Effectiveness of case-area targeted interventions including vaccination on the control of epidemic cholera: protocol for a prospective observational study
Introduction Cholera outbreaks in fragile settings are prone to rapid expansion. Case-area targeted interventions (CATIs) have been proposed as a rapid and efficient response strategy to halt or substantially reduce the size of small outbreaks. CATI aims to deliver synergistic interventions (eg, wat...
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2022-07-01
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| author | Lauren D'Mello-Guyett Ruwan Ratnayake Andrew S Azman Yap Boum Francesco Checchi W John Edmunds Placide Okitayemba Welo Nicolas Peyraud Iza Ciglenecki Etienne Gignoux Maria Lightowler Primitive Gakima Jean Patrick Ouamba Joseph Amadomon Sagara Rollin Ndombe Nana Mimbu Alexandra Ascorra Elisabeth Mukamba Musenga Berthe Miwanda Francisco Luquero Klaudia Porten Flavio Finger Miriam Alia Bachir Assao Catherine Bachy Rob D'hondt Karl Njuwa Fai Caroline Henry-Ostian Abdoul-Moumouni Issa-Soumana Danish Malik Herbert Mutubuki Rodrigue Ntone Isabella Panunzi Issaka Soumana Oumar Touré Mamady Traore |
| author_facet | Lauren D'Mello-Guyett Ruwan Ratnayake Andrew S Azman Yap Boum Francesco Checchi W John Edmunds Placide Okitayemba Welo Nicolas Peyraud Iza Ciglenecki Etienne Gignoux Maria Lightowler Primitive Gakima Jean Patrick Ouamba Joseph Amadomon Sagara Rollin Ndombe Nana Mimbu Alexandra Ascorra Elisabeth Mukamba Musenga Berthe Miwanda Francisco Luquero Klaudia Porten Flavio Finger Miriam Alia Bachir Assao Catherine Bachy Rob D'hondt Karl Njuwa Fai Caroline Henry-Ostian Abdoul-Moumouni Issa-Soumana Danish Malik Herbert Mutubuki Rodrigue Ntone Isabella Panunzi Issaka Soumana Oumar Touré Mamady Traore |
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| description | Introduction Cholera outbreaks in fragile settings are prone to rapid expansion. Case-area targeted interventions (CATIs) have been proposed as a rapid and efficient response strategy to halt or substantially reduce the size of small outbreaks. CATI aims to deliver synergistic interventions (eg, water, sanitation, and hygiene interventions, vaccination, and antibiotic chemoprophylaxis) to households in a 100—250 m ‘ring’ around primary outbreak cases.Methods and analysis We report on a protocol for a prospective observational study of the effectiveness of CATI. Médecins Sans Frontières (MSF) plans to implement CATI in the Democratic Republic of the Congo (DRC), Cameroon, Niger and Zimbabwe. This study will run in parallel to each implementation. The primary outcome is the cumulative incidence of cholera in each CATI ring. CATI will be triggered immediately on notification of a case in a new area. As with most real-world interventions, there will be delays to response as the strategy is rolled out. We will compare the cumulative incidence among rings as a function of response delay, as a proxy for performance. Cross-sectional household surveys will measure population-based coverage. Cohort studies will measure effects on reducing incidence among household contacts and changes in antimicrobial resistance.Ethics and dissemination The ethics review boards of MSF and the London School of Hygiene and Tropical Medicine have approved a generic protocol. The DRC and Niger-specific versions have been approved by the respective national ethics review boards. Approvals are in process for Cameroon and Zimbabwe. The study findings will be disseminated to the networks of national cholera control actors and the Global Task Force for Cholera Control using meetings and policy briefs, to the scientific community using journal articles, and to communities via community meetings. |
| format | Article |
| id | doaj-art-f9b4f98d133749e7b36c8c8c1b60e180 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
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| spelling | doaj-art-f9b4f98d133749e7b36c8c8c1b60e1802025-01-31T02:10:10ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2022-061206Effectiveness of case-area targeted interventions including vaccination on the control of epidemic cholera: protocol for a prospective observational study Lauren D'Mello-GuyettRuwan Ratnayake0Andrew S Azman1Yap Boum2Francesco Checchi3W John Edmunds4Placide Okitayemba Welo5Nicolas Peyraud6Iza Ciglenecki7Etienne Gignoux8Maria Lightowler9Primitive Gakima10Jean Patrick Ouamba11Joseph Amadomon Sagara12Rollin Ndombe13Nana Mimbu14Alexandra Ascorra15Elisabeth Mukamba Musenga16Berthe Miwanda17Francisco Luquero18Klaudia Porten19Flavio Finger20Miriam AliaBachir AssaoCatherine BachyRob D'hondtKarl Njuwa FaiCaroline Henry-OstianAbdoul-Moumouni Issa-SoumanaDanish MalikHerbert MutubukiRodrigue NtoneIsabella PanunziIssaka SoumanaOumar TouréMamady Traore2 Epicentre, Paris, France3 Médecins Sans Frontières, Geneva, Switzerland9 Epicentre, Yaoundé, Cameroon1 Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK1 Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK6 Programme National d’Elimination du Choléra et de lutte contre les autres Maladies Diarrhéiques, Kinshasa, Congo (the Democratic Republic of the)3 Médecins Sans Frontières, Geneva, Switzerland3 Médecins Sans Frontières, Geneva, Switzerland2 Epicentre, Paris, France2 Epicentre, Paris, France5 Medecins Sans Frontieres, Kinshasa and Goma, Congo5 Medecins Sans Frontieres, Kinshasa and Goma, Congo5 Medecins Sans Frontieres, Kinshasa and Goma, Congo5 Medecins Sans Frontieres, Kinshasa and Goma, Congo2 Epicentre, Paris, France2 Epicentre, Paris, FranceExpanded Programme for Immunization, Ministry of Health, Democratic Republic of the Congo, Kinshasa, Congo (the Democratic Republic of the)8 Institut National de Recherche Biologique, Kinshasa, Congo (the Democratic Republic of the)2 Epicentre, Paris, France2 Epicentre, Paris, France2 Epicentre, Paris, FranceIntroduction Cholera outbreaks in fragile settings are prone to rapid expansion. Case-area targeted interventions (CATIs) have been proposed as a rapid and efficient response strategy to halt or substantially reduce the size of small outbreaks. CATI aims to deliver synergistic interventions (eg, water, sanitation, and hygiene interventions, vaccination, and antibiotic chemoprophylaxis) to households in a 100—250 m ‘ring’ around primary outbreak cases.Methods and analysis We report on a protocol for a prospective observational study of the effectiveness of CATI. Médecins Sans Frontières (MSF) plans to implement CATI in the Democratic Republic of the Congo (DRC), Cameroon, Niger and Zimbabwe. This study will run in parallel to each implementation. The primary outcome is the cumulative incidence of cholera in each CATI ring. CATI will be triggered immediately on notification of a case in a new area. As with most real-world interventions, there will be delays to response as the strategy is rolled out. We will compare the cumulative incidence among rings as a function of response delay, as a proxy for performance. Cross-sectional household surveys will measure population-based coverage. Cohort studies will measure effects on reducing incidence among household contacts and changes in antimicrobial resistance.Ethics and dissemination The ethics review boards of MSF and the London School of Hygiene and Tropical Medicine have approved a generic protocol. The DRC and Niger-specific versions have been approved by the respective national ethics review boards. Approvals are in process for Cameroon and Zimbabwe. The study findings will be disseminated to the networks of national cholera control actors and the Global Task Force for Cholera Control using meetings and policy briefs, to the scientific community using journal articles, and to communities via community meetings.https://bmjopen.bmj.com/content/12/7/e061206.full |
| spellingShingle | Lauren D'Mello-Guyett Ruwan Ratnayake Andrew S Azman Yap Boum Francesco Checchi W John Edmunds Placide Okitayemba Welo Nicolas Peyraud Iza Ciglenecki Etienne Gignoux Maria Lightowler Primitive Gakima Jean Patrick Ouamba Joseph Amadomon Sagara Rollin Ndombe Nana Mimbu Alexandra Ascorra Elisabeth Mukamba Musenga Berthe Miwanda Francisco Luquero Klaudia Porten Flavio Finger Miriam Alia Bachir Assao Catherine Bachy Rob D'hondt Karl Njuwa Fai Caroline Henry-Ostian Abdoul-Moumouni Issa-Soumana Danish Malik Herbert Mutubuki Rodrigue Ntone Isabella Panunzi Issaka Soumana Oumar Touré Mamady Traore Effectiveness of case-area targeted interventions including vaccination on the control of epidemic cholera: protocol for a prospective observational study BMJ Open |
| title | Effectiveness of case-area targeted interventions including vaccination on the control of epidemic cholera: protocol for a prospective observational study |
| title_full | Effectiveness of case-area targeted interventions including vaccination on the control of epidemic cholera: protocol for a prospective observational study |
| title_fullStr | Effectiveness of case-area targeted interventions including vaccination on the control of epidemic cholera: protocol for a prospective observational study |
| title_full_unstemmed | Effectiveness of case-area targeted interventions including vaccination on the control of epidemic cholera: protocol for a prospective observational study |
| title_short | Effectiveness of case-area targeted interventions including vaccination on the control of epidemic cholera: protocol for a prospective observational study |
| title_sort | effectiveness of case area targeted interventions including vaccination on the control of epidemic cholera protocol for a prospective observational study |
| url | https://bmjopen.bmj.com/content/12/7/e061206.full |
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