from the global oral cholera vaccine stockpile in over 20 cholera-affected countries. However, information on Euvichol-Plus’s effectiveness is limited. Using this vaccine in a cholera epidemic in Dhaka, Bangladesh, provided the opportun...
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Global Health |
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| author | Amanda Tiffany Ashraful Islam Khan Firdausi Qadri John D Clemens Faisal Ahmmed Farhana Khanam Tahmina Shirin Fahima Chowdhury Md. Taufiqul Islam Md Nazmul Islam Md Nazmul Hasan Rajib Md Ismail Hossen Md. Taufiqur Rahman Bhuiyan Shahinur Haque Prasanta Kumar Biswas Amirul Islam Bhuiyan Zahid Hasan Khan Mohammad Ashraful Amin Aninda Rahman S M Shahriar Rizvi Lucy Breakwell |
| author_facet | Amanda Tiffany Ashraful Islam Khan Firdausi Qadri John D Clemens Faisal Ahmmed Farhana Khanam Tahmina Shirin Fahima Chowdhury Md. Taufiqul Islam Md Nazmul Islam Md Nazmul Hasan Rajib Md Ismail Hossen Md. Taufiqur Rahman Bhuiyan Shahinur Haque Prasanta Kumar Biswas Amirul Islam Bhuiyan Zahid Hasan Khan Mohammad Ashraful Amin Aninda Rahman S M Shahriar Rizvi Lucy Breakwell |
| author_sort | Amanda Tiffany |
| collection | DOAJ |
| description | Introduction Millions of Euvichol-Plus doses have been deployed from the global oral cholera vaccine stockpile in over 20 cholera-affected countries. However, information on Euvichol-Plus’s effectiveness is limited. Using this vaccine in a cholera epidemic in Dhaka, Bangladesh, provided the opportunity to evaluate the vaccine effectiveness (VE) using a test-negative design.Methods A two-dose regimen of Euvichol-Plus was administered to individuals aged >1 year in a population of ca. 900 000 in two campaign rounds between June and August 2022, with prospective registration of all persons who received at least one dose. We conducted systematic surveillance in two key facilities, enrolling patients with acute watery diarrhoea who were eligible for vaccination from the campaign’s start and who presented for care between 21 August 2022 and 20 August 2023. Faecal culture-positive cholera cases were matched to up to four faecal culture-negative controls by age, presentation date and facility. Vaccination status was documented without knowledge of culture results. Conditional logistic regression models estimated the OR for the vaccination-cholera association, and the VE of the two-dose regimen was calculated as [(1−OR) × 100].Results The analysis included 226 cases and 552 matched controls. The adjusted VE of two doses of the Euvichol-Plus vaccine against medically attended cholera was 66% (99.5% CI: 30 to 83) for all recipients. Limited protection (12%; 95% CI: −95 to 60) was observed for children aged 1–4 years; whereas, protection was 79% (95% CI: 60 to 89) for those aged ≥5 years. VE against cholera with moderate to severe dehydration was 69% (95% CI: 44 to 83) overall but 6% (95% CI: −206 to 71) for children aged 1–4 years.Conclusion Euvichol-Plus provided significant protection against medically attended cholera of any severity as well as cholera with moderate to severe dehydration. However, significant levels of protection were only observed for those aged ≥5 years. |
| format | Article |
| id | doaj-art-a908d05302444d6cac650fad86c40c21 |
| institution | Kabale University |
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| publishDate | 2025-02-01 |
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| spelling | doaj-art-a908d05302444d6cac650fad86c40c212025-02-04T03:35:12ZengBMJ Publishing GroupBMJ Global Health2059-79082025-02-0110210.1136/bmjgh-2024-016571Evaluation of oral cholera vaccine (Euvichol-Plus) effectiveness against Vibrio cholerae in Bangladesh: an interim analysisAmanda Tiffany0Ashraful Islam Khan1Firdausi Qadri2John D Clemens3Faisal Ahmmed4Farhana Khanam5Tahmina Shirin6Fahima Chowdhury7Md. Taufiqul Islam8Md Nazmul Islam9Md Nazmul Hasan Rajib10Md Ismail Hossen11Md. Taufiqur Rahman Bhuiyan12Shahinur Haque13Prasanta Kumar Biswas14Amirul Islam Bhuiyan15Zahid Hasan Khan16Mohammad Ashraful Amin17Aninda Rahman18S M Shahriar Rizvi19Lucy Breakwell20Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USAInfectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshInternational Vaccine Institute, Gwanak-gu, Seoul, Korea (the Republic of)Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshInstitute of Epidemiology Disease Control and Research, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshCommunicable Disease Control, Dhaka, BangladeshInfectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshCommunicable Disease Control, Dhaka, BangladeshCommunicable Disease Control, Dhaka, BangladeshGlobal Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USAIntroduction Millions of Euvichol-Plus doses have been deployed from the global oral cholera vaccine stockpile in over 20 cholera-affected countries. However, information on Euvichol-Plus’s effectiveness is limited. Using this vaccine in a cholera epidemic in Dhaka, Bangladesh, provided the opportunity to evaluate the vaccine effectiveness (VE) using a test-negative design.Methods A two-dose regimen of Euvichol-Plus was administered to individuals aged >1 year in a population of ca. 900 000 in two campaign rounds between June and August 2022, with prospective registration of all persons who received at least one dose. We conducted systematic surveillance in two key facilities, enrolling patients with acute watery diarrhoea who were eligible for vaccination from the campaign’s start and who presented for care between 21 August 2022 and 20 August 2023. Faecal culture-positive cholera cases were matched to up to four faecal culture-negative controls by age, presentation date and facility. Vaccination status was documented without knowledge of culture results. Conditional logistic regression models estimated the OR for the vaccination-cholera association, and the VE of the two-dose regimen was calculated as [(1−OR) × 100].Results The analysis included 226 cases and 552 matched controls. The adjusted VE of two doses of the Euvichol-Plus vaccine against medically attended cholera was 66% (99.5% CI: 30 to 83) for all recipients. Limited protection (12%; 95% CI: −95 to 60) was observed for children aged 1–4 years; whereas, protection was 79% (95% CI: 60 to 89) for those aged ≥5 years. VE against cholera with moderate to severe dehydration was 69% (95% CI: 44 to 83) overall but 6% (95% CI: −206 to 71) for children aged 1–4 years.Conclusion Euvichol-Plus provided significant protection against medically attended cholera of any severity as well as cholera with moderate to severe dehydration. However, significant levels of protection were only observed for those aged ≥5 years.https://gh.bmj.com/content/10/2/e016571.full |
| spellingShingle | Amanda Tiffany Ashraful Islam Khan Firdausi Qadri John D Clemens Faisal Ahmmed Farhana Khanam Tahmina Shirin Fahima Chowdhury Md. Taufiqul Islam Md Nazmul Islam Md Nazmul Hasan Rajib Md Ismail Hossen Md. Taufiqur Rahman Bhuiyan Shahinur Haque Prasanta Kumar Biswas Amirul Islam Bhuiyan Zahid Hasan Khan Mohammad Ashraful Amin Aninda Rahman S M Shahriar Rizvi Lucy Breakwell Evaluation of oral cholera vaccine (Euvichol-Plus) effectiveness against Vibrio cholerae in Bangladesh: an interim analysis BMJ Global Health |
| title | Evaluation of oral cholera vaccine (Euvichol-Plus) effectiveness against Vibrio cholerae in Bangladesh: an interim analysis |
| title_full | Evaluation of oral cholera vaccine (Euvichol-Plus) effectiveness against Vibrio cholerae in Bangladesh: an interim analysis |
| title_fullStr | Evaluation of oral cholera vaccine (Euvichol-Plus) effectiveness against Vibrio cholerae in Bangladesh: an interim analysis |
| title_full_unstemmed | Evaluation of oral cholera vaccine (Euvichol-Plus) effectiveness against Vibrio cholerae in Bangladesh: an interim analysis |
| title_short | Evaluation of oral cholera vaccine (Euvichol-Plus) effectiveness against Vibrio cholerae in Bangladesh: an interim analysis |
| title_sort | evaluation of oral cholera vaccine euvichol plus effectiveness against vibrio cholerae in bangladesh an interim analysis |
| url | https://gh.bmj.com/content/10/2/e016571.full |
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