Abstract
Following mass population displacements in South Sudan, preventive cholera vaccination campaigns were conducted in displaced persons camps before a 2014 cholera outbreak. We compare cholera transmission in vaccinated and unvaccinated areas and show vaccination likely halted transmission within vaccinated areas, illustrating the potential for oral cholera vaccine to stop cholera transmission in vulnerable populations.
Highlights
Following mass population displacements in South Sudan, preventive cholera vaccination campaigns were conducted in displaced persons camps before a 2014 cholera outbreak
We estimated that the daily reproductive number (Rt; i.e., average number of secondary cases from a case becoming symptomatic on day t; online Technical Appendix) in vaccinated camps was
Each vaccinated camp had only 2 days on which the 95% CI of Rt was above unity. This finding contrasts with our estimates in unvaccinated areas, where despite conditions that may have been less suitable for transmission, Rt remained >1 for a sufficient and significantly longer time for an epidemic to progress (p
Summary
Following mass population displacements in South Sudan, preventive cholera vaccination campaigns were conducted in displaced persons camps before a 2014 cholera outbreak. To estimate the overall effect, the observed epidemic in vaccinated areas must be compared with a counterfactual epidemic that is modeled or based on an observed suitable control population. We compared epidemics in 2 areas that included vaccinated and unvaccinated populations: 1) PoC sites (vaccinated) and the community (unvaccinated) in Juba; and 2) Malakal PoC (vaccinated) and Wau Shilluk IDP (unvaccinated), 2 similar camps separated by a river.
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