George Christine Marie, Namunesha Alves, Endres Kelly, Felicien Willy, Sanvura Presence, Bisimwa Jean-Claude, Perin Jamie, Bengehya Justin, Maheshe Ghislain, Cikomola Cirhuza, Bisimwa Lucien, Mwishingo Alain, Sack David A, Domman Daryl
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo.
medRxiv. 2024 Dec 16:2024.12.16.24318874. doi: 10.1101/2024.12.16.24318874.
This study investigated whole-cell oral cholera vaccine (kOCV) single-dose effectiveness and transmission dynamics of through 4 years of epidemiological and genomic surveillance in Democratic Republic of the Congo (DRC). Whole genome sequencing was performed on clinical and water strains from 200 patient households and found annual bimodal peaks of clade AFR10e. 1154 diarrhea patients were enrolled with 342 culture confirmed cholera patients. A large clonal cholera outbreak occurred 18 months after a kOCV campaign of >1 million doses of Euvichol-Plus, likely because of low vaccine coverage in informal settlements (9%). Clinical and water strains in the same household were more closely related than different households suggesting both person-to-person and water-to-person transmission. Single-dose kOCV vaccine effectiveness in the first 24 month after vaccination was 56.9% (95% CI: 18.6%-77.2%), suggesting a single-dose provided modest protection against medically attended cholera during the 24 months post-vaccination.
本研究通过在刚果民主共和国（DRC）进行4年的流行病学和基因组监测，调查了全细胞口服霍乱疫苗（kOCV）单剂量的有效性及其传播动态。对来自200个患者家庭的临床和水源菌株进行了全基因组测序，发现AFR10e分支存在年度双峰。共招募了1154名腹泻患者，其中342名经培养确诊为霍乱患者。在接种超过100万剂Euvichol-Plus的kOCV疫苗接种活动18个月后，发生了一次大规模的克隆性霍乱疫情，可能是由于非正式定居点的疫苗覆盖率较低（9%）。同一家庭中的临床和水源菌株比不同家庭中的菌株关系更密切，这表明存在人传人以及水传人的传播方式。接种疫苗后的前24个月，单剂量kOCV疫苗的有效性为56.9%（95%CI：18.6%-77.2%），这表明单剂量疫苗在接种后的24个月内对就医的霍乱提供了适度的保护。
