12 / 18
Page 36
Notes:
allied
academies
Ann Clin Trials Vaccines Res. 2017 | Volume 1 Issue 2
Global Vaccines & Vaccination Summit & B2B
November 01-02, 2017 | Toronto, Canada
Impact of vaccination on the socioeconomic risk factors for cholera in an endemic setting of Bangladesh
Amit Saha
1,2
, Andrew Hayen
1,3
, Mohammad Ali
4
, Alexander Rosewell
1
, C Raina MacIntyre
1
and
Firdausi Qadri
2
1
UNSW Sydney, Australia
2
International Centre for Diarrhoeal Disease Research, Bangladesh
3
University of Technology Sydney, Australia
4
Johns Hopkins Bloomberg School of Public Health, USA
Background:
Cholera continues to be a threat in many
developing countries. Socioeconomic factors play an
important role in transmitting the disease. Killed whole-cell
oral cholera vaccines (OCV) are now considered an important
tool to control cholera. This study aims to investigate the
impact of vaccination on the socioeconomic risk factors of
the disease.
Methods:
The study was conducted in Dhaka, Bangladesh.
The study area was divided into 90 geographic clusters; 30 in
each of the three arms of the study: vaccine (VAC), vaccine
plus behavioural change (VBC) and a non-intervention arm.
Socio-demographic data of each individual were linked
to vaccination and cholera surveillance using a unique ID
given to each individual in the study population. The data
were analysed for the three populations: 1) recipients
of two-doses of OCV in the intervention arm (VAC and
VBC arms) 2) OCV non-recipients within the intervention
arm and 3) all participants in the non-intervention arm. A
generalized estimating equation with logit link function was
used to estimate the risk for cholera among these different
populations adjusting for household level correlation in the
data.
Results:
Vaccine was associated with significant protection
of cholera. A total of 528 cholera and 226 cholera with
severe dehydration (CSD) cases in 268,896 participants were
observed in the two-year follow-up. For population 1, no
socioeconomic factors were found to be risk for cholera;
however, CSD was less likely among participants living in
a household having ≤4 members (aOR=0.55, 95% CI=0.32-
0.96). Among population 2, younger people and individuals
having diarrhoea during baseline census were more likely
to have cholera than their counterpart. In this population,
females and individuals with diarrhoea at baseline census
were at increased risk of CSD. Among population 3,
participants living in a household without a concrete floor,
or in an area with high population density, or closer to
the icddrb hospital, or not treating drinking water were at
significantly higher risk for cholera and CSD.
Conclusion:
A cholera vaccination eliminates the risk for
cholera due to socioeconomic disparities among population
in an economically disadvantage setting.
Speaker Biography
Dr Amit Saha is an epidemiologist with special interest in the epidemiology of vaccine-
preventable diseases and promoting the implementation of vaccines in resource-poor
settings. He is a medical graduate and holds Master of Medicine (M.Med.) in Infection
and immunity from the University of Sydney. Amit is an Associate Scientist in the
group of Infectious Disease Division at icddr,b in Bangladesh and currently a doctoral
candidate with the School of Public Health and Community Medicine, UNSW. He has
over fifteen years of professional experience in a wide range of fields in infectious
diseases epidemiology and large field-based clinical studies on enteric vaccines in low
and middle income countries.
e:
amiticddrb@yahoo.com