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Abstract：
In response to a cholera outbreak among mobile, difficult-to-reach fishermen on Lake Chilwa, Malawi in 2016, a novel vaccine distribution strategy exploited the proven vaccine thermostability. Fishermen, while taking the first vaccine dose under supervision, received the second dose in a sealed bag, and were told to drink it two weeks later. This study assessed short-term vaccine protection of this strategy.
Patients with diarrhoea admitted to health facilities around lake were interviewed and a stool sample collected for PCR testing. Vaccine effectiveness was assessed in a case-control test-negative design by comparing cases (PCR-positive for V. cholerae O1) and controls (patients with diarrhoea but PCR-negative) and with the screening method that compared the proportions of vaccinated among cholera cases versus the general fishermen population.
Of 145 study participants, 120 were fishermen living on the lake. Vaccine effectiveness at three-months was 90.0% [95%CI:38.8;98.4] among fishermen and 83.3% [95%CI: 20.8; 96.5] among all participants in the case-control test-negative design, and 97.5% [95%CI: 90.9;99.3] with the screening method.
This strategy was effective in providing short-term protection in fishermen against cholera. Further research is needed to determine the adding value of the second dose and to identify the optimal vaccination strategies for different contexts.
Patients with diarrhoea admitted to health facilities around lake were interviewed and a stool sample collected for PCR testing. Vaccine effectiveness was assessed in a case-control test-negative design by comparing cases (PCR-positive for V. cholerae O1) and controls (patients with diarrhoea but PCR-negative) and with the screening method that compared the proportions of vaccinated among cholera cases versus the general fishermen population.
Of 145 study participants, 120 were fishermen living on the lake. Vaccine effectiveness at three-months was 90.0% [95%CI:38.8;98.4] among fishermen and 83.3% [95%CI: 20.8; 96.5] among all participants in the case-control test-negative design, and 97.5% [95%CI: 90.9;99.3] with the screening method.
This strategy was effective in providing short-term protection in fishermen against cholera. Further research is needed to determine the adding value of the second dose and to identify the optimal vaccination strategies for different contexts.
摘要：
为了应对移动的霍乱爆发，奇尔瓦湖上难以到达的渔民，马拉维在2016年，一种新的疫苗分销策略利用了经过验证的疫苗热稳定性。渔民,在监管下服用第一剂疫苗时，在密封的袋子里接受了第二剂，两周后被告知要喝。这项研究评估了该策略的短期疫苗保护。
对在湖边医疗机构就诊的腹泻患者进行了访谈，并收集了粪便样本进行PCR检测。通过比较病例（霍乱弧菌O1的PCR阳性）和对照（腹泻但PCR阴性的患者），并使用筛选方法比较了霍乱病例中接种疫苗的比例，在病例对照试验阴性设计中评估了疫苗的有效性。
在145名研究参与者中，120人是生活在湖上的渔民。3个月时，渔民的疫苗有效率为90.0%[95CI:38.8;98.4]，病例对照试验阴性设计的所有参与者的有效率为83.3%[95CI:20.8;96.5]，和97.5%[95CI：90.9;99.3]的筛选方法。
这一策略在为渔民提供短期霍乱保护方面是有效的。需要进一步的研究来确定第二剂量的附加值，并确定针对不同情况的最佳疫苗接种策略。
对在湖边医疗机构就诊的腹泻患者进行了访谈，并收集了粪便样本进行PCR检测。通过比较病例（霍乱弧菌O1的PCR阳性）和对照（腹泻但PCR阴性的患者），并使用筛选方法比较了霍乱病例中接种疫苗的比例，在病例对照试验阴性设计中评估了疫苗的有效性。
在145名研究参与者中，120人是生活在湖上的渔民。3个月时，渔民的疫苗有效率为90.0%[95CI:38.8;98.4]，病例对照试验阴性设计的所有参与者的有效率为83.3%[95CI:20.8;96.5]，和97.5%[95CI：90.9;99.3]的筛选方法。
这一策略在为渔民提供短期霍乱保护方面是有效的。需要进一步的研究来确定第二剂量的附加值，并确定针对不同情况的最佳疫苗接种策略。
