Cholera Vaccine Research Articles

Collection, compilation and analysis of bacterial vaccines

BackgroundBacterial diseases are one of the leading causes of millions of fatalities worldwide, mainly due to antimicrobial resistance. The discovery of chicken cholera vaccine in 1879 revolutionized our fight against bacterial infections. Bacterial vaccines are proven to be highly effective in preventing many infectious diseases. Currently, various licensed vaccines are available against bacterial infections such as typhoid, diphtheria, cholera and tetanus in the market. In this study, we have attempted to compile different information regarding bacterial vaccines, their types, efficacy, mechanism of action, status, route of administration and other relevant details as a knowledgebase known as BacVacDB. MethodsBacVacDB was implemented using Linux-Apache-MySQL-PHP. HTML, PHP, CSS and Javascript have been used to develop the front end and MySQL for the back end. The data was curated from several sources, including literature, databases and relevant web resources. ResultsThis paper reviewed 371 vaccines against 30 human bacterial diseases maintained in BacVacDB, of which 167 are approved and 204 in clinical trials. This database provides the users an effortless search facility in the four modules, ‘Search,’ ‘Browse,’ ‘External Links’ and ‘General Information’. In this systematic attempt, we also included the history of vaccines, their mechanism, types, route of administration and approving agencies. ConclusionsThis knowledgebase has an intuitive interface that allows users to explore, search, and download information as well as to submit new bacterial vaccines (https://webs.iiitd.edu.in/raghava/bacvacdb/).

Pre-emptive oral cholera vaccine (OCV) mass vaccination campaign in Cuamba District, Niassa Province, Mozambique: feasibility, vaccination coverage and delivery costs using CholTool

IntroductionMozambique suffers from regular floods along its principal river basins and periodic cyclones that resulted in several cholera epidemics during the last decades. Cholera outbreaks in the recent 5 years...

Are better existing WASH practices in urban slums associated with a lower long-term risk of severe cholera? A prospective cohort study with 4 years of follow-up in Mirpur, Bangladesh

ObjectiveTo investigate the association between existing household water quality, sanitation and hygiene (WASH) practices and severe cholera risk in a dense urban slum where cholera is highly endemic.Design, setting and...

Use of a MAIT-Activating Ligand, 5-OP-RU, as a Mucosal Adjuvant in a Murine Model of Vibrio cholerae O1 Vaccination.

Background:Mucosal-associated invariant T (MAIT) cells are innate-like T cells enriched in the mucosa with capacity for B-cell help. We hypothesize that targeting MAIT cells, using a MAIT-activating ligand as an adjuvant, could improve mucosal vaccine responses to bacterial pathogens such as Vibrio cholerae.Methods:We utilized murine models of V. cholerae vaccination to test the adjuvant potential of the MAIT-activating ligand, 5-(2-oxopropylideneamino)-6-D-ribitylaminouracil (5-OP-RU). We measured V. cholerae-specific antibody and antibody-secreting cell responses and used flow cytometry to examine MAIT-cell and B-cell phenotype, in blood, bronchoalveolar lavage fluid (BALF), and mucosal tissues, following intranasal vaccination with live V. cholerae O1 or a V. cholerae O1 polysaccharide conjugate vaccine.Results:We report significant expansion of MAIT cells in the lungs (P < 0.001) and BALF (P < 0.001) of 5-OP-RU treated mice, and higher mucosal (BALF, P = 0.045) but not systemic (serum, P = 0.21) V. cholerae O-specific-polysaccharide IgG responses in our conjugate vaccine model when adjuvanted with low-dose 5-OP-RU. In contrast, despite significant MAIT cell expansion, no significant differences in V. cholerae-specific humoral responses were found in our live V. cholerae vaccination model.Conclusions:Using a murine model, we demonstrate the potential, as well as the limitations, of targeting MAIT cells to improve antibody responses to mucosal cholera vaccines. Our study highlights the need for future research optimizing MAIT-cell targeting for improving mucosal vaccines.

Challenges, best practices, and lessons learned from oral cholera mass vaccination campaign in urban Cameroon during the COVID-19 era

BackgroundSince 1971, Cameroon has been facing an ever-growing series of cholera epidemics; despite all the efforts made by the government to address this substantial public health problem. In 2020, in addition to the COVID-19 pandemic, Cameroon recorded a high cholera case fatality rate of 5.3% following epidemics noted in the South, Littoral, and South-West regions which is far higher than the 1% World Health Organization acceptable rate. Methodology/principal findingsThe Ministry of Public Health organized a reactive vaccination campaign against cholera to address the high mortality rate in the affected health districts. The first round was in August 2020 and the second in March 2021. We conducted a cross-sectional study and reviewed this vaccination campaign's challenges, best practices, and lessons. The vaccination coverage for the two doses of the oral cholera vaccine was 80.4%, with a refusal rate as high as 67%. People 20 years and above recorded the lowest vaccination coverage. The main challenge was misinformation about the cholera vaccine. The best practice was thorough population sensitization through community actors. ConclusionProper communication will always brave the odds of hesitancy and favor mass population vaccination to thwart hesitancy and consolidate herd immunity.

Development of Pediatric Dosage Preparation for CVD 103-HgR Live Oral Cholera Vaccine.

PXVX0200 is an oral cholera vaccine that is approved for use by the U.S. Food and Drug Administration and European Medicines Agency under the tradename Vaxchora. The vaccine is supplied as two packets, one containing buffer component and the other the active component, that are mixed with water and ingested. The aim of this study was to develop vaccine preparation methods that are appropriate for administering PXVX0200 to children. Developing oral liquid medication for children has unique challenges, including administration volume and palatability. These challenges were addressed by preparing PXVX0200 in different volumes and testing the potency of the vaccine in the presence of sweeteners, flavorings, and food and drinks. Vaccine potency, defined as colony-forming units/dose, was used to determine the compatibility of PXVX0200 with different vaccine preparation methods. We found that the reconstitution volume can be reduced from 100 to 50 mL to accommodate children aged 2 to 6 years and to 10 mL for children aged 6 months to 2 years, as long as the buffer concentration is the same as for the approved (100 mL) dose. Sucrose or stevia sweeteners may also be added without affecting the vaccine potency. Reconstitution in juices or foods was challenging because of effervescence caused by bicarbonate in the buffer component. An alternate preparation method was developed for reconstitution in baby formula. Vaccine preparation methods to make PXVX0200 appropriate for pediatric administration will facilitate administration of the vaccine to improve compliance and protect children from cholera infection while traveling.

Optimal Control Analysis of Treatment Strategies of the Dynamics of Cholera

A nine-compartment deterministic cholera model was formulated, and the model describes interactions between human, Vibrio cholerae bacteria, and the enviroment that warrant the interaction. Realities and socioeconomic burden influence spread and control mechanism of the disease. The model investigated some effective ways of hindering cholera outbreak and spread. The existence and uniqueness of solution of the system of equations that the model comprises were ascertained. The basic reproduction number R 0 of the model was obtained using “next-generation matrix” method, and the most sensitive parameters were identified using “normalised forward sensitivity index” method. Three controls, hygiene consciousness denoted by X1, cholera vaccine X2, and cholera awareness programme X3, were chosen. Optimal control theory is applied to ascertain the level of effect of the controls in reducing susceptible, exposed, infected individuals and causative pathogen population. Pontryagin’s maximum principle is used to prove the optimal solution of the model, and the optimal system was derived and numerically solved. Simulations were made with graphs that show the effects of the controls on susceptible, exposed, infected, and Vibrio cholerae population. The findings are that simultaneous application of the three controls can be one of the fast and effective ways of controlling cholera. If two controls are to be selected, hygiene consciousness and vaccine are the best combination.

Firdausi Qadri: putting Bangladeshi science on the map

Firdausi Qadri, infectious disease specialist and Senior Scientist at icddr,b, found time on a hectic day to speak with me. She was taking a lunch break on day 5 of Bangladesh's 7-day vaccination blitz in July, 2022, during which more than 2·4 million people were immunised with oral cholera vaccine (OCV). A vaccination roll-out of this speed and scale is not unusual for Bangladesh. But this year's campaign is different because “it is aimed at breaking the cycle of infection in the country's worst cholera outbreak in 60 years”, says Qadri.

Embracing complexity

Pioneering enteric disease researcher Gagandeep Kang discusses her work on rotavirus vaccines, understanding immune responses to oral vaccines, and the importance of mentorship for the next generation of Indian health sciences researchers.Gagandeep Kang is a Professor of Microbiology at the Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences at the Christian Medical College (CMC) in Vellore. She has worked on the development and use of vaccines for rotaviruses, cholera, and typhoid, conducting large studies to define burden, test vaccines, and measure their impact. Working in partnership with non-governmental organizations and the government, she has carried out phase I-III studies of rotaviral vaccines and provided laboratory support for vaccine development in India and for other developing countries. With the Indian Council for Medical Research and the World Health Organization, she has supported the establishment of networks of sentinel hospitals and laboratories that carry out surveillance for rotavirus disease in children and ancillary studies. She is the first woman working in India to be elected a Fellow of the Royal Society.

CHOLERA IN SANA'A, YEMEN: CLINICAL FEATURES, RISK FACTORS AND ANTIBIOTIC SENSITIVITY OF VIBRIO CHOLERAE

Background: Cholera, caused by Vibrio cholerae O1 or O139 serotypes, is one of the most important healthcare associated infections (HAI) among patients in Yemen.&#x0D; Aim: This study aimed to determine the risk factors associated with cholera outbreaks, clinical presentations, and antibiotic susceptibility of the V. cholerae strains isolated among inpatient in Diarrheal Treatment Centers (DTCs) in Sana’a City.&#x0D; Methods: This is a matched case-control study carried out on 134 DTC inpatients (cases) aged from 2 to 85 years who had a mean age of 26.8 years; and 134 community healthy individuals (control), ranged in age from 2 to 85 years with a mean age of 27.1 years in Sana'a. The identified isolates were tested for antibiotics susceptibility using disc diffusion technique. Data were analyzed using Epi Info 7.2. Express the quantitative data as mean values, standard deviation (SD), when the data are normally distributed.&#x0D; Results: Among the cases, females are more susceptible to cholera than males (62.7% vs. 37.3%), and there is an increase in the incidence of cholera with age as 32.8% of cases were in the ≥35-year age group. There were significant risk factors for cholera with unwashed fruits (OR=33, p&lt;0.001), unwashed vegetables (OR=5.3, p=0.001), outside foods (OR=129, p&lt;0.001), and leftovers un-cooled food (OR=2, p=0.04). Also, collapsed drinking water and sanitation system (OR=4.5, p&lt;0.001), sewage running in street (OR=8.7, p&lt;0.001), and contact with diarrhea persons in the home (OR=33.3, p&lt;0.001) were factors associated with cholera, while being vaccinated with cholera vaccines (OR=0.11, p&lt;0.001) and use of pipes for sewage disposal (OR=0.5, p=0.02) were factors protectively associated with cholera.&#x0D; Conclusion: Cholera affects all age groups in Sana’a, with females and persons of the age group greater than 35 years mostly affected. The most common clinical presentations were watery diarrhea and abdominal pain. Consumption of unwashed fruits, vegetables, outside food, unrefrigerated food, use of breakdown sewage system, dilapidated sewage near the home, running of street sewage, and contact with diarrhea in the home were risk factors, while cholera vaccination was protective against it. Therefore there is need to ensure that proper hygiene and sanitation to prevent infection.&#x0D; &#x0D; Peer Review History: &#x0D; Received: 1 May 2022; Revised: 12 June; Accepted: 28 June, Available online: 15 July 2022&#x0D; Academic Editor: Dr. Asia Selman Abdullah, Pharmacy institute, University of Basrah, Iraq, asia_abdullah65@yahoo.com&#x0D; UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. &#x0D; Received file: Reviewer's Comments:&#x0D; Average Peer review marks at initial stage: 6.0/10&#x0D; Average Peer review marks at publication stage: 7.0/10&#x0D; Reviewers:&#x0D; Dr. Bountain Welcome Tebeda,Chemical Pathology Department, Federal Medical Centre, Yenagoa, Nigeria. bountaintebeda@yahoo.com&#x0D; Dr. Esther Marguerite Chase DJANGA, Faculty of Medicine and Biomedical Sciences. Department of Public Health. University of Yaoundé I, Cameroon. e.djanga@yahoo.com&#x0D; Similar Articles: &#x0D; EPIDEMICITY OF VIBRIO CHOLERA IN SANA’A CITY, YEMEN: PREVALENCE AND POTENTIAL DETERMINANTS&#x0D; SURVEY OF SAFETY PRACTICES IN DIARRHEAL TREATMENT CENTERS: CHOLERA TREATMENT CENTERS IN YEMEN

Investigating the stability of the Properties of Vibrio cholerae strains – Producers of Active Components of the Chemical Cholera Vaccine

One of the key requirements to producer strains used in the manufacturing of immunobiological preparations is their stability, which consists in maintaining the main cultural, morphological, physiological, and productive properties in a series of generations. This paper describes a comprehensive methodological approach to testing strain stability using in vitro techniques.The purpose of this study was to conduct an integrated analysis of the stability in the strains that produce active components of the chemical cholera vaccine when preparing seed material and at the stage of cultivation.Materials and methods. Toxigenic strains of Vibrio сholerae 569B of the classical biovar, serovar Inaba and V. сholerae M-41 of the classical biovar, serovar Ogawa were used in the work. Cell morphology was monitored through light and transmission electron microscopy. Atomic force microscopy was applied to measure the main parameters of the bacterial cell. The strains were tested for the presence of ctxA gene in the chromosome using the “GenChol” test system with electrophoretic registration of results. Whole genome sequencing of the strains was performed on the Ion Torrent PGM platform using the Ion 318 Chip Kit and the Ion PGM Hi-Q View Chef 400 Kit. To determine the specific activity of cholera toxin and O-antigen, a DOT immunoassay with a conjugate based on staphylococcal protein A and colloidal gold nanoparticles was applied.Results and discussion. The stability of the main properties of industrial V. сholerae strains – producers of the active components of the chemical cholera vaccine has been confirmed using microbiological, immunochemical, molecular-genetic methods and microscopic analysis at all stages of cultivation, and the prospects for using the integrated methodological approach experimentally substantiated. Tailoring of these methods will make it possible to control the stability of producer strains, optimize cultivation conditions and, as a result, increase the yield of the necessary antigenic component of the vaccine.

Antigenic Components of Chemical Bivalent Cholera Vaccine, Methods of their Isolation and Control

The paper presents a review of the data on the methods of isolation and control of Vibrio cholerae antigens – cholerogen-anatoxin and O-antigens of Inaba and Ogawa – components of the oral bivalent chemical cholera vaccine produced by the RusRAPI “Microbe”, the only prophylactic drug against cholera registered in the territory of the Russian Federation. Currently, the vaccine is produced using the method of segregated manufacturing of cholerogenanatoxin and O-antigens Inaba and Ogawa with step-by-step control of their main properties, which ensures the production of a high-quality finished product. Ultrafiltration is an effective method for concentrating a semi-finished product, which helps to reduce losses and increases the yield of the final product. It remains promising to develop a method for gentle steril ization of O-antigens to maximize the preservation of specific activity. To control the specific activity of the antigenic components and the finished vaccine preparation, a complex of in vivo and in vitro methods is applied. However, the multi-stage process and duration, the use of several types of laboratory animals, as well as modern WHO requirements determine the need for the introduction of alternative in vitro control methods. The use of cell cultures as a replacement for the biological method appears prospective, and demonstrates a positive correlation with animal tests. To assess the activity of antigens, the use of an immunochemical method – dot-immunoassay with gold nanoparticles – is put forward, which will make it possible to harmonize the control method at all stages of the production process, as well as to determine the serovar specificity of Vibrio cholerae O-antigens. The development of molecular-genetic, microbiological, immunochemical methods is relevant for a more complete and comprehensive control of the main immunogens of industrial strains of cholera vibrio. The introduction of promising methods for obtaining antigens and monitoring their properties will allow for a more complete characterization of the component composition of the finished dosage form of the chemical cholera vaccine.

Renewed Interest in Cholera Control

Cholera is an ancient disease of significant public health importance accounting for approximately 1.3-4 million cases worldwide and about 21000–143,000 deaths. Cholera is endemic in many developing countries where sanitation is poor and lack in safe water. The disease has the potential to cause large-scale epidemics and pandemics. The ongoing seventh pandemic has spread to more than 100 countries since its origin in 1961 in Indonesia. Travellers from developed countries travelling to cholera endemic areas are at higher risk of getting cholera. Oral rehydration therapy (ORT) has revolutionized the treatment of cholera and causes reduction of mortality. ORT has saved the lives of millions of children all over the world and is considered the single most significant discovery in medicine of the century. Effective oral cholera vaccines have been developed and are being used but not to its full potential to control cholera. Since the disease burden due to cholera is huge and we have the tools to combat cholera, particularly reduce mortality, it is imperative that the global communities should embark on cholera control as an urgent priority of human health. Cholera control should be viewed as a poverty alleviation programme for the marginalised population. The current pandemic of COVID-19 overwhelmed the economy and healthcare systems so much so that the health authorities undermined the cholera control measures even during ongoing epidemics of cholera. The World Health Organization (WHO) has reframed the strategy with renewed interest on cholera control with a target of reducing the mortality from cholera by 90 percent by 2030. Member countries should mobilize enough funds for the programme and actively implement it. Improvement of sanitation and safe water for all should continue as long-term solution for combating the menace of cholera.

Emerging Concepts in Cholera Vaccine Design.

Cholera is a severe diarrheal disease caused by the bacterium Vibrio cholerae and constitutes a significant public health threat in many areas of the world. V. cholerae infection elicits potent and long-lasting immunity, and efforts to develop cholera vaccines have been ongoing for more than a century. Currently available inactivated two-dose oral cholera vaccines are increasingly deployed to both prevent and actively curb cholera outbreaks, and they are key components of the global effort to eradicate cholera. However, these killed whole-cell vaccines have several limitations, and a variety of new oral and nonoral cholera vaccine platforms have recently been developed. Here, we review emerging concepts in cholera vaccine design and implementation that have been driven by insights from human and animal studies. As a prototypical vaccine-preventable disease, cholera continues to be an excellent target for the development and application of cutting-edge technologies and platforms that may transform vaccinology.

Diagnosis, Management, and Future Control of Cholera.

Cholera, caused by Vibrio cholerae, persists in developing countries due to inadequate access to safe water, sanitation, and hygiene. There are approximately 4 million cases and 143,000 deaths each year due to cholera. The disease is transmitted fecally-orally via contaminated food or water. Severe dehydrating cholera can progress to hypovolemic shock due to the rapid loss of fluids and electrolytes, which requires a rapid infusion of intravenous (i.v.) fluids. The case fatality rate exceeds 50% without proper clinical management but can be less than 1% with prompt rehydration and antibiotics. Oral cholera vaccines (OCVs) serve as a major component of an integrated control package during outbreaks or within zones of endemicity. Water, sanitation, and hygiene (WaSH); health education; and prophylactic antibiotic treatment are additional components of the prevention and control of cholera. The World Health Organization (WHO) and the Global Task Force for Cholera Control (GTFCC) have set an ambitious goal of eliminating cholera by 2030 in high-risk areas.

Economic impact of cholera in households in rural southern Malawi: a prospective study

IntroductionCholera remains a significant contributor to diarrhoeal illness, especially in sub-Saharan Africa. Few studies have estimated the cost of illness (COI) of cholera in Malawi, a cholera-endemic country. The present...

Cholera: A Recent Epidemic

Cholera in an intestinal infection caused by Vibrio cholerae. Its symptoms include profuse secretory diarrhea. Cholera can be endemic, epidemic or pandemic. This disease still remains a challenge to the modern world. Although it can be asymptomatic or mild but in severe complications it can cause death within hours due to dehydration. About one in 20 infected people have severe water diarrhea along with vomiting, leading to dehydration. Even the asymptomatic people can spread the infection. Other symptoms include rapid heart rate, loss of skin elasticity, dry mucous membranes, low blood pressure, thirst and muscle cramps.&#x0D; Precautionary measures include increased water intake and use of boiled water for drinking, washing face, teeth, washing vegetable and fruits, washing utensils. Avoid raw or unpeeled fruits and vegetables, unpasteurized milk, uncooked meat. It is highly treatable disease but hydration is must and maintained. Antibiotics are not used for emergency treatment but it can only reduce the span of disease by half and thus help in further spread of disease [1].&#x0D; Director General of ‘Global Task Force; on cholera control side event in observance of WHA, held of 25th May, 2022 stated that, ‘Although cholera was eliminated from the globe north more than 150 years ago, it continues to plague the global south. Cholera is a disease of inequity. Almost exclusively, it affects the communities without adequate water, sanitation and hygiene and those who have been displaced. Despite pandemic, humanitarian crises and natural disasters, the Democratic Republic of Congo, Malawi, Tanzania, Uganda, Yemen, Zambia all conducted preventive campaigns with oral cholera vaccine. Cases and deaths have declined in the recent years but preliminary data for 2021 shows a massive increase in the number of cholera-related death, with an average case fatality rate of 3%. The trend in 2022 remains very concerning, with at least 14 countries experiencing new cholera outbreaks. This is why the work of Global Task Force on Cholera Control is so important’ [2].

Travel vaccines are strongly associated to reduced mortality in prostate cancer patients - a real effect or residual confounding?

Repurposing of existing drugs and vaccines for diseases that they were not originally intended for is a promising research field. Recently there has been evidence that oral cholera vaccine might be used in the treatment of inflammatory disease and some common cancers. Specifically, Ji et al showed that the administration of cholera vaccine after a prostate cancer diagnosis reduced prostate cancer specific mortality rates by almost 50%. In a cohort of men from Stockholm, Sweden, with more detailed cancer data and a higher coverage of exposure to vaccine, we replicated these findings using a marginal structural Cox model. We showed that administration of cholera vaccine after prostate cancer diagnosis is associated with a significant reduction in mortality (HR 0.46, 95% CI 0.31–0.69, p-value 0.0001) even after adjusting for all known confounders. However, the same effect (or even stronger) could be seen for several other traveling vaccines and malaria prophylaxis. Therefore, we conclude that this effect is most likely due to a healthy traveler bias and is an example of residual confounding.

Oral cholera vaccines; current perspective and future need; towards the development of Novel DNA vaccine for Vibrio species.

About one-third of the countries in the world are on the verge of a cholera outbreak placing over a billion individuals at risk. Water sanitation and health (WASH) programs together with vaccination are preventive measures to eradicate cholera by 2030. While WASH takes a long time to successfully implement, vaccinations can reduce the cholera burden. 2030 is in less than a decade and yet the current WHO prequalified oral cholera vaccines (OCVs) failed to provide sufficient protective immunity to infants – the most affected age group in cholera outbreaks and cholera endemic regions, a shorter immunity in older children and adults, the requirement of multiple doses, and cold-chain for transport and storage are some of the limitations of OCVs and WHO recommends further research to provide better vaccines. DNA vaccine approach could be a potential approach in the future of cholera vaccines, providing ease of vaccine design and hence reducing production time, it is safer and cheaper, stable at room temperature, and can induce both humoral and cellular immune responses. Therefore, this can be a better alternative to the over-dependence on the first and second generations of vaccines.

Causes of death through verbal autopsy: findings from a sub-study of single dose oral cholera vaccination in urban Dhaka, Bangladesh

Background Verbal autopsy can play a key crucial to identify significant causes of death in a developing country like Bangladesh where post-death pathological or forensic examination is not common. Single-dose Cholera Vaccination in Bangladesh (SCVB) was an individually randomized, placebo-controlled, double-blind study where verbal autopsy had been conducted for the participants who died within three months of receiving study agents This study aim was to determine the major causes of death through a verbal autopsy in a defined urban population. Methods The trial was conducted in urban slums of Dhaka among persons aged one year and older. A census was carried out bi-annually in the study area (Mirpur) including collecting death information from every household. Screening data on death was matched with the vaccination database to confirm whether the participants received the investigational products (IP) or not. The trained physician conducted a verbal autopsy usually within 7 days of notification. Results The screening period for verbal autopsy was from May 22 to July 18, 2014. Among 250 detected deaths, 99 received study agents (50 vaccines and 49 placeboes). The Verbal autopsy could not be completed for 10 deaths due to the unavailability of a next of kin respondent. Of the total of 240 verbal autopsies performed, 217 were in adults aged 18 years and above, 6 in 5-17 years of age, and rest were ≤ 5 years. The Most common causes of death were non-communicable diseases. 163 deaths occurred at home, 59 in a hospital and others died in different places. No significant difference in cause of death among vaccine and placebo group was found from this analysis. Conclusions Verbal autopsies usefully identified probable causes of death in participants in an oral cholera vaccine trial. The findings highlight that in this urban slum, noncommunicable diseases account for most of deaths.