Real-world effectiveness of oral cholera vaccine amid fragility: A case-control study from Eastern Sudan, 2024

Résumé fourni par la source

• Reactive vaccination was vital in outbreak control amid fragility. • OCV cut cholera infection risk by 93% in Kassala, Sudan. • Poor hygiene and street food strongly increased infection risk. • Overcrowding and exposure at funerals fuelled transmission. • Lasting control needs WASH, hygiene, and risk communication. Cholera is a serious public health threat, especially in fragile conflict-affected areas. Reactive oral cholera vaccine (rOCV) during outbreaks is a key response strategy recommended by the World Health Organization. Sudan implemented a large-scale reactive campaign during 2024 cholera outbreak in Kassala State. This unmatched case-control study was conducted between 6–26 October 2024 in Kassala locality, targeted by the national OCV campaign using Euvichol–Plus. Data were collected through structured interviews using a pre-tested questionnaire, and analysed in Epi Info 7 with logistic regression to estimate vaccine effectiveness and identify predictors of infection. The mean age was significantly lower in cases (30.6 years, SD = 20.8, p < 0.001). Cases had bigger households and multiple families per household (p < 0.001). Only 42.5% of cases used soap after defecation vs 97.5% of controls (OR = 0.018), while 57% used only water (OR = 52.9). Street food consumption (OR = 4.04), funeral exposure (OR = 13.3), and family history (OR = 124.4) were strong predictors. OCV reduced infection odds by 93% (aOR = 0.07, 95% CI: 0.037 -0.13, p < 0.001). Findings reaffirm OCV effectiveness but emphasize the need for sustainable investment in WASH, hygiene promotion, and risk communication in fragile settings.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.