Epicentre, 8 rue Saint-Sabin, 75011 Paris, France.
Agence de Médecine Préventive, Paris, France.
Bull World Health Organ. 2018 Dec 1;96(12):817-825. doi: 10.2471/BLT.17.206417. Epub 2018 Sep 27.
To evaluate vaccination coverage, identify reasons for non-vaccination and assess satisfaction with two innovative strategies for distributing second doses in an oral cholera vaccine campaign in 2016 in Lake Chilwa, Malawi, in response to a cholera outbreak.
We performed a two-stage cluster survey. The population interviewed was divided in three strata according to the second-dose vaccine distribution strategy: (i) a standard strategy in 1477 individuals (68 clusters of 5 households) on the lake shores; (ii) a simplified cold-chain strategy in 1153 individuals (59 clusters of 5 households) on islands in the lake; and (iii) an out-of-cold-chain strategy in 295 fishermen (46 clusters of 5 to 15 fishermen) in floating homes, called .
Vaccination coverage with at least one dose was 79.5% (1153/1451) on the lake shores, 99.3% (1098/1106) on the islands and 84.7% (200/236) on . Coverage with two doses was 53.0% (769/1451), 91.1% (1010/1106) and 78.8% (186/236), in the three strata, respectively. The most common reason for non-vaccination was absence from home during the campaign. Most interviewees liked the novel distribution strategies.
Vaccination coverage on the shores of Lake Chilwa was moderately high and the innovative distribution strategies tailored to people living on the lake provided adequate coverage, even among hard-to-reach communities. Community engagement and simplified delivery procedures were critical for success. Off-label, out-of-cold-chain administration of oral cholera vaccine should be considered as an effective strategy for achieving high coverage in hard-to-reach communities. Nevertheless, coverage and effectiveness must be monitored over the short and long term.
评估疫苗接种率，确定未接种疫苗的原因，并评估在马拉维奇利瓦湖 2016 年霍乱暴发期间使用两种创新策略分发第二剂口服霍乱疫苗活动的满意度，这两种策略用于应对霍乱疫情。
我们进行了两阶段的聚类调查。接受访谈的人群根据第二剂疫苗分发策略分为三个层次：(i) 在湖岸的 1477 人（68 个 5 户家庭的群组）中采用标准策略；(ii) 在湖中的 1153 人（59 个 5 户家庭的群组）中采用简化冷链策略；(iii) 在 295 名居住在浮动房屋（称为.）的渔民中采用冷链外策略。
湖岸至少接种一剂的疫苗接种率为 79.5%（1153/1451），岛屿上为 99.3%（1098/1106），而.上为 84.7%（200/236）。在这三个层次上，接种两剂的疫苗接种率分别为 53.0%（769/1451）、91.1%（1010/1106）和 78.8%（186/236）。未接种疫苗的最常见原因是在活动期间不在家。大多数受访者喜欢新颖的分发策略。
奇利瓦湖湖岸的疫苗接种率适中，针对居住在湖上的人群量身定制的创新分发策略提供了充足的覆盖范围，即使在难以到达的社区也是如此。社区参与和简化的交付程序对于成功至关重要。口服霍乱疫苗的标签外冷链外管理应被视为在难以到达的社区实现高覆盖率的有效策略。然而，必须在短期和长期内监测覆盖率和效果。
