TY - JOUR
T1 - Effectiveness of case-area targeted interventions including vaccination on the control of epidemic cholera
T2 - protocol for a prospective observational study
AU - Ratnayake, Ruwan
AU - Peyraud, Nicolas
AU - Ciglenecki, Iza
AU - Gignoux, Etienne
AU - Lightowler, Maria
AU - Azman, Andrew S.
AU - Gakima, Primitive
AU - Ouamba, Jean Patrick
AU - Sagara, Joseph Amadomon
AU - Ndombe, Rollin
AU - Mimbu, Nana
AU - Ascorra, Alexandra
AU - Welo, Placide Okitayemba
AU - Mukamba Musenga, Elisabeth
AU - Miwanda, Berthe
AU - Boum, Yap
AU - Checchi, Francesco
AU - Edmunds, W. John
AU - Luquero, Francisco
AU - Porten, Klaudia
AU - Finger, Flavio
N1 - Funding Information:
This research is internally funded by Médecins Sans Frontières and therefore received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. RR is funded by a Doctoral Foreign Study Award from the Canadian Institutes of Health Research (award number DFS-164266). FC and WJE are funded by UK Research and Innovation as part of the Global Challenges Research Fund (grant number ES/P010873/1).
Publisher Copyright:
© Author(s) (or their employer(s)) 2022.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Introduction Cholera outbreaks in fragile settings are prone to rapid expansion. Case-area targeted interventions (CATIs) have been proposed as a rapid and efficient response strategy to halt or substantially reduce the size of small outbreaks. CATI aims to deliver synergistic interventions (eg, water, sanitation, and hygiene interventions, vaccination, and antibiotic chemoprophylaxis) to households in a 100 - 250 m ring' around primary outbreak cases. Methods and analysis We report on a protocol for a prospective observational study of the effectiveness of CATI. Médecins Sans Frontières (MSF) plans to implement CATI in the Democratic Republic of the Congo (DRC), Cameroon, Niger and Zimbabwe. This study will run in parallel to each implementation. The primary outcome is the cumulative incidence of cholera in each CATI ring. CATI will be triggered immediately on notification of a case in a new area. As with most real-world interventions, there will be delays to response as the strategy is rolled out. We will compare the cumulative incidence among rings as a function of response delay, as a proxy for performance. Cross-sectional household surveys will measure population-based coverage. Cohort studies will measure effects on reducing incidence among household contacts and changes in antimicrobial resistance. Ethics and dissemination The ethics review boards of MSF and the London School of Hygiene and Tropical Medicine have approved a generic protocol. The DRC and Niger-specific versions have been approved by the respective national ethics review boards. Approvals are in process for Cameroon and Zimbabwe. The study findings will be disseminated to the networks of national cholera control actors and the Global Task Force for Cholera Control using meetings and policy briefs, to the scientific community using journal articles, and to communities via community meetings.
AB - Introduction Cholera outbreaks in fragile settings are prone to rapid expansion. Case-area targeted interventions (CATIs) have been proposed as a rapid and efficient response strategy to halt or substantially reduce the size of small outbreaks. CATI aims to deliver synergistic interventions (eg, water, sanitation, and hygiene interventions, vaccination, and antibiotic chemoprophylaxis) to households in a 100 - 250 m ring' around primary outbreak cases. Methods and analysis We report on a protocol for a prospective observational study of the effectiveness of CATI. Médecins Sans Frontières (MSF) plans to implement CATI in the Democratic Republic of the Congo (DRC), Cameroon, Niger and Zimbabwe. This study will run in parallel to each implementation. The primary outcome is the cumulative incidence of cholera in each CATI ring. CATI will be triggered immediately on notification of a case in a new area. As with most real-world interventions, there will be delays to response as the strategy is rolled out. We will compare the cumulative incidence among rings as a function of response delay, as a proxy for performance. Cross-sectional household surveys will measure population-based coverage. Cohort studies will measure effects on reducing incidence among household contacts and changes in antimicrobial resistance. Ethics and dissemination The ethics review boards of MSF and the London School of Hygiene and Tropical Medicine have approved a generic protocol. The DRC and Niger-specific versions have been approved by the respective national ethics review boards. Approvals are in process for Cameroon and Zimbabwe. The study findings will be disseminated to the networks of national cholera control actors and the Global Task Force for Cholera Control using meetings and policy briefs, to the scientific community using journal articles, and to communities via community meetings.
UR - http://www.scopus.com/inward/record.url?scp=85133600538&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85133600538&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2022-061206
DO - 10.1136/bmjopen-2022-061206
M3 - Article
C2 - 35793924
AN - SCOPUS:85133600538
SN - 2044-6055
VL - 12
JO - BMJ open
JF - BMJ open
IS - 7
M1 - e061206
ER -