Presentation is loading. Please wait.

Presentation is loading. Please wait.

First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan Lucy Anne Parker, John Rumunu, Christine Jamet,

Published byErica Tucker Modified over 6 years ago

Similar presentations

Presentation on theme: "First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan Lucy Anne Parker, John Rumunu, Christine Jamet,"— Presentation transcript:

1 First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan Lucy Anne Parker, John Rumunu, Christine Jamet, Yona Kenyi, Richard Laku, Lul Deng, Bior K Bior, Michael Lasuba, Joseph F Wamala, Allan M Mpairwe, Fisseha Tadesse, Augusto Llosa, Sandra Cohuet, Marie-Laure Quilici, David A Sack, Iza Ciglenecki, Francesco Grandesso, Francisco J Luquero, Andrew S Azman. Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

2 Global cholera burden continues to be high
Introduction Global cholera burden continues to be high Source: WHO Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

3 Context: South Sudan Independence from Sudan in July, 2011
Civil war broke out in 2013 Nearly 2 million internally displaced Over 7,500 medically attended cholera cases in 2014 and 2015 Image : Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

4 Oral Cholera Vaccine 3 vaccines prequalified by WHO
OCV Shanchol® (2011) Semi-affordable (<2USD/vial) 2 doses proven feasible and effective Preventative Reactive (response to outbreaks) Vaccine shortage is a major obstacle Photo: Jacob Kuehn, MSF Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

5 Cholera Timeline, Juba, 2015 Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

6 Rational: Single-dose OCV Juba
Juba appears to serve as a hub of transmission for the country Limited number of vaccines available Single dose of OCV has potential to save more lives Herd protection, immunological studies, preliminary trial data, mathematical modelling Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

7 OCV campaign (31 July-5 Aug 2015)
Single-dose Shanchol® offered to individuals aged ≥1 year targeted areas of Juba high risk groups Large fixed sites and mobile teams Limited social mobilisation Vaccination coverage survey using spatial random sampling Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

8 Aim To evaluate the feasibility, coverage, and vaccine effectiveness of this first ever use of single-dose OCV as an outbreak response Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

9 Methods: Case-cohort study
Suspected cholera cases confirmed through multiple diagnostic tests Cohort of a spatially representative sample from across Juba Vaccination status ascertained by interview and inspection of vaccination card Unadjusted and adjusted vaccine effectiveness estimates were derived from proportional hazard regression models. Ethics: Approved by the John Hopkins Bloomberg School of Public Health IRB and the Ethical Committee of the Ministry of Health, Republic of South Sudan. Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

10 Results: Feasibility ~143,000 persons ~ 22,000 persons
main campaign 31 July-5 Aug 2015 ~ 22,000 persons comprehensive package immediate neighbourhoods of suspected cases Vaccine coverage in targeted areas 68.8% (95%CI: 63.9 – 73.6%) Photo: Jacob Kuehn, MSF Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

11 Results: Vaccine effectiveness (VE)
87 suspected cases; 32 classified as cholera positive 898 cohort members; 858 successfully followed No cohort members sought care for clinical cholera Direct and Indirect protection offered by the vaccine: Unadjusted single-dose VE: 79.5% (95%CI ) Adjusted single-dose VE: 89.6% (95%CI ) Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

12 Limitations Observational study in challenging field conditions
Confirmed cholera cases in Juba ceased within 2-weeks of vaccination campaign limited sample size, high uncertainty Nearly 50% of participants did not have their vaccination cards Potential for natural immunity in the study population due to cholera history in Juba Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

13 Discussion Important evidence for deciding on vaccine strategy in light of limited OVC supply A single-dose of OCV offers high levels of protection against severe cholera both direct and indirect herd protection A single dose also logistically simpler and less expensive to deploy in emergencies Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

14 Conclusions Until sufficient doses of OCV are available, flexible alternative vaccination strategies are needed including highly targeted vaccination campaigns and single-dose regimens. Our results from an outbreak in an urban context show that both are feasible and effective. Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

15 MSF-OCG Iza Ciglenecki Lameck Ontweka OCG Cell 1 (Christine, Barbara, Javier) Jean-Clement Cabrol Micaela Serafini Florent Uzzeni Epicentre Paris Francisco Luquero (Co-PI) Fisseha Tadesse Francesco Grandesso Augusto Llosa Sandra Cohuet Anne-Laure Page Thank you! South Sudan Ministry of Health John Rumunu Richard Laku Thomas Ujjiga Yona Kenyi Lul Deng Bior Bior Michael Lasuba Abiem Bona Institute Pasteur, Paris Marie-Laure Quilici WHO Juba, South Sudan Alan Mpwaire Joseph Wamala Johns Hopkins University Andrew Azman (Co-PI) David Sack Justin Lessler Amanda Debes Lucy A Parker - MSF - First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan

Download ppt "First mass vaccination with single-dose oral cholera vaccine in response to an outbreak in Juba, South Sudan Lucy Anne Parker, John Rumunu, Christine Jamet,"

Similar presentations

Socio Economic study of meningitis epidemic Anaïs Colombini, AMP GEO meningitis meeting 26-27 September, 2007.

Socio Economic study of meningitis epidemic Anaïs Colombini, AMP GEO meningitis meeting September, 2007.
Overview of HPV vaccination Training GardasilTM

Overview of HPV vaccination Training GardasilTM
Rotavirus vaccine impact. Introduction. Rotavirus vaccines lead to significant reductions in severe and fatal diarrhea in both vaccinated and unvaccinated.

Rotavirus vaccine impact. Introduction. Rotavirus vaccines lead to significant reductions in severe and fatal diarrhea in both vaccinated and unvaccinated.
HRH Research Forum National Human Resources for Health Observatory.

HRH Research Forum National Human Resources for Health Observatory.
FACTORS HINDERING ATTITUDE TO TREATMENT AMONG PATIENTS WITH TYPE-2 DIABETES MELLITUS IN THE NIGER DELTA, NIGERIA by AGOFURE OTOVWE and OYEWOLE OYEDIRAN.

FACTORS HINDERING ATTITUDE TO TREATMENT AMONG PATIENTS WITH TYPE-2 DIABETES MELLITUS IN THE NIGER DELTA, NIGERIA by AGOFURE OTOVWE and OYEWOLE OYEDIRAN.
Instructions for users This slide presentation provides an overview of the control of JE and prevention of JE by immunization. Below many of the slides,

Instructions for users This slide presentation provides an overview of the control of JE and prevention of JE by immunization. Below many of the slides,
Elements of a clinical trial research protocol

Elements of a clinical trial research protocol
Challenges in Measles Outbreak Responses MSF Perspectives Florence Fermon - Myriam Henkens 10th Annual Measles Initiative Meeting 14/09/2011.

Challenges in Measles Outbreak Responses MSF Perspectives Florence Fermon - Myriam Henkens 10th Annual Measles Initiative Meeting 14/09/2011.
Recurrent PID, Subsequent STI, and Reproductive Health Outcomes: Findings from the PID Evaluation and Clinical Health (PEACH) Study Maria Trent, MD, MPH.

Recurrent PID, Subsequent STI, and Reproductive Health Outcomes: Findings from the PID Evaluation and Clinical Health (PEACH) Study Maria Trent, MD, MPH.
Taking stock of reproductive health in humanitarian settings: Preliminary findings from the 2012-2014 global evaluation Sandra Krause Women’s Refugee Commission.

Taking stock of reproductive health in humanitarian settings: Preliminary findings from the global evaluation Sandra Krause Women’s Refugee Commission.
Introduction to Developing a Vaccination Strategy for Smallpox Preparedness Department of Health and Human Services Centers for Disease Control and Prevention.

Introduction to Developing a Vaccination Strategy for Smallpox Preparedness Department of Health and Human Services Centers for Disease Control and Prevention.
Measles vaccination in MSF context: priorities, results and challenges/concerns AFRICAN REGIONAL MEASLES-RUBELLA TAG MEETING Nairobi, June 2nd-3rd 2015.

Measles vaccination in MSF context: priorities, results and challenges/concerns AFRICAN REGIONAL MEASLES-RUBELLA TAG MEETING Nairobi, June 2nd-3rd 2015.
Departmental Perspectives on Viral Hepatitis

Departmental Perspectives on Viral Hepatitis
Clinical Trials. What is a clinical trial? Clinical trials are research studies involving people Used to find better ways to prevent, detect, and treat.

Clinical Trials. What is a clinical trial? Clinical trials are research studies involving people Used to find better ways to prevent, detect, and treat.
Vaccination Strategy Against HPAI (H 5 N 1 ) in Egypt by Ehab El Masry General Organization for Veterinary Services (GOVS) Tel: +2012 260 23 50 e-mail:

Vaccination Strategy Against HPAI (H 5 N 1 ) in Egypt by Ehab El Masry General Organization for Veterinary Services (GOVS) Tel:
Immunization in the Time of H1N1 Anne Schuchat, MD Rear Admiral, US Public Health Service Director, National Center for Immunization and Respiratory Diseases.

Immunization in the Time of H1N1 Anne Schuchat, MD Rear Admiral, US Public Health Service Director, National Center for Immunization and Respiratory Diseases.
Social Disparities and Mortality in a Large Metropolitan HIV Cohort Peter Messeri 1 Mary Ann Chiasson 2 1 Columbia University, Mailman School of Public.

Social Disparities and Mortality in a Large Metropolitan HIV Cohort Peter Messeri 1 Mary Ann Chiasson 2 1 Columbia University, Mailman School of Public.
Global Task Force on Cholera Control Cholera vaccine use: a snap shot Training course on CDS in emergencies 13.12.2007 Dr Claire-Lise Chaignat Global Task.

Global Task Force on Cholera Control Cholera vaccine use: a snap shot Training course on CDS in emergencies Dr Claire-Lise Chaignat Global Task.
EXPERIMENTAL EPIDEMIOLOGY

EXPERIMENTAL EPIDEMIOLOGY
TM OPV Stockpiling in the United States Trudy V. Murphy, M.D. National Immunization Program Centers for Disease Control and Prevention February 5, 2003.

TM OPV Stockpiling in the United States Trudy V. Murphy, M.D. National Immunization Program Centers for Disease Control and Prevention February 5, 2003.

Similar presentations

Ads by Google