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Effekten av vaccin vid pågående utbrott av kolera: En systematisk litteraturöversikt
University of Skövde, School of Health Sciences.
2021 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesisAlternative title
The effectiveness of oral cholera vaccine in response to an outbreak : A systematic literature review (English)
Abstract [sv]

Introduktion: Kolera är en sjukdom som orsakar akut diarré. Kolera fortsätter att orsaka stor sjukdomsbörda och dödlighet världen över. Vaccin mot kolera kan användas i kombination med WASH åtgärder (wash, sanitation and hygiene) för att stävja utbrott eller som proaktiv åtgärd i områden som anses vara högriskområden för att drabbas av kolera. Trots att WHO (Världshälsorganisationen) sedan 2010 rekommenderar vaccin som en reaktiv åtgärd vid utbrott används det sällan på grund av en global brist av vaccin och bristen på forskning kring vaccinets effekt i verkliga miljöer, särskilt vid pågående kolera utbrott. Det finns fortsatt ett behov att utforska vaccin som en reaktiv åtgärd vid pågående kolera utbrott. Syfte: Syftet med studien var att analysera effekten av vaccin vid pågående kolera utbrott. Metod: En systematisk litteraturöversikt där analysen utfördes genom narrativ syntes. Även en evidensgradering enligt EPPI-center modellen utfördes. Resultat: Resultatet av syntesen antyder att vaccin kan vara effektivt som en reaktiv åtgärd, även i miljöer där befolkningen saknar grundläggande immunitet. Två doser vaccin ger ett skydd som varar i upp till fyra år, effekten av vaccinet varierar inte nämndvärt beroende på hur lång tid som passerat sedan vaccinering. Effekten av vaccinet är högre i endemiska miljöer, skillnaden är dock marginell.Slutsats: Vaccin kan vara en effektiv åtgärd för att kontrollera utbrott av kolera.

Abstract [en]

Introduction: Cholera is an acute diarrhoeal disease with high morbidity and mortality globally. Oral cholera vaccines can be used in conjunction with improvements of water and sanitation to control cholera outbreaks as well as for prevention in areas known to be in high risk for cholera. Altough WHO has recommended oral cholera vaccines as a reactive measure since 2010 they are not routinely used during cholera outbreaks due to global vaccine shortage and the scarcity of data on the effectiveness of the vaccines in real life settings, especially during a cholera epidemic. As a consequense of this there is a need to explore the effectiveness of reactive use of oral cholera vaccines during cholera outbreaks. Aim: The aim of this study was to analyze the effectiveness of oral cholera vaccines in response to an outbreak. Method: Astructured literature review was performed and analysed trough narrative synthesis. Furthermore an assesment of the overal weight of evidence was conducted using the EPPIaproach. Result: The result of the synthesis suggest that vaccines may be an effective reactive measure during an outbreak, even in areas of little or no recent exposure to cholera. Two doses of oral cholera vaccine provides protection, lasting up to four years. The effectiveness did not wary much depending on the time passed since vaccination. The vaccine effectiveness is higher in endemic settings, altough the difference is only marginal. Conclusion: The findings suggest that vaccine may be effective in controlling cholera outbreaks.

Place, publisher, year, edition, pages
2021. , p. 34
Keywords [en]
Cholera, Vaccine, effectiveness, outbreak, Reactive Vaccination
Keywords [sv]
Kolera, vaccin, effektivitet, utbrott, reaktiv vaccinering
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:his:diva-20875OAI: oai:DiVA.org:his-20875DiVA, id: diva2:1633623
Subject / course
Public Health Science
Educational program
Public Health Science: Infection Prevention and Control - Master’s Programme 60 ECTS
Supervisors
Examiners
Available from: 2022-01-31 Created: 2022-01-31 Last updated: 2022-01-31Bibliographically approved

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