1e:I[23489,["/_next/static/immutable/chunks/0cmb0ng968nlp.js","/_next/static/immutable/chunks/1c7dg80qt12uw.js","/_next/static/immutable/chunks/2bmdwv49ba1qx.js","/_next/static/immutable/chunks/3ld61_1ghpsxn.js"],"ShareMenu"] 1f:I[55078,["/_next/static/immutable/chunks/0cmb0ng968nlp.js","/_next/static/immutable/chunks/1c7dg80qt12uw.js","/_next/static/immutable/chunks/2bmdwv49ba1qx.js","/_next/static/immutable/chunks/3ld61_1ghpsxn.js"],"AuthorMetricsPanel"] 20:I[39060,["/_next/static/immutable/chunks/0cmb0ng968nlp.js","/_next/static/immutable/chunks/1c7dg80qt12uw.js","/_next/static/immutable/chunks/2bmdwv49ba1qx.js","/_next/static/immutable/chunks/3ld61_1ghpsxn.js"],"AuthorPapers"] 41:I[49310,["/_next/static/immutable/chunks/0cmb0ng968nlp.js","/_next/static/immutable/chunks/1c7dg80qt12uw.js"],"IconMark"] 21:T895,BACKGROUND: The burden of shigellosis is greatest in resource-poor countries. Although this diarrheal disease has been thought to cause considerable morbidity and mortality in excess of 1,000,000 deaths globally per year, little recent data are available to guide intervention strategies in Asia. We conducted a prospective, population-based study in six Asian countries to gain a better understanding of the current disease burden, clinical manifestations, and microbiology of shigellosis in Asia. METHODS AND FINDINGS: Over 600,000 persons of all ages residing in Bangladesh, China, Pakistan, Indonesia, Vietnam, and Thailand were included in the surveillance. Shigella was isolated from 2,927 (5%) of 56,958 diarrhoea episodes detected between 2000 and 2004. The overall incidence of treated shigellosis was 2.1 episodes per 1,000 residents per year in all ages and 13.2/1,000/y in children under 60 months old. Shigellosis incidence increased after age 40 years. S. flexneri was the most frequently isolated Shigella species (1,976/2,927 [68%]) in all sites except in Thailand, where S. sonnei was most frequently detected (124/146 [85%]). S. flexneri serotypes were highly heterogeneous in their distribution from site to site, and even from year to year. PCR detected ipaH, the gene encoding invasion plasmid antigen H in 33% of a sample of culture-negative stool specimens. The majority of S. flexneri isolates in each site were resistant to amoxicillin and cotrimoxazole. Ciprofloxacin-resistant S. flexneri isolates were identified in China (18/305 [6%]), Pakistan (8/242 [3%]), and Vietnam (5/282 [2%]). CONCLUSIONS: Shigella appears to be more ubiquitous in Asian impoverished populations than previously thought, and antibiotic-resistant strains of different species and serotypes have emerged. Focusing on prevention of shigellosis could exert an immediate benefit first by substantially reducing the overall diarrhoea burden in the region and second by preventing the spread of panresistant Shigella strains. The heterogeneous distribution of Shigella species and serotypes suggest that multivalent or cross-protective Shigella vaccines will be needed to prevent shigellosis in Asia.22:T78a,BACKGROUND: New-generation, orally administered cholera vaccines offer the promise of improved control of cholera in sub-Saharan Africa. However, the high prevalence of human immunodeficiency virus (HIV) infection in many cholera-affected African populations has raised doubts about the level of protection possible with vaccination. We evaluated a mass immunization program with recombinant cholera-toxin B subunit, killed whole-cell (rBS-WC) oral cholera vaccine in Beira, Mozambique, a city where the seroprevalence of HIV is 20 to 30 percent. METHODS: From December 2003 to January 2004, we undertook mass immunization of nonpregnant persons at least two years of age, using a two-dose regimen of rBS-WC vaccine in Esturro, Beira (population 21,818). We then assessed vaccine protection in a case-control study during an outbreak of El Tor Ogawa cholera in Beira between January and May 2004. To estimate the level of vaccine protection, antecedent rates of vaccination were compared between persons with culture-confirmed cholera severe enough to have prompted them to seek treatment and age- and sex-matched neighborhood controls without treated diarrhea. RESULTS: We assessed the effectiveness of the vaccine in 43 persons with cholera and 172 controls. Receipt of one or more doses of rBS-WC vaccine was associated with 78 percent protection (95 percent confidence interval, 39 to 92 percent; P=0.004). The vaccine was equally effective in children younger than five years of age and in older persons. A concurrently conducted case-control study designed to detect bias compared persons with treated, noncholeraic diarrhea and controls without diarrhea in the same population and found no protection associated with receipt of the rBS-WC vaccine. CONCLUSIONS: The rBS-WC vaccine was highly effective against clinically significant cholera in an urban sub-Saharan African population with a high prevalence of HIV infection.23:T5cc,BACKGROUND: Data from the largest randomized, controlled trial for the treatment of children hospitalized with severe malaria were used to identify such predictors of a poor outcome from severe malaria. METHODS: African children (<15 years) with severe malaria participated in a randomized comparison of parenteral artesunate and parenteral quinine in 9 African countries. Detailed clinical assessment was performed on admission. Parasite densities were assessed in a reference laboratory. Predictors of death were examined using a multivariate logistic regression model. RESULTS: Twenty indicators of disease severity were assessed, out of which 5 (base deficit, impaired consciousness, convulsions, elevated blood urea, and underlying chronic illness) were associated independently with death. Tachypnea, respiratory distress, deep breathing, shock, prostration, low pH, hyperparasitemia, severe anemia, and jaundice were statistically significant indicators of death in the univariate analysis but not in the multivariate model. Age, glucose levels, axillary temperature, parasite density, heart rate, blood pressure, and blackwater fever were not related to death in univariate models. CONCLUSIONS: Acidosis, cerebral involvement, renal impairment, and chronic illness are key independent predictors for a poor outcome in African children with severe malaria. Mortality is markedly increased in cerebral malaria combined with acidosis. Clinical Trial Registration. ISRCTN50258054.24:T4d0,BACKGROUND: Cholera remains an important public health problem. Yet there are few reliable population-based estimates of laboratory-confirmed cholera incidence in endemic areas around the world. METHODS: We established treatment facility-based cholera surveillance in three sites in Jakarta (Indonesia), Kolkata (India), and Beira (Mozambique). The annual incidence of cholera was estimated using the population census as the denominator and the age-specific number of cholera cases among the study cohort as the numerator. FINDINGS: The lowest overall rate was found in Jakarta, where the estimated incidence was 0.5/1000 population/year. The incidence was three times higher in Kolkata (1.6/1000/year) and eight times higher in Beira (4.0/1000/year). In all study sites, the greatest burden was in children under 5 years of age. CONCLUSION: There are considerable differences in cholera incidence across these endemic areas but in all sites, children are the most affected. The study site in Africa had the highest cholera incidence consistent with a growing impression of the large cholera burden in Africa. Burden estimates are useful when considering where and among whom interventions such as vaccination would be most needed.25:T45a,Household contacts of primary pertussis cases were evaluated. Infection was determined by culture, direct fluorescent antibody assay, and serological criteria. Agglutinin titers and values of ELISA IgG and IgA antibodies to lymphocytosis-promoting factor, filamentous hemagglutinin, and pertactin were determined. In 39 households 255 subjects were exposed; 114 remained well (group 1), 53 had mild illness (group 2), and 88 had pertussis (group 3). The infection rates were 46% (group 1), 43% (group 2), and 80% (group 3). In a subgroup of subjects seen within 14-28 days of exposure, it was found that none with clinical pertussis had a value of IgG antibody to pertactin in acute-phase sera of > or = 50 ELISA units (EU) per mL or an agglutinin titer of > 256. Of the primary cases, 53% were > or = 13 years of age. These data point out the importance of Bordetella pertussis infections in adolescents and adults as a source of infection in young children. Our subgroup data suggest that high values of antibody to pertactin and high agglutinin titers may be predictive of protection against clinical pertussis.26:T5fc,Little is known about the causes of enteric fever in Asia.Most cases are believed to be caused by Salmonella enterica serovar Typhi and the remainder by S. Paratyphi A. We compared their incidences by using standardized methods from population-based studies in China, Indonesia, India, and Pakistan.E nteric fever still causes substantial illness and death in many parts of the world, especially in poorer nations.Salmonella enterica serovar Typhi is believed to cause most enteric fever episodes, and a smaller portion are caused by S. Paratyphi (1-3).This assumption, however, may no longer be true.Since 1999, more S. Paratyphi A than S. Typhi strains have been isolated in the province of Guangxi, southeastern China (4).Increasing isolation rates of S. Paratyphi A has also been reported from India (5).This finding has 2 major implications for the prevention of enteric fever.First, licensed typhoid fever vaccines (Vi polysaccharide and live oral Ty21a) do not protect against infections caused by S. Paratyphi A, and they may become less useful in controlling enteric fever in regions of Asia.Second, transmission and risk factors for S. Typhi and S. Paratyphi are different in Indonesia (6), so reduction strategies effective against S. Typhi may not protect against S. Paratyphi.Since little is known about the current cause of enteric fever in Asia, we compared S. Typhi and S. Paratyphi A incidence from study sites in China, Indonesia, India, and Pakistan by using standardized epidemiologic and laboratory methods (7).27:T78a,COVID-19 spreads via aerosols, droplets, fomites and faeces. The built environment that facilitates crowding increases exposure and hence transmission of COVID-19 as evidenced by outbreaks in both cool-dry and hot-humid climates, such as in the US prison system and dormitories in Singapore, respectively. This paper explores how the built environment influences crowding and COVID-19 transmission, focusing on informal urban settlements (slums). We propose policy and practice changes that could reduce COVID-19 transmission. There are several issues on how COVID-19 affects informal urban settlements. Slum populations tend to be younger than the overall population. Lower numbers of older people lessen the morbidity and mortality of the pandemic in slum areas. Second, many slum populations are highly mobile. By returning to their ancestral villages residents can avoid the risks of overcrowding and reduce the population density in a given area but may spread COVID-19 to other areas. Third, detection and registration of COVID-19 cases depends on patients presenting to health care providers. If the risk of visiting a health care centre outweighs the potential benefits patients may prefer not to seek treatment. The control and prevention of COVID-19 in informal urban settlements starts with organizing community infrastructure for diagnosis and treatment and assuring that basic needs (food, water, sanitation, health care and public transport) are met during quarantine. Next, community members at highest risk need to be identified and protected. Low-income, informal settlements need to be recognized as a reservoir and source for persistent transmission. Solutions to overcrowding must be developed for this and future pandemics. In view of the constant risk that slums present to the entire population decisive steps need to be taken to rehabilitate and improve informal settlements, while avoiding stigmatization.28:T5b4,BACKGROUND: Killed oral cholera vaccines (OCVs) have been licensed for use in developing countries, but protection conferred by licensed OCVs beyond two years of follow-up has not been demonstrated in randomized, clinical trials. METHODS/PRINCIPAL FINDINGS: We conducted a cluster-randomized, placebo-controlled trial of a two-dose regimen of a low-cost killed whole cell OCV in residents 1 year of age and older living in 3,933 clusters in Kolkata, India. The primary endpoint was culture-proven Vibrio cholerae O1 diarrhea episodes severe enough to require treatment in a health care facility. Of the 66,900 fully dosed individuals (31,932 vaccinees and 34,968 placebo recipients), 38 vaccinees and 128 placebo-recipients developed cholera during three years of follow-up (protective efficacy 66%; one-sided 95%CI lower bound = 53%, p<0.001). Vaccine protection during the third year of follow-up was 65% (one-sided 95%CI lower bound = 44%, p<0.001). Significant protection was evident in the second year of follow-up in children vaccinated at ages 1-4 years and in the third year in older age groups. CONCLUSIONS/SIGNIFICANCE: The killed whole-cell OCV conferred significant protection that was evident in the second year of follow-up in young children and was sustained for at least three years in older age groups. Continued follow-up will be important to establish the vaccine's duration of protection. TRIAL REGISTRATION: ClinicalTrials.gov NCT00289224.29:T161c,To the Editor: Cholera outbreaks caused by toxigenic Vibrio cholerae serogroup O1 frequently occur in many sub-Saharan African countries. The serogroup O1 is classified into two biotypes, classical and El Tor. The seventh and current pandemic of cholera is caused by the El Tor biotype; the classical biotype is believed to be extinct. The classical and El Tor biotypes of V. cholerae O1 are closely related in their O-antigen biosynthetic genes but differ in other regions of the genome. The genomic structure of the CTXΦ filamentous phage (1), in which the cholera toxin genes are contained, differs between the classical and El Tor biotypes. CTXclassΦ is found in classical strains, CTXETΦ is present in El Tor and O139 strains, and CTXcalcΦ is found in resurgent O139 strains. The diversity of CTXΦ among biotypes is mainly due to the variations in the repeat sequence elements, particularly in the rstR gene region (2). While conducting surveillance in the cholera treatment center in Beira, the second largest city in Mozambique, we examined 175 rectal swabs or stool samples from January 7 to March 8, 2004, using standard published procedures. During this period, we isolated 58 strains of V. cholerae O1. The isolates were transported to the Enteric Microbiology Unit of the International Center for Diarrhoeal Disease Research in Dhaka, Bangladesh (ICDDRD,B), for further phenotypic and genotypic characterization to determine serotype, biotype, and presence of important virulence genes. All 58 strains were identified as V. cholerae O1 of the Ogawa serotype. Forty strains selected for detailed characterization were resistant to polymyxin B, agglutinated chicken cells, yielded a positive Voges-Proskauer reaction, were positive for the El Tor hemolysin by the tube agglutination method, and were sensitive to group IV El Tor phage but resistant to the classical group V phage and were therefore classified as the El Tor biotype. The antimicrobial susceptibility of 15 of the 40 isolates examined showed that the strains were sensitive to tetracycline, ampicillin, furazolidone, erythromycin, and ciprofloxacin but resistant to trimethoprim-sulfamethoxazole, and also to the vibriostatic compound 0/129. By using polymerase chain reaction (PCR), we established that all 40 strains carried the ctxA gene (constituent gene of the CTX prophage) and the tcpA gene (the El Tor type), a constituent gene of the vibrio pathogenicity island. We then focused on the rstR gene because of its diversity between the two biotypes. All of the 40 El Tor strains produced a 500-bp PCR product of the rstR gene of the classical type (rstRclass), despite belonging to the El Tor biotype. Nucleotide sequence analysis of the rstR gene of two representative Mozambique strains showed 100% homology to the classical rstR gene of classical reference strain O395. The amino acid sequence of the B-subunit of classical and El Tor biotypes have distinct signature sequences (3). We amplified the ctxB gene using specific primers and found that the deduced amino acid sequence of the CT-B subunit of the Mozambique strains varied from the El Tor CT-B subunit at positions 39 (histidine replaces tyrosine in El Tor) and 68 (threonine replaces isoleucine in El Tor), and the amino acid residues at these positions are identical to those of the classical CT-B subunit (Figure). The nucleotide sequences obtained for ctxB of the two Mozambique strains B33 and B65 were deposited in GenBank under accession no. {type:entrez-nucleotide,attrs:{text:AY648939,term_id:55668281,term_text:AY648939}}AY648939 and AY6448940, respectively. Therefore, the Mozambique strains of V. cholerae O1 displayed typical traits of the El Tor biotype overall but carried the classical CTX prophage. Figure Amino acid sequence alignment of CT-B subunit of Vibrio cholerae O1 classical, El Tor, and Mozambique (B33 and B65) strains. Identical amino acid residues are indicated by a period. Amino acid sequences of CtxB of V. cholerae classical ({type:entrez-protein,attrs:{text:AAL60524.1,term_id:18141147,term_text:AAL60524.1}} ... Our findings that El Tor strains of V. cholerae O1 from Mozambique are carrying the classical prophage shows the presence of genetic materials associated with the classical biotype in Mozambique. Further, these findings provide the first circumstantial evidence of transmission of the classical CTX prophage. The CTX prophages in El Tor strains give rise to infectious phage particles (1), but neither of the two CTX prophages integrated at two different sites of the classical genome give rise to phage particles (4). Subsequent studies have shown that, although the genes of the classical prophages encode functional forms of all of the proteins needed for production of CTXΦ, the CTX prophage does not yield virions because of the atypical arrangement of its prophage arrays (4). Genetic hybrids between El Tor and classical biotypes of O1 V. cholerae were reported among sporadic isolates earlier in Bangladesh (5) and were named the Matlab variants after the place where they were first isolated. The Mozambique strains of V. cholerae likely evolved from an El Tor strain, which shed its CTX phage and acquired the classical prophage. Alternatively, strains like the Matlab variant may have spread to the African subcontinent. Whether introducing the CTX prophage in the El Tor genome background will increase pathogenicity, affect genomic stability, or enhance the epidemic-causing potential is uncertain. This subtle genetic change might also alter the effectiveness of current cholera vaccines which stimulate antitoxic as well as antibacterial immunity.2a:T794,BACKGROUND: In preparation of vaccines trials to estimate protection against shigellosis and cholera we conducted a two-year community-based surveillance study in an impoverished area of North Jakarta which provided updated information on the disease burden in the area. METHODS: We conducted a two-year community-based surveillance study from August 2001 to July 2003 in an impoverished area of North Jakarta to assess the burden of diarrhoea, shigellosis, and cholera. At participating health care providers, a case report form was completed and stool sample collected from cases presenting with diarrhoea. RESULTS: Infants had the highest incidences of diarrhoea (759/1,000/year) and cholera (4/1,000/year). Diarrhea incidence was significantly higher in boys under 5 years (387/1,000/year) than girls under 5 years (309/1,000/year; p < 0.001). Children aged 1 to 2 years had the highest incidence of shigellosis (32/1,000/year). Shigella flexneri was the most common Shigella species isolated and 73% to 95% of these isolates were resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol and tetracycline but remain susceptible to nalidixic acid, ciprofloxacin, and ceftriaxone. We found an overall incidence of cholera of 0.5/1,000/year. Cholera was most common in children, with the highest incidence at 4/1,000/year in those less than 1 year of age. Of the 154 V. cholerae O1 isolates, 89 (58%) were of the El Tor Ogawa serotype and 65 (42%) were El Tor Inaba. Thirty-four percent of patients with cholera were intravenously rehydrated and 22% required hospitalization. V. parahaemolyticus infections were detected sporadically but increased from July 2002 onwards. CONCLUSION: Diarrhoea causes a heavy public health burden in Jakarta particularly in young children. The impact of shigellosis is exacerbated by the threat of antimicrobial resistance, whereas that of cholera is aggravated by its severe manifestations.2b:T6c4,Infectious diseases kill about 11 million children each year while acute diarrhoeal diseases account for 3.1 million deaths in children under 5 yr of age, of which 6,00,000 deaths annually are contributed by shigellosis alone. Shigellosis, also known as acute bacillary dysentery, is characterized by the passage of loose stools mixed with blood and mucus and accompanied by fever, abdominal cramps and tenesmus. It may be associated with a number of complications of which haemolytic uraemic syndrome is the most serious. Shigellosis is caused by Shigella spp. which can be subdivided into four serogroups namely S.sonnei, S.boydii, S.flexneri and S.dysenteriae. Organisms as low as 10-100 in number can cause the disease. Shigellosis can occur in sporadic, epidemic and pandemic forms. Epidemics have been reported from Central American countries, Bangladesh, Sri Lanka, Maldives, Nepal, Bhutan, Myanmar and from the Indian subcontinent, Vellore, eastern India and Andaman and Nicobar islands. Plasmid profile of shigellae in Kolkata has shown a correlation between presence of smaller plasmids and shigellae serotypes- indicating epidemiological changes of the species. Diagnosis of shigellosis is essentially clinical. Laboratory diagnosis includes stool culture and polymerase chain reaction (PCR). Treatment includes use of an effective antibiotic, rehydration therapy (if there is dehydration) and appropriate feeding during and after an episode of shigellosis. Hand-washing is the single most important strategy for prevention of transmission of shigellosis from person to person. A safe and effective vaccine should be developed against the more important circulating strains i.e., S. dysenteriae type 1 and S. flexneri 2a.2c:T759,OBJECTIVES: An effective vaccine against cholera has been used for public health purposes in Vietnam since the 1990s. This vaccine was reformulated to meet WHO requirements. We assessed the safety and immunogenicity of the reformulated bivalent (Vibrio cholerae 01 and 0139) killed whole cell oral vaccine in a cholera endemic area in Kolkata, India. DESIGN: Double-blind, randomized, placebo controlled trial. SETTING: The trial was conducted in the clinical trial ward of the Infectious Diseases Hospital in Kolkata, India. PARTICIPANTS: The participants were 101 healthy adults (males and non-pregnant females) aged 18-40 years and 100 healthy children (males and non-pregnant females) aged 1-17 years. INTERVENTIONS: Participants were randomized to receive either the bivalent killed whole cell oral cholera vaccine or placebo (killed oral Escherichia coli K12). OUTCOME MEASURES: For safety: proportion of subjects with adverse events during the duration of study participation. For immunogenicity: Proportion of subjects who had a > or = 4-fold rise in serum vibriocidal antibody titers 14 days after the second dose of vaccine or placebo. RESULTS: Adverse reactions were observed with similar frequency among vaccine and placebo recipients in both age groups. Among adults 4% of vaccine and 8% of placebo recipients and among children 4% of vaccine and 2% of placebo recipients had at least one adverse event within 28 days of the first dose of the vaccine. Following immunization, 53% of adult and 80% of children vaccinees showed a > or = 4 fold rise in serum V. cholerae O1 vibriocidal antibody titers. A less pronounced response to V. cholerae O139 vibriocidal antibody titers post-immunization was noted among vaccinees. CONCLUSIONS: We found the vaccine to be safe and immunogenic in a cholera-endemic area in India. TRIAL REGISTRATION: ClinicalTrials.gov NCT00119197.2d:T47b,Malaria and malnutrition cause high morbidity and mortality in rural sub-Saharan Africa. To explore the relationship between nutritional status and malaria, a cohort of Gambian children under 5 years of age was followed weekly during one malaria season. Anthropometric measurements were made at the beginning and at the end of the season. A total of 55/107 (51.4 per cent) children with baseline stunting, defined as having a height-for-age z-score below -2 standard deviations, subsequently experienced malaria episodes, compared to 145/380 (38.2 per cent) children who were not stunted (RR = 1.35; 95 per cent CI, 1.08-1.69; p value = 0.01). Neither wasting (weight-for-height z-score below -2 standard deviations) nor undernutrition (weight-for-age z-score below -2 standard deviations) influenced susceptibility to malaria. Adjustment for characteristics of age, sex, and ethnicity did not significantly change the risk ratios. Malaria had no effect on the nutritional status from the beginning to the end of the malaria season. Our findings suggest that chronically malnourished children may be at higher risk for developing malaria episodes.2e:T468,Forty-two episodes of Vibrio parahaemolyticus infections were detected in Beira, Mozambique, from January to May 2004. The majority of the isolates (81%) belonged to the pandemic serovars (O3:K6 and O4:K68) of V. parahaemolyticus. The pandemic serovars were positive by group-specific PCR (GS-PCR) and a PCR specific for open reading frame ORF8 (ORF8-PCR), which are molecular markers of the pandemic clone, and were positive for tdh but negative for trh. The remaining 19% of the strains also possessed the tdh gene but were GS-PCR and ORF8-PCR negative and did not belong to the pandemic serovars. Patients with V. parahaemolyticus infection were older (mean age, 27 years) than patients infected by other diarrheal agents (mean age, 21 years). Ten percent of diarrhea patients from whom no V. parahaemolyticus was cultured were severely dehydrated, but none of the V. parahaemolyticus cases were severely dehydrated. This is the first report of the isolation of pandemic strains of V. parahaemolyticus in sub-Saharan Africa and clearly indicates that the pandemic of V. parahaemolyticus has spread into the African continent.2f:T771,INTRODUCTION: Mass vaccinations are a main strategy in the deployment of oral cholera vaccines. Campaigns avoid giving vaccine to pregnant women because of the absence of safety data of the killed whole-cell oral cholera (rBS-WC) vaccine. Balancing this concern is the known higher risk of cholera and of complications of pregnancy should cholera occur in these women, as well as the lack of expected adverse events from a killed oral bacterial vaccine. METHODOLOGY/PRINCIPAL FINDINGS: From January to February 2009, a mass rBS-WC vaccination campaign of persons over two years of age was conducted in an urban and a rural area (population 51,151) in Zanzibar. Pregnant women were advised not to participate in the campaign. More than nine months after the last dose of the vaccine was administered, we visited all women between 15 and 50 years of age living in the study area. The outcome of pregnancies that were inadvertently exposed to at least one oral cholera vaccine dose and those that were not exposed was evaluated. 13,736 (94%) of the target women in the study site were interviewed. 1,151 (79%) of the 1,453 deliveries in 2009 occurred during the period when foetal exposure to the vaccine could have occurred. 955 (83%) out of these 1,151 mothers had not been vaccinated; the remaining 196 (17%) mothers had received at least one dose of the oral cholera vaccine. There were no statistically significant differences in the odds ratios for birth outcomes among the exposed and unexposed pregnancies. CONCLUSIONS/SIGNIFICANCE: We found no statistically significant evidence of a harmful effect of gestational exposure to the rBS-WC vaccine. These findings, along with the absence of a rational basis for expecting a risk from this killed oral bacterial vaccine, are reassuring but the study had insufficient power to detect infrequent events. TRIAL REGISTRATION: ClinicalTrials.gov NCT00709410.30:T76d,BACKGROUND: Exposure of the individual to contaminated food or water correlates closely with the risk for enteric fever. Since public health interventions such as water improvement or vaccination campaigns are implemented for groups of individuals we were interested whether risk factors not only for the individual but for households, neighbourhoods and larger areas can be recognised? METHODS: We conducted a large enteric fever surveillance study and analyzed factors which correlate with enteric fever on an individual level and factors associated with high and low risk areas with enteric fever incidence. Individual level data were linked to a population based geographic information systems. Individual and household level variables were fitted in Generalized Estimating Equations (GEE) with the logit link function to take into account the likelihood that household factors correlated within household members. RESULTS: Over a 12-month period 80 typhoid fever cases and 47 paratyphoid fever cases were detected among 56,946 residents in two bustees (slums) of Kolkata, India. The incidence of paratyphoid fever was lower (0.8/1000/year), and the mean age of paratyphoid patients was older (17.1 years) than for typhoid fever (incidence 1.4/1000/year, mean age 14.7 years). Residents in areas with a high risk for typhoid fever had lower literacy rates and economic status, bigger household size, and resided closer to waterbodies and study treatment centers than residents in low risk areas. CONCLUSION: There was a close correlation between the characteristics detected based on individual cases and characteristics associated with high incidence areas. Because the comparison of risk factors of populations living in high versus low risk areas is statistically very powerful this methodology holds promise to detect risk factors associated with diseases using geographic information systems.31:T540,Recent research has indicated that the malaria burden in Asia may have been vastly underestimated. We conducted a prospective community-based study in an impoverished urban site in Kolkata, India, to estimate the burden of malaria and typhoid fever and to identify risk factors for these diseases. In a population of 60452 people, 3605 fever episodes were detected over a 12-month period. The blood films of 93 febrile patients contained Plasmodium (90 P. vivax, 2 P. falciparum and 1 P. malariae). Blood cultures from 95 patients grew Salmonella enterica serotype Typhi. Malaria patients were found to be significantly older (mean age 29 years) compared with patients with typhoid fever (15 years; P<0.001) but had similar clinical features on presentation. Having a household member with malaria, illiteracy, low household income and living in a structure not built of bricks were associated with an increased risk for malaria. Having a household member with typhoid fever and poor hygiene were associated with typhoid fever. A geographic analysis of the spatial distribution of malaria and typhoid fever cases detected high-risk neighbourhoods for each disease. Focal interventions to minimise human-vector contact and improved personal hygiene and targeted vaccination campaigns could help to prevent malaria and typhoid fever in this site.32:T674,Malaria during pregnancy is associated with an increased risk of severe anaemia and low-birthweight babies. Effective intermittent therapy with pyrimethamine-sulfadoxine (PSD) decreases parasitaemia and severe anaemia and improves birthweight in areas where Plasmodium falciparum is sensitive to this drug. Increasing resistance to PSD is a concern and alternative antimalarial regimens during pregnancy are needed. Artesunate with PSD is a promising antimalarial combination but few data are available on the safety of artemisinins when taken during pregnancy. Outcome of pregnancy was evaluated for 287 women in The Gambia who were exposed in June 1999 to a single dose of the combination artesunate and PSD during a mass drug administration and 172 women who were not exposed. Women who received placebo (40) and those who did not participate in the mass drug administration (132) comprised the non-exposed group. There was no difference in the proportion of abortions, stillbirths, or infant deaths among those exposed or not exposed to the drugs. The mean weight of 18 infants born to mothers who had received artesunate and PSD during the third trimester was 3.10 kg compared to a mean weight of 2.62 kg of the 10 infants of untreated mothers (adjusted P value = 0.05). We found no evidence of a teratogenic or otherwise harmful effect of gestational exposure to artesunate and PSD. Treatment of a self-selected group of pregnant women with PSD and artesunate during pregnancy was associated with a greater birthweight, which may have resulted from clearance of malaria parasites. However, the influence of confounding factors cannot be excluded.33:T680,BACKGROUND: Entering data on case report forms and subsequently digitizing them in electronic media is the traditional way to maintain a record keeping system in field studies. Direct data entry using an electronic device avoids this two-step process. It is gaining in popularity and has replaced the paper-based data entry system in many studies. We report our experiences with paper- and PDA-based data collection during a fever surveillance study in Pemba Island, Zanzibar, Tanzania. METHODS: Data were collected on a 14-page case report paper form in the first period of the study. The case report paper forms were then replaced with handheld computers (personal digital assistants or PDAs). The PDAs were used for screening and clinical data collection, including a rapid assessment of patient eligibility, real time errors, and inconsistency checking. RESULTS: A comparison of paper-based data collection with PDA data collection showed that direct data entry via PDA was faster and 25% cheaper. Data was more accurate (7% versus 1% erroneous data) and omission did not occur with electronic data collection. Delayed data turnaround times and late error detections in the paper-based system which made error corrections difficult were avoided using electronic data collection. CONCLUSIONS: Electronic data collection offers direct data entry at the initial point of contact. It has numerous advantages and has the potential to replace paper-based data collection in the field. The availability of information and communication technologies for direct data transfer has the potential to improve the conduct of public health research in resource-poor settings.34:T71a,BACKGROUND: The importance of invasive salmonellosis in African children is well recognized but there is inadequate information on these infections. We conducted a fever surveillance study in a Tanzanian rural hospital to estimate the case fraction of invasive salmonellosis among pediatric admissions, examine associations with common co-morbidities and describe its clinical features. We compared our main findings with those from previous studies among children in sub-Saharan Africa. METHODOLOGY/PRINCIPAL FINDINGS: From 1 March 2008 to 28 Feb 2009, 1,502 children were enrolled into the study. We collected clinical information and blood for point of care tests, culture, and diagnosis of malaria and HIV. We analyzed the clinical features on admission and outcome by laboratory-confirmed diagnosis. Pathogenic bacteria were isolated from the blood of 156 (10%) children, of which 14 (9%) were S. typhi, 45 (29%) were NTS and 97 (62%) were other pathogenic bacteria. Invasive salmonellosis accounted for 59/156 (38%) bacteremic children. Children with typhoid fever were significantly older and presented with a longer duration of fever. NTS infections were significantly associated with prior antimalarial treatment, malarial complications and with a high risk for death. CONCLUSIONS/SIGNIFICANCE: Invasive salmonellosis, particularly NTS infection, is an important cause of febrile disease among hospitalized children in our rural Tanzanian setting. Previous studies showed considerable variation in the case fraction of S. typhi and NTS infections. Certain suggestive clinical features (such as older age and long duration of fever for typhoid whereas concomitant malaria, anemia, jaundice and hypoglycemia for NTS infection) may be used to distinguish invasive salmonellosis from other severe febrile illness.35:T70a,BACKGROUND: We evaluated the herd protection conferred by an oral cholera vaccine using 2 approaches: cluster design and geographic information system (GIS) design. METHODS: Residents living in 3933 dwellings (clusters) in Kolkata, India, were cluster-randomized to receive either cholera vaccine or oral placebo. Nonpregnant residents aged≥1 year were invited to participate in the trial. Only the first episode of cholera detected for a subject between 14 and 1095 days after a second dose was considered. In the cluster design, indirect protection was assessed by comparing the incidence of cholera among nonparticipants in vaccine clusters vs those in placebo clusters. In the GIS analysis, herd protection was assessed by evaluating association between vaccine coverage among the population residing within 250 m of the household and the occurrence of cholera in that population. RESULTS: Among 107 347 eligible residents, 66 990 received 2 doses of either cholera vaccine or placebo. In the cluster design, the 3-year data showed significant total protection (66% protection, 95% confidence interval [CI], 50%-78%, P<.01) but no evidence of indirect protection. With the GIS approach, the risk of cholera among placebo recipients was inversely related to neighborhood-level vaccine coverage, and the trend was highly significant (P<.01). This relationship held in multivariable models that also controlled for potentially confounding demographic variables (hazard ratio, 0.94 [95% CI, .90-.98]; P<.01). CONCLUSIONS: Indirect protection was evident in analyses using the GIS approach but not the cluster design approach, likely owing to considerable transmission of cholera between clusters, which would vitiate herd protection in the cluster analyses. CLINICAL TRIALS REGISTRATION: NCT00289224.36:Teea,BACKGROUND: The population of sub-Saharan Africa is currently estimated to be 1245 million and is expected to quadruple by the end of the century, necessitating the building of millions of homes. Malaria remains a substantial problem in this region and efforts to minimise transmission should be considered in future house planning. We studied how building elements, which have been successfully employed in southeast Asia to prevent mosquitos from entering and cooling the house, could be integrated in a more sustainable house design in rural northeastern Tanzania, Africa, to decrease mosquito density and regulate indoor climate. METHODS: In this field study, six prototype houses of southeast Asian design were built in in the village of Magoda in Muheza District, Tanga Region, Tanzania, and compared with modified and unmodified, traditional, sub-Saharan African houses. Prototype houses were built with walls made of lightweight permeable materials (bamboo, shade net, or timber) with bedrooms elevated from the ground and with screened windows. Modified and unmodified traditional African houses, wattle-daub or mud-block constructions, built on the ground with poor ventilation served as controls. In the modified houses, major structural problems such as leaking roofs were repaired, windows screened, open eaves blocked with bricks and mortar, cement floors repaired or constructed, and rain gutters and a tank for water storage added. Prototype houses were randomly allocated to village households through a free, fair, and transparent lottery. The lottery tickets were deposited in a bucket made of transparent plastic. Each participant could draw one ticket. Hourly measurements of indoor temperature and humidity were recorded in all study houses with data loggers and mosquitoes were collected indoors and outdoors using Furvela tent traps and were identified with standard taxonomic keys. Mosquitoes of the Anopheles gambiae complex were identified to species using PCR. Attitudes towards the new house design were assessed 6-9 months after the residents moved into their new or modified homes through 15 in-depth interviews with household heads of the new houses and five focus group discussions including neighbours of each group of prototype housing. FINDINGS: Between July, 2014, and July, 2015, six prototype houses were constructed; one single and one double storey building with each of the following claddings: bamboo, shade net, and timber. The overall reduction of all mosquitoes caught was highest in the double-storey buildings (96%; 95% CI 92-98) followed closely by the reduction found in single-storey buildings (77%; 72-82) and lowest in the modified reference houses (43%; 36-50) and unmodified reference houses (23%; 18-29). The indoor temperature in the new design houses was 2·3°C (95% CI 2·2-2·4) cooler than in the reference houses. While both single and two-storey buildings provided a cooler indoor climate than did traditional housing, two-story buildings provided the biggest reduction in mosquito densities (96%, 95% CI 89-100). Seven people who moved into the prototype houses and seven of their neighbours (three of whom had their houses modified) participated in in-depth interviews. After living in their new prototype houses for 6-9 months, residents expressed satisfaction with the new design, especially the second-storey sleeping area because of the privacy and security of upstairs bedrooms. INTERPRETATION: The new design houses had fewer mosquitoes and were cooler than modified and unmodified traditional homes. New house designs are an underused intervention and hold promise to reduce malaria transmission in sub-Saharan Africa and keep areas malaria-free after elimination. FUNDING: Ruth W Jensens Foundation, Copenhagen and Hanako Foundation, Singapore.37:T56b,A double-blind, community-randomized, placebo-controlled trial was conducted in a rural area of The Gambia between June and December 1999 to test whether a reduction in the infectious reservoir can reduce malaria transmission. Overall 14,017 (85%) individuals living in the study area were treated with either placebo or sulfadoxine-pyrimethamine (SP) combined with a single dose of artesunate (AS). Following the mass drug administration (MDA) 1375 children aged 6 months to 10 years were kept under surveillance for clinical malaria in 18 villages throughout the 1999 malaria transmission season. During a 20-week surveillance period 637 episodes of malaria were detected. The mean incidence rate was 2.5/100 child-weeks in the placebo villages, and 2.3/100 child-weeks in villages that received SP + AS. The mean rate ratio, adjusted for individual and village-level covariates, was 0.91 (95% CI 0.68-1.22, P = 0.49). During the first 2 months of surveillance, the malaria incidence was lower in treated villages. After 2 months the incidence was slightly higher in the MDA group but this was not statistically significant. Overall, no benefit of the MDA could be detected. The reason for the absence of an impact on malaria transmission is probably the very high basic reproductive number of malaria, and the persistence of mature gametocytes, which are not affected by AS treatment.38:Taa0,INTRODUCTION: The outbreak of cholera in Zimbabwe intensified interest in the control and prevention of cholera. While there is agreement that safe water, sanitation, and personal hygiene are ideal for the long term control of cholera, there is controversy about the role of newer approaches such as oral cholera vaccines (OCVs). In October 2009 the Strategic Advisory Group of Experts advised the World Health Organization to consider reactive vaccination campaigns in response to large cholera outbreaks. To evaluate the potential benefit of this pivotal change in WHO policy, we used existing data from cholera outbreaks to simulate the number of cholera cases preventable by reactive mass vaccination. METHODS: Datasets of cholera outbreaks from three sites with varying cholera endemicity--Zimbabwe, Kolkata (India), and Zanzibar (Tanzania)--were analysed to estimate the number of cholera cases preventable under differing response times, vaccine coverage, and vaccine doses. FINDINGS: The large cholera outbreak in Zimbabwe started in mid August 2008 and by July 2009, 98,591 cholera cases had been reported with 4,288 deaths attributed to cholera. If a rapid response had taken place and half of the population had been vaccinated once the first 400 cases had occurred, as many as 34,900 (40%) cholera cases and 1,695 deaths (40%) could have been prevented. In the sites with endemic cholera, Kolkata and Zanzibar, a significant number of cases could have been prevented but the impact would have been less dramatic. A brisk response is required for outbreaks with the majority of cases occurring during the early weeks. Even a delayed response can save a substantial number of cases and deaths in long, drawn-out outbreaks. If circumstances prevent a rapid response there are good reasons to roll out cholera mass vaccination campaigns well into the outbreak. Once a substantial proportion of a population is vaccinated, outbreaks in subsequent years may be reduced if not prevented. A single dose vaccine would be of advantage in short, small outbreaks. CONCLUSIONS: We show that reactive vaccine use can prevent cholera cases and is a rational response to cholera outbreaks in endemic and non-endemic settings. In large and long outbreaks a reactive vaccination with a two-dose vaccine can prevent a substantial proportion of cases. To make mass vaccination campaigns successful, it would be essential to agree when to implement reactive vaccination campaigns and to have a dynamic and determined response team that is familiar with the logistic challenges on standby. Most importantly, the decision makers in donor and recipient countries have to be convinced of the benefit of reactive cholera vaccinations.39:T69c,OBJECTIVE: To investigate the problems, benefits, feasibility, and sustainability of implementation of WHO guidelines on management of severe malnutrition. METHODS: A postal survey invited staff from 12 African hospitals to participate in the study. Five hospitals were evaluated and two were selected to take part in the study: a district hospital in South Africa and a mission hospital in Ghana. At an initial visit, an experienced paediatrician reviewed the situation in the hospitals and introduced the principles of the guidelines through a participatory approach. During a second visit about six months later, the paediatrician reviewed the feasibility and sustainability of the introduced changes and helped find solutions to problems. At a final visit after one year, the paediatrician reassessed the overall situation. FINDINGS: Malnutrition management practices improved at both hospitals. Measures against hypoglycaemia, hypothermia, and infection were strengthened. Early, frequent feeding was established as a routine practice. Some micronutrients for inclusion in the diet were not locally available and needed to be imported. Problems were encountered with monitoring of weight gain and introducing a rehydration solution for malnutrition. CONCLUSION: Implementation of the main principles of the WHO guidelines on severe malnutrition was feasible, affordable, and sustainable at two African hospitals. The guidelines could be improved by including suggestions on how to adapt specific recommendations to local situations. The guidelines are well supported by experience and published reports, but more information is needed about some components and their impact on mortality.3a:T6b7,BACKGROUND: The annual incidence and temporal trend of severe malaria and community-acquired bacteraemia during a four-year period in Muheza, Tanzania was assessed. METHODS: Data on severely ill febrile children aged 2 months to 14 years from three prospective studies conducted at Muheza District Hospital from 2006 to 2010 was pooled and analysed. On admission, each enrolled child had a thin and thick blood film and at least one rapid diagnostic test for falciparum malaria, as well as a blood culture. The annual incidence of bacteraemia and severe malaria among children coming from Muheza was calculated and their temporal trend was assessed. RESULTS: Overall, 1, 898 severe falciparum malaria and 684 bacteraemia cases were included. Of these, 1, 356 (71%) and 482 (71%), respectively, were from the referral population of Muheza. The incidence of falciparum malaria and all-cause bacteraemia in Muheza decreased five-fold and three-fold, respectively, from the first to the fourth year of surveillance (p < 0.0001). During this period, the median ages of children from Muheza admitted with severe malaria increased from 1.7 to 2.5 years (p < 0.0001). The reduction in all-cause bacteraemia was mainly driven by the 11-fold decline in the incidence of non-typhoidal salmonellosis. The annual incidences of Haemophilus influenzae and pneumococcal invasive bacterial infections decreased as well but were much fewer in number. CONCLUSIONS: These results add to the growing evidence of the decline in malaria associated with a decrease in non-typhoidal salmonellosis and possibly other bacteraemias. Malarial prevention and control strategies may provide a greater benefit than the mere reduction of malaria alone.3b:T565,OBJECTIVE: To describe and analyse the characteristics of oral cholera vaccination campaigns; including location, target population, logistics, vaccine coverage and delivery costs. METHODS: We searched PubMed, the World Health Organization (WHO) website and the Cochrane database with no date or language restrictions. We contacted public health personnel, experts in the field and in ministries of health and did targeted web searches. FINDINGS: A total of 33 documents were included in the analysis. One country, Viet Nam, incorporates oral cholera vaccination into its public health programme and has administered approximately 10.9 million vaccine doses between 1997 and 2012. In addition, over 3 million doses of the two WHO pre-qualified oral cholera vaccines have been administered in more than 16 campaigns around the world between 1997 and 2014. These campaigns have either been pre-emptive or reactive and have taken place under diverse conditions, such as in refugee camps or natural disasters. Estimated two-dose coverage ranged from 46 to 88% of the target population. Approximate delivery cost per fully immunized person ranged from 0.11-3.99 United States dollars. CONCLUSION: Experience with oral cholera vaccination campaigns continues to increase. Public health officials may draw on this experience and conduct oral cholera vaccination campaigns more frequently.3c:T663,BACKGROUND: The gold standard for the diagnosis of cholera is stool culture, but this requires laboratory facilities and takes at least 24 hours. A rapid diagnostic test (RDT) that can be used by minimally trained staff at treatment centers could potentially improve the reporting and management of cholera outbreaks. METHODS: We evaluated the Crystal VC™ RDT under field conditions in Zanzibar in 2009. Patients presenting to treatment centers with watery diarrhea provided a stool sample for rapid diagnostic testing. Results were compared to stool culture performed in a reference laboratory. We assessed the overall performance of the RDT and evaluated whether previous intake of antibiotics, intravenous fluids, location of testing, and skill level of the technician affected the RDT results. RESULTS: We included stool samples from 624 patients. Compared to culture, the overall sensitivity of the RDT was 93.1% (95%CI: 88.7 to 96.2%), specificity was 49.2% (95%CI: 44.3 to 54.1%), the positive predictive value was 47.0% (95%CI: 42.1 to 52.0%) and the negative predictive value was 93.6% (95%CI: 89.6 to 96.5%). The overall false positivity rate was 50.8% (213/419); fieldworkers frequently misread very faint test lines as positive. CONCLUSION: The observed sensitivity of the Crystal VC RDT evaluated was similar compared to earlier versions, while specificity was poorer. The current version of the RDT could potentially be used as a screening tool in the field. Because of the high proportion of false positive results when field workers test stool specimens, positive results will need to be confirmed with stool culture.3d:T43c,The objective of this study was to describe a mass-immunization campaign of a locally-produced oral, killed whole-cell cholera vaccine in Hue city, Vietnam. Mass immunization with a 2-dose regimen of the vaccine was conducted in 13 communes in early 1998. The total, age- and sex-specific vaccine coverage was calculated using data from the vaccination records and the government census. The number of vaccine doses procured, administered, wasted, and left over, and the human and other resources required to prepare and conduct the vaccination campaign were systematically recorded. Government expenditure for planning, procurement, and delivery of the vaccine were documented. In total, 118,555 (79%) of the 49,557 targeted population were fully vaccinated during the mass-vaccination campaign. The total expenditure for the project was US dollar 105,447, resulting in a cost per fully-vaccinated person of US dollar 0.89. Mass immunization with this locally-produced oral, killed cholera vaccine was found to be feasible and affordable with attainment of high vaccination coverage.3e:T557,BACKGROUND: The diagnosis of typhoid fever is confirmed by culture of Salmonella enterica serotype Typhi (S. typhi). However, a more rapid, simpler, and cheaper diagnostic method would be very useful especially in developing countries. The Widal test is widely used in Africa but little information exists about its reliability. METHODS: We assessed the performance of the Widal tube agglutination test among febrile hospitalized Tanzanian children. We calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of various anti-TH and -TO titers using culture-confirmed typhoid fever cases as the "true positives" and all other febrile children with blood culture negative for S. typhi as the "true negatives." RESULTS: We found that 16 (1%) of 1,680 children had culture-proven typhoid fever. A single anti-TH titer of 1:80 and higher was the optimal indicator of typhoid fever. This had a sensitivity of 75%, specificity of 98%, NPV of 100%, but PPV was only 26%. We compared our main findings with those from previous studies. CONCLUSION: Among febrile hospitalized Tanzanian children with a low prevalence of typhoid fever, a Widal titer of > or = 1:80 performed well in terms of sensitivity, specificity, and NPV. However a test with improved PPV that is similarly easy to apply and cost-efficient is desirable.3f:Ta73,BACKGROUND: Detection of dengue virus antibodies is important for understanding future dengue virus risk and for prevaccination screening. We aimed to evaluate the performance of a dengue IgG indirect ELISA in determining dengue seroprevalence in a cohort of children in the Philippines, using a focus reduction neutralisation test (FRNT) as the reference test. METHODS: In this prospective population-based cohort study, we enrolled healthy children residing in Bogo or Balamban, Cebu, Philippines, who were to be aged 9-14 years at the time of a mass dengue vaccination campaign. Sera were collected from participants and batch tested by indirect IgG ELISA and FRNT. The primary endpoint was dengue seroprevalence in the cohort, detected by ELISA, and validated by that detected by reference FRNT. This study is registered with ClinicalTrials.gov, NCT03465254. FINDINGS: We collected 2996 serum samples between May 2, and June 2, 2017, and we tested each sample with IgG ELISA. Using 1961 samples (65·5%) that were tested with FRNT, and 1035 samples (34·5%) with imputed results, we found that 320 (10·7%) of 2996 children were dengue naive and 2676 (89·3%) were seropositive for previous dengue virus infection. Based on the 1961 non-imputed FRNT results classified as dengue seronegative or seropositive, the ELISA (with a 0·9 index value cutoff) showed 95·2% sensitivity, 93·4% specificity, 6·6% false positivity, and 4·8% false negativity. However, sensitivity of the ELISA was poor (77·1%) among children with immunity to just one dengue virus serotype. Of the 11 sera that were false positive with ELISA, seven samples (63·6%) were seropositive for Zika virus or Japanese encephalitis virus with FRNT. INTERPRETATION: Most children (89·3%) assessed in our study and eligible to participate in the mass dengue vaccination campaign were seropositive for previous dengue virus infection. Compared with FRNT, ELISA had high sensitivity and specificity (>90%), but the false-negative and false-positive rates makes the test suboptimal for prevaccination screening. Individuals who are falsely identified as seropositive by dengue IgG ELISA and then vaccinated might be at risk of developing severe disease during a subsequent exposure to wild-type dengue virus. Those with a monotypic profile would benefit the most from vaccination, but the sensitivity of the IgG ELISA was much lower in this group than in those with a multitypic profile. FUNDING: Philippine Department of Health, Hanako Foundation, WHO, Swedish International Development Cooperation Agency through the International Vaccine Institute, and University of North Carolina, Chapel Hill, NC, USA.16:["$","div",null,{"className":"mx-auto max-w-6xl px-4 py-6 sm:px-6 sm:py-10","children":[["$","header",null,{"className":"grid gap-6 lg:grid-cols-[1fr_22rem] lg:items-end","children":[["$","div",null,{"children":[["$","p",null,{"className":"label mb-2 text-accent","children":["Researcher profile · ","OpenAlex"]}],["$","h1",null,{"className":"text-3xl font-bold sm:text-4xl","children":"Jacqueline L. 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Grais","id":"openalex:A5046960097","orcid":"https://orcid.org/0000-0002-5037-8218","affiliation":"Epicentre","institutionId":"I4387152612","institutionUrl":"https://ror.org/034w22c34","affiliations":["Epicentre, Paris, France"]},{"name":"Sujit Bhattacharya","id":"openalex:A5057018288","orcid":"https://orcid.org/0000-0002-6769-8293","affiliation":"National Institute of Cholera and Enteric Diseases","institutionId":"I4210101909","institutionUrl":"https://ror.org/018azgd14","affiliations":["NICED, Kolkata, India"]},{"name":"Dipika Sur","id":"openalex:A5109067964","affiliation":"National Institute of Cholera and Enteric Diseases","institutionId":"I4210101909","institutionUrl":"https://ror.org/018azgd14","affiliations":["NICED, Kolkata, India"]},{"name":"Anna Lena Lopez","id":"openalex:A5004233631","orcid":"https://orcid.org/0000-0003-0013-620X","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["International Vaccine Institute (IVI), Seoul, Korea"]},{"name":"Mohamed Saleh Jiddawi","id":"openalex:A5025356629","affiliation":"Ministry of Health and Social Welfare","institutionId":"I118086122","institutionUrl":"https://ror.org/03vt2s541","affiliations":["Ministry of Health and Social Welfare, Zanzibar, Tanzania"]},{"name":"John David Clemens","id":"openalex:A5041318439","orcid":"https://orcid.org/0000-0002-6379-1052","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["International Vaccine Institute (IVI), Seoul, Korea"]},{"name":"Lorenz von Seidlein","id":"openalex:A5029292055","orcid":"https://orcid.org/0000-0002-0282-6469","affiliation":"Menzies School of Health Research","institutionId":"I4210085939","institutionUrl":"https://ror.org/006mbby82","affiliations":["Menzies School of Health Research, Casuarina, Australia"]}],"venue":"PLoS neglected tropical diseases","venueId":"S46544255","publisher":"Public Library of Science","publisherId":"P4310315706","year":2011,"publishedDate":"2011-01-25","type":"article","citationCount":79,"referenceCount":18,"isOpenAccess":true,"sourceUrl":"https://doi.org/10.1371/journal.pntd.0000952","oaUrl":"https://doi.org/10.1371/journal.pntd.0000952","topics":[{"id":"T11684","name":"Vibrio bacteria research studies","score":0.9990000128746033,"subfieldId":"1310","subfield":"Endocrinology","fieldId":"13","field":"Biochemistry, Genetics and Molecular Biology"},{"id":"T10873","name":"Bacterial Infections and Vaccines","score":0.00039999998989515007,"subfieldId":"2404","subfield":"Microbiology","fieldId":"24","field":"Immunology and Microbiology"},{"id":"T10486","name":"Salmonella and Campylobacter epidemiology","score":0.0003000000142492354,"subfieldId":"1106","subfield":"Food Science","fieldId":"11","field":"Agricultural and Biological Sciences"}],"sources":["openalex"],"id":"openalex:W1975805409"},{"ids":{"openalex":"W2145772589","pmid":"12764489"},"title":"Implementation of WHO guidelines on management of severe malnutrition in hospitals in Africa.","abstract":"$39","authors":[{"name":"Jacqueline L. Deen","id":"openalex:A5070377442","orcid":"https://orcid.org/0000-0001-8875-5026","affiliation":"Southern Islands Medical Center, Cebu, Philippines. jdeen@ivi.int","affiliations":["Southern Islands Medical Center, Cebu, Philippines. jdeen@ivi.int","Southern Islands Medical Center, Cebu, Philippines"]},{"name":"Matthias Funk","affiliation":"Catholic Hospital, Battor, Ghana","affiliations":["Catholic Hospital, Battor, Ghana"]},{"name":"Victor C. Guevara","id":"openalex:A5061875001","affiliation":"Mapulaneng Hospital, Bushbuckridge, South Africa","affiliations":["Mapulaneng Hospital, Bushbuckridge, South Africa"]},{"name":"Haroon Saloojee","id":"openalex:A5061867436","orcid":"https://orcid.org/0000-0002-8298-7210","affiliation":"University of the Witwatersrand","institutionId":"I192619145","institutionUrl":"https://ror.org/03rp50x72","affiliations":["University of the Witwatersrand, Johannesburg,South Africa#TAB#"]},{"name":"James Yao Doe","id":"openalex:A5049082157","affiliation":"Catholic Hospital, Battor, Ghana","affiliations":["Catholic Hospital, Battor, Ghana"]},{"name":"Ayo Palmer","id":"openalex:A5113863716","affiliation":"United Nations Children's Fund","institutionId":"I112289208","institutionUrl":"https://ror.org/02dg0pv02","affiliations":["United Nations Children's Fund, Banjul, Gambia"]},{"name":"Martin Willi Weber","id":"openalex:A5104780383","affiliation":"World Health Organization","institutionId":"I4210105654","institutionUrl":"https://ror.org/01f80g185","affiliations":["*World Health Organization, Geneva, Switzerland"]}],"venue":"PubMed","venueId":"S4306525036","publisher":"National Institutes of Health","year":2003,"publishedDate":"2003-01-01","type":"article","citationCount":78,"referenceCount":11,"isOpenAccess":true,"sourceUrl":"https://pubmed.ncbi.nlm.nih.gov/12764489","oaUrl":"https://www.ncbi.nlm.nih.gov/pmc/articles/2572430","topics":[{"id":"T10596","name":"Child Nutrition and Water Access","score":0.9717000126838684,"subfieldId":"2916","subfield":"Nutrition and Dietetics","fieldId":"29","field":"Nursing"},{"id":"T10858","name":"Clinical Nutrition and Gastroenterology","score":0.006500000134110451,"subfieldId":"2916","subfield":"Nutrition and Dietetics","fieldId":"29","field":"Nursing"},{"id":"T10629","name":"Health Policy Implementation Science","score":0.004999999888241291,"subfieldId":"3600","subfield":"General Health Professions","fieldId":"36","field":"Health Professions"}],"sources":["openalex"],"id":"openalex:W2145772589"},{"ids":{"openalex":"W2162924863","doi":"10.1186/1475-2875-10-320","pmid":"22029477"},"title":"Decreasing incidence of severe malaria and community-acquired bacteraemia among hospitalized children in Muheza, north-eastern Tanzania, 2006-2010","abstract":"$3a","authors":[{"name":"George A. Mtove","id":"openalex:A5091453196","orcid":"https://orcid.org/0000-0001-5173-0829","affiliation":"National Institute for Medical Research","institutionId":"I4210164902","institutionUrl":"https://ror.org/05fjs7w98","affiliations":["National Institute for Medical Research - Amani Centre, Tanga, Tanzania"]},{"name":"Ben Amos","id":"openalex:A5073941479","orcid":"https://orcid.org/0000-0002-8569-1650","affiliation":"Rajabu St Augustine's, Hospitali Teule","institutionId":"I4210101398","institutionUrl":"https://ror.org/016570d63","affiliations":["Joint Malaria Programme, Moshi, Tanzania","Teule Hospital, Muheza, Tanga, Tanzania"]},{"name":"Behzad Nadjm","id":"openalex:A5077764617","orcid":"https://orcid.org/0000-0002-7704-3629","affiliation":"London School of Hygiene & Tropical Medicine","institutionId":"I4210089966","institutionUrl":"https://ror.org/00a0jsq62","affiliations":["Joint Malaria Programme, Moshi, Tanzania","London School of Hygiene and Tropical Medicine, London, UK"]},{"name":"Ilse C. E. Hendriksen","id":"openalex:A5108534985","affiliation":"Mahidol Oxford Tropical Medicine Research Unit","institutionId":"I4210126604","institutionUrl":"https://ror.org/03fs9z545","affiliations":["Joint Malaria Programme, Moshi, Tanzania","Mahidol-Oxford Research Unit, Bangkok, Thailand"]},{"name":"Arjen M. Dondorp","id":"openalex:A5051408897","orcid":"https://orcid.org/0000-0001-5190-2395","affiliation":"Mahidol Oxford Tropical Medicine Research Unit","institutionId":"I4210126604","institutionUrl":"https://ror.org/03fs9z545","affiliations":["Mahidol-Oxford Research Unit, Bangkok, Thailand"]},{"name":"Abraham Mwambuli","id":"openalex:A5040306650","affiliation":"Joint Malaria Programme, Moshi, Tanzania","affiliations":["Joint Malaria Programme, Moshi, Tanzania"]},{"name":"Deok Ryun Kim","id":"openalex:A5033554066","orcid":"https://orcid.org/0009-0007-3085-6773","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["International Vaccine Institute, SNU Research Park, San 4-8, Nakseongdae-dong, Gwanak-gu, Seoul, Korea"]},{"name":"R. Leon Ochiai","id":"openalex:A5073246127","orcid":"https://orcid.org/0000-0002-5079-6786","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["International Vaccine Institute, SNU Research Park, San 4-8, Nakseongdae-dong, Gwanak-gu, Seoul, Korea"]},{"name":"John David Clemens","id":"openalex:A5041318439","orcid":"https://orcid.org/0000-0002-6379-1052","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["International Vaccine Institute, SNU Research Park, San 4-8, Nakseongdae-dong, Gwanak-gu, Seoul, Korea"]},{"name":"Lorenz von Seidlein","id":"openalex:A5029292055","orcid":"https://orcid.org/0000-0002-0282-6469","affiliation":"Menzies School of Health Research","institutionId":"I4210085939","institutionUrl":"https://ror.org/006mbby82","affiliations":["Joint Malaria Programme, Moshi, Tanzania","Menzies School of Health Research, Casuarina, NT, Australia"]},{"name":"Hugh Reyburn","id":"openalex:A5103024456","orcid":"https://orcid.org/0000-0003-4186-8861","affiliation":"London School of Hygiene & Tropical Medicine","institutionId":"I4210089966","institutionUrl":"https://ror.org/00a0jsq62","affiliations":["Joint Malaria Programme, Moshi, Tanzania","London School of Hygiene and Tropical Medicine, London, UK"]},{"name":"Jacqueline L. Deen","id":"openalex:A5070377442","orcid":"https://orcid.org/0000-0001-8875-5026","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["International Vaccine Institute, SNU Research Park, San 4-8, Nakseongdae-dong, Gwanak-gu, Seoul, Korea","Joint Malaria Programme, Moshi, Tanzania","Menzies School of Health Research, Casuarina, NT, Australia"],"corresponding":true}],"venue":"Malaria Journal","venueId":"S93003929","publisher":"BioMed Central","publisherId":"P4310320256","year":2011,"publishedDate":"2011-10-27","type":"article","citationCount":71,"referenceCount":41,"isOpenAccess":true,"sourceUrl":"https://doi.org/10.1186/1475-2875-10-320","oaUrl":"https://malariajournal.biomedcentral.com/counter/pdf/10.1186/1475-2875-10-320","pdfUrl":"https://malariajournal.biomedcentral.com/counter/pdf/10.1186/1475-2875-10-320","topics":[{"id":"T10091","name":"Malaria Research and Control","score":0.9980000257492065,"subfieldId":"2739","subfield":"Public Health, Environmental and Occupational Health","fieldId":"27","field":"Medicine"},{"id":"T10654","name":"Pneumonia and Respiratory Infections","score":0.0006000000284984708,"subfieldId":"2713","subfield":"Epidemiology","fieldId":"27","field":"Medicine"},{"id":"T10873","name":"Bacterial Infections and Vaccines","score":0.00009999999747378752,"subfieldId":"2404","subfield":"Microbiology","fieldId":"24","field":"Immunology and Microbiology"}],"sources":["openalex"],"id":"openalex:W2162924863"},{"ids":{"openalex":"W1920331751","doi":"10.1186/1471-2334-6-17","pmid":"16451731"},"title":"Field evaluation of a rapid immunochromatographic dipstick test for the diagnosis of cholera in a high-risk population","abstract":"BACKGROUND: Early detection of cholera outbreaks is crucial for the implementation of the most appropriate control strategies. METHODS: The performance of an immunochromatographic dipstick test (Institute Pasteur, Paris, France) specific for Vibrio cholerae O1 was evaluated in a prospective study in Beira, Mozambique, during the 2004 cholera season (January-May). Fecal specimens were collected from 391 patients with acute watery nonbloody diarrhea and tested by dipstick and conventional culture. RESULTS: The overall sensitivity and specificity of the rapid test compared to culture were 95% (95% confidence interval [CI]: 91%-99%) and 89% (95% CI: 86%-93%), respectively. After stratification by type of sample (rectal swab/bulk stool) and severity of diarrhea, the sensitivity ranged between 85% and 98% and specificity between 77% and 97%. CONCLUSION: This one-step dipstick test performed well in the diagnosis of V. cholerae O1 in a setting with seasonal outbreaks where rapid tests are most urgently needed.","authors":[{"name":"Xuanyi Wang","id":"openalex:A5060949947","orcid":"https://orcid.org/0000-0001-6398-9184","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["The International Vaccine Institute, Seoul, Korea. xywang@ivi.int","The International Vaccine Institute, Seoul, South Korea"],"corresponding":true},{"name":"Mohammed Ansaruzzaman","id":"openalex:A5111751464","affiliation":"International Centre for Diarrhoeal Disease Research","institutionId":"I205889620","institutionUrl":"https://ror.org/04vsvr128","affiliations":["ICDDR,B: Centre for Health and Population Research, Dhaka, Bangladesh","ICDDR, B: Centre for Health and Population Research, Dhaka, Bangladesh"]},{"name":"Raul Vaz","id":"openalex:A5031539112","affiliation":"CHAEM, Beira, Mozambique","affiliations":["CHAEM, Beira, Mozambique"]},{"name":"Catarina Mondlane","id":"openalex:A5109052340","affiliation":"CHAEM, Beira, Mozambique","affiliations":["CHAEM, Beira, Mozambique"]},{"name":"Marcelino E. S. Lucas","id":"openalex:A5109068890","affiliation":"Ministry of Health","institutionId":"I4210166169","institutionUrl":"https://ror.org/059f2k568","affiliations":["Ministry of Health, Maputo, Mozambique"]},{"name":"Lorenz von Seidlein","id":"openalex:A5029292055","orcid":"https://orcid.org/0000-0002-0282-6469","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["The International Vaccine Institute, Seoul, South Korea"]},{"name":"Jacqueline L. Deen","id":"openalex:A5070377442","orcid":"https://orcid.org/0000-0001-8875-5026","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["The International Vaccine Institute, Seoul, South Korea"]},{"name":"Julia S. Ampuero","id":"openalex:A5000395106","orcid":"https://orcid.org/0000-0001-5486-1656","affiliation":"Médecins Sans Frontières","institutionId":"I4210128224","institutionUrl":"https://ror.org/032mwd808","affiliations":["Médecins Sans Frontières, Geneva, Switzerland"]},{"name":"Mahesh K. Puri","id":"openalex:A5113700475","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["The International Vaccine Institute, Seoul, South Korea"]},{"name":"Taesung Park","id":"openalex:A5100643662","orcid":"https://orcid.org/0000-0002-8294-590X","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["Department of Statistics, Seoul National University, Seoul","The International Vaccine Institute, Seoul, South Korea"]},{"name":"GB Nair","id":"openalex:A5109068889","affiliation":"International Centre for Diarrhoeal Disease Research","institutionId":"I205889620","institutionUrl":"https://ror.org/04vsvr128","affiliations":["ICDDR,B: Centre for Health and Population Research, Dhaka, Bangladesh","ICDDR, B: Centre for Health and Population Research, Dhaka, Bangladesh"]},{"name":"John David Clemens","id":"openalex:A5041318439","orcid":"https://orcid.org/0000-0002-6379-1052","affiliation":"National Institutes of Health","institutionId":"I1299303238","institutionUrl":"https://ror.org/01cwqze88","affiliations":["National Institute of Child Health and Human Development, Bethesda, Maryland, USA","The International Vaccine Institute, Seoul, South Korea","National Institute of Child Health and Human Development, Bethesda, USA"]},{"name":"Claire‐Lise Chaignat","id":"openalex:A5112409793","affiliation":"World Health Organization","institutionId":"I4210105654","institutionUrl":"https://ror.org/01f80g185","affiliations":["World Health Organization, Geneva, Switzerland","*World Health Organization, Geneva, Switzerland"]},{"name":"Minoarisoa Esther Rajerison","id":"openalex:A5022054893","orcid":"https://orcid.org/0000-0002-0389-9280","affiliation":"Institut Pasteur de Madagascar","institutionId":"I4210133373","institutionUrl":"https://ror.org/03fkjvy27","affiliations":["Institut Pasteur, Antananarivo, Madagascar","‡‡Institut Pasteur, Antananarivo, Madagascar"]},{"name":"Farida Nato","id":"openalex:A5051684746","affiliation":"Institut Pasteur","institutionId":"I157536573","institutionUrl":"https://ror.org/0495fxg12","affiliations":["Institute Pasteur, Paris, France"]},{"name":"Jean-Michel Fournier","affiliation":"Institut Pasteur","institutionId":"I157536573","institutionUrl":"https://ror.org/0495fxg12","affiliations":["Institute Pasteur, Paris, France"]}],"venue":"BMC Infectious Diseases","venueId":"S171015910","publisher":"BioMed Central","publisherId":"P4310320256","year":2006,"publishedDate":"2006-02-01","type":"article","citationCount":67,"referenceCount":19,"isOpenAccess":true,"sourceUrl":"https://doi.org/10.1186/1471-2334-6-17","oaUrl":"https://bmcinfectdis.biomedcentral.com/counter/pdf/10.1186/1471-2334-6-17","pdfUrl":"https://bmcinfectdis.biomedcentral.com/counter/pdf/10.1186/1471-2334-6-17","topics":[{"id":"T11684","name":"Vibrio bacteria research studies","score":0.9937000274658203,"subfieldId":"1310","subfield":"Endocrinology","fieldId":"13","field":"Biochemistry, Genetics and Molecular Biology"},{"id":"T11393","name":"Biosensors and Analytical Detection","score":0.00570000009611249,"subfieldId":"2204","subfield":"Biomedical Engineering","fieldId":"22","field":"Engineering"},{"id":"T12167","name":"Bacterial Identification and Susceptibility Testing","score":0.00019999999494757503,"subfieldId":"1308","subfield":"Clinical Biochemistry","fieldId":"13","field":"Biochemistry, Genetics and Molecular Biology"}],"sources":["openalex"],"id":"openalex:W1920331751"},{"ids":{"openalex":"W2132721401","doi":"10.2471/blt.14.139949","pmid":"25552772"},"title":"Post-licensure deployment of oral cholera vaccines: a systematic review","abstract":"$3b","authors":[{"name":"Stephen Martin","affiliation":"World Health Organization","institutionId":"I4210105654","institutionUrl":"https://ror.org/01f80g185","affiliations":["Pandemic and Epidemic Diseases Department, World Health Organization, Geneva, Switzerland"]},{"name":"Anna Lena Lopez","id":"openalex:A5004233631","orcid":"https://orcid.org/0000-0003-0013-620X","affiliation":"University of the Philippines Manila","institutionId":"I5791819","institutionUrl":"https://ror.org/01rrczv41","affiliations":["University of the Philippines Manila-National Institutes of Health, Manila, Philippines"]},{"name":"Anna Bellos","id":"openalex:A5084325527","affiliation":"World Health Organization","institutionId":"I4210105654","institutionUrl":"https://ror.org/01f80g185","affiliations":["Pandemic and Epidemic Diseases Department, World Health Organization, Geneva, Switzerland"]},{"name":"Jacqueline L. Deen","id":"openalex:A5070377442","orcid":"https://orcid.org/0000-0001-8875-5026","affiliation":"Johns Hopkins University","institutionId":"I145311948","institutionUrl":"https://ror.org/00za53h95","affiliations":["Delivering Oral Vaccine Effectively (DOVE), Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, United States of America (USA)"]},{"name":"Mohammad Ali","id":"openalex:A5039070711","orcid":"https://orcid.org/0000-0003-1410-388X","affiliation":"Johns Hopkins University","institutionId":"I145311948","institutionUrl":"https://ror.org/00za53h95","affiliations":["Delivering Oral Vaccine Effectively (DOVE), Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, United States of America (USA)"]},{"name":"Kathryn P. Alberti","id":"openalex:A5114006758","affiliation":"United Nations Children's Fund","institutionId":"I112289208","institutionUrl":"https://ror.org/02dg0pv02","affiliations":["United Nations Children’s Fund, United Nations Plaza, New York, USA","United Nations Children's Fund, United Nations Plaza, New York, USA"]},{"name":"Đặng Đức Anh","id":"openalex:A5110111674","affiliation":"National Institute Of Hygiene And Epidemiology","institutionId":"I4210109089","institutionUrl":"https://ror.org/01teg2k73","affiliations":["National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam"]},{"name":"Alejandro Costa","id":"openalex:A5047921171","affiliation":"World Health Organization","institutionId":"I4210105654","institutionUrl":"https://ror.org/01f80g185","affiliations":["Pandemic and Epidemic Diseases Department, World Health Organization, Geneva, Switzerland"]},{"name":"Rebecca F. Grais","id":"openalex:A5046960097","orcid":"https://orcid.org/0000-0002-5037-8218","affiliation":"Epicentre","institutionId":"I4387152612","institutionUrl":"https://ror.org/034w22c34","affiliations":["Epicentre, Paris, France"]},{"name":"Dominique Legros","id":"openalex:A5044971903","affiliation":"World Health Organization","institutionId":"I4210105654","institutionUrl":"https://ror.org/01f80g185","affiliations":["Pandemic and Epidemic Diseases Department, World Health Organization, Geneva, Switzerland"]},{"name":"Francisco Javier Luquero","id":"openalex:A5029214445","orcid":"https://orcid.org/0000-0003-0885-8418","affiliation":"Epicentre","institutionId":"I4387152612","institutionUrl":"https://ror.org/034w22c34","affiliations":["Epicentre, Paris, France"]},{"name":"Megan B. Ghai","id":"openalex:A5024019833","orcid":"https://orcid.org/0009-0007-5153-7368","affiliation":"World Health Organization","institutionId":"I4210105654","institutionUrl":"https://ror.org/01f80g185","affiliations":["Pandemic and Epidemic Diseases Department, World Health Organization, Geneva, Switzerland"]},{"name":"William Perea","id":"openalex:A5109397400","affiliation":"World Health Organization","institutionId":"I4210105654","institutionUrl":"https://ror.org/01f80g185","affiliations":["Pandemic and Epidemic Diseases Department, World Health Organization, Geneva, Switzerland"]},{"name":"David Allen Sack","id":"openalex:A5041377151","orcid":"https://orcid.org/0000-0002-9338-5119","affiliation":"Johns Hopkins University","institutionId":"I145311948","institutionUrl":"https://ror.org/00za53h95","affiliations":["Delivering Oral Vaccine Effectively (DOVE), Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, United States of America (USA)"]}],"venue":"Bulletin of the World Health Organization","venueId":"S22004576","publisher":"World Health Organization","publisherId":"P4310319663","year":2014,"publishedDate":"2014-09-29","type":"review","citationCount":65,"referenceCount":41,"isOpenAccess":true,"sourceUrl":"https://doi.org/10.2471/blt.14.139949","oaUrl":"https://doi.org/10.2471/blt.14.139949","pdfUrl":"https://doi.org/10.2471/blt.14.139949","topics":[{"id":"T11684","name":"Vibrio bacteria research studies","score":0.9911999702453613,"subfieldId":"1310","subfield":"Endocrinology","fieldId":"13","field":"Biochemistry, Genetics and Molecular Biology"},{"id":"T10833","name":"Vaccine Coverage and Hesitancy","score":0.002899999963119626,"subfieldId":"3306","subfield":"Health","fieldId":"33","field":"Social Sciences"},{"id":"T10873","name":"Bacterial Infections and Vaccines","score":0.002300000051036477,"subfieldId":"2404","subfield":"Microbiology","fieldId":"24","field":"Immunology and Microbiology"}],"sources":["openalex"],"id":"openalex:W2132721401"},{"ids":{"openalex":"W2016010606","doi":"10.1016/j.vaccine.2006.12.027","pmid":"17258844"},"title":"Private demand for cholera vaccines in Beira, Mozambique","authors":[{"name":"Marcelino E. 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Wierzba","id":"openalex:A5089769333","orcid":"https://orcid.org/0000-0001-9757-5596","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["Translational Research Division, International Vaccine Institute, Seoul, Korea"]},{"name":"John David Clemens","id":"openalex:A5041318439","orcid":"https://orcid.org/0000-0002-6379-1052","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["Translational Research Division, International Vaccine Institute, Seoul, Korea"]},{"name":"Harald Wilfing","id":"openalex:A5057433192","orcid":"https://orcid.org/0000-0001-8591-2145","affiliation":"University of Vienna","institutionId":"I129774422","institutionUrl":"https://ror.org/03prydq77","affiliations":["Biocenter, University of Vienna, Vienna, Austria"]},{"name":"Godwin Enwere","id":"openalex:A5107073181","affiliation":"World Health Organization","institutionId":"I4210105654","institutionUrl":"https://ror.org/01f80g185","affiliations":["World Health Organization, Geneva, Switzerland"]},{"name":"Theresa Aguado","id":"openalex:A5004726872","affiliation":"World Health Organization","institutionId":"I4210105654","institutionUrl":"https://ror.org/01f80g185","affiliations":["World Health Organization, Geneva, Switzerland"]},{"name":"Mohammad S. Jiddawi","id":"openalex:A5014255469","affiliation":"Ministry of Health and Social Welfare","institutionId":"I118086122","institutionUrl":"https://ror.org/03vt2s541","affiliations":["Ministry of Health and Social Welfare, Zanzibar, Tanzania"]},{"name":"David Allen Sack","id":"openalex:A5041377151","orcid":"https://orcid.org/0000-0002-9338-5119","affiliation":"Johns Hopkins University","institutionId":"I145311948","institutionUrl":"https://ror.org/00za53h95","affiliations":["John Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America"]},{"name":"Said Mohammed Ali","id":"openalex:A5109546429","affiliation":"Ministry of Health and Social Welfare","institutionId":"I118086122","institutionUrl":"https://ror.org/03vt2s541","affiliations":["Ministry of Health and Social Welfare, Zanzibar, Tanzania","Public Health Laboratory (Pemba) – Ivo de Carneri, Chake Chake, Tanzania"]}],"venue":"PLoS ONE","venueId":"S202381698","publisher":"Public Library of Science","publisherId":"P4310315706","year":2012,"publishedDate":"2012-05-25","type":"article","citationCount":62,"referenceCount":12,"isOpenAccess":true,"sourceUrl":"https://doi.org/10.1371/journal.pone.0036930","oaUrl":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0036930&type=printable","pdfUrl":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0036930&type=printable","topics":[{"id":"T11684","name":"Vibrio bacteria research studies","score":0.9883000254631042,"subfieldId":"1310","subfield":"Endocrinology","fieldId":"13","field":"Biochemistry, Genetics and Molecular Biology"},{"id":"T11393","name":"Biosensors and Analytical Detection","score":0.009499999694526196,"subfieldId":"2204","subfield":"Biomedical Engineering","fieldId":"22","field":"Engineering"},{"id":"T12167","name":"Bacterial Identification and Susceptibility Testing","score":0.0012000000569969416,"subfieldId":"1308","subfield":"Clinical Biochemistry","fieldId":"13","field":"Biochemistry, Genetics and Molecular Biology"}],"sources":["openalex"],"id":"openalex:W1967821571"},{"ids":{"openalex":"W1919112789","pmid":"15043004"},"title":"Coverage and costs of mass immunization of an oral cholera vaccine in Vietnam.","abstract":"$3d","authors":[{"name":"Vũ Đình Thiểm","id":"openalex:A5031878877","orcid":"https://orcid.org/0000-0001-6168-4555","affiliation":"National Institute Of Hygiene And Epidemiology","institutionId":"I4210109089","institutionUrl":"https://ror.org/01teg2k73","affiliations":["National Institute of Hygiene and Epidemiology, Hanoi, Vietnam"]},{"name":"Md. Moyazzem Hossain","id":"openalex:A5013520964","orcid":"https://orcid.org/0000-0003-3593-6936"},{"name":"Dinh Son Nguyen"},{"name":"Thai Hoa Nguyen","id":"openalex:A5108379566"},{"name":"Malla R. Rao","id":"openalex:A5111923395","orcid":"https://orcid.org/0000-0001-7193-188X"},{"name":"Do Gia Canh","id":"openalex:A5048114482"},{"name":"Abdollah B. Naficy","id":"openalex:A5108221228"},{"name":"Nguyen Thi Ke","id":"openalex:A5110142945"},{"name":"Camilo J. Acosta","id":"openalex:A5103148574","orcid":"https://orcid.org/0000-0002-2313-3493"},{"name":"Jacqueline L. 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Mtove","id":"openalex:A5091453196","orcid":"https://orcid.org/0000-0001-5173-0829","affiliation":"National Institute for Medical Research","institutionId":"I4210164902","institutionUrl":"https://ror.org/05fjs7w98","affiliations":["Joint Malaria Program, Tanga, Tanzania","National Institute for Medical Research - Amani Centre, Tanga, Tanzania"]},{"name":"Kamala Thriemer","id":"openalex:A5091743305","orcid":"https://orcid.org/0000-0001-7536-7497","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["International Vaccine Institute, Seoul, Republic of Korea"]},{"name":"Ben Amos","id":"openalex:A5073941479","orcid":"https://orcid.org/0000-0002-8569-1650","affiliation":"Rajabu St Augustine's, Hospitali Teule","institutionId":"I4210101398","institutionUrl":"https://ror.org/016570d63","affiliations":["Joint Malaria Program, Tanga, Tanzania","Teule Hospital, Muheza, Tanga, Tanzania"]},{"name":"Lorenz von Seidlein","id":"openalex:A5029292055","orcid":"https://orcid.org/0000-0002-0282-6469","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["International Vaccine Institute, Seoul, Republic of Korea","Joint Malaria Program, Tanga, Tanzania"]},{"name":"Ilse C. E. 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Kim","id":"openalex:A5050439282","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["International Vaccine Institute, Seoul, Republic of Korea"]},{"name":"R. Leon Ochiai","id":"openalex:A5073246127","orcid":"https://orcid.org/0000-0002-5079-6786","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["International Vaccine Institute, Seoul, Republic of Korea"]},{"name":"John David Clemens","id":"openalex:A5041318439","orcid":"https://orcid.org/0000-0002-6379-1052","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["International Vaccine Institute, Seoul, Republic of Korea"]},{"name":"Hugh Reyburn","id":"openalex:A5103024456","orcid":"https://orcid.org/0000-0003-4186-8861","affiliation":"London School of Hygiene & Tropical Medicine","institutionId":"I4210089966","institutionUrl":"https://ror.org/00a0jsq62","affiliations":["Joint Malaria Program, Tanga, Tanzania","London School of Hygiene and Tropical Medicine, Keppel St, London, UK"]},{"name":"Harald Wilfing","id":"openalex:A5057433192","orcid":"https://orcid.org/0000-0001-8591-2145","affiliation":"University of Vienna","institutionId":"I129774422","institutionUrl":"https://ror.org/03prydq77","affiliations":["University of Vienna, Biocenter, Vienna, Austria"]},{"name":"Stephen Magesa","id":"openalex:A5107836932","affiliation":"National Institute for Medical Research","institutionId":"I4210164902","institutionUrl":"https://ror.org/05fjs7w98","affiliations":["Joint Malaria Program, Tanga, Tanzania","National Institute for Medical Research - Amani Centre, Tanga, Tanzania"]},{"name":"Jacqueline L. Deen","id":"openalex:A5070377442","orcid":"https://orcid.org/0000-0001-8875-5026","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["International Vaccine Institute, Seoul, Republic of Korea","Joint Malaria Program, Tanga, Tanzania"]}],"venue":"BMC Infectious Diseases","venueId":"S171015910","publisher":"BioMed Central","publisherId":"P4310320256","year":2010,"publishedDate":"2010-06-22","type":"article","citationCount":57,"referenceCount":27,"isOpenAccess":true,"sourceUrl":"https://doi.org/10.1186/1471-2334-10-180","oaUrl":"https://bmcinfectdis.biomedcentral.com/counter/pdf/10.1186/1471-2334-10-180","pdfUrl":"https://bmcinfectdis.biomedcentral.com/counter/pdf/10.1186/1471-2334-10-180","topics":[{"id":"T10486","name":"Salmonella and Campylobacter epidemiology","score":0.975600004196167,"subfieldId":"1106","subfield":"Food Science","fieldId":"11","field":"Agricultural and Biological Sciences"},{"id":"T12167","name":"Bacterial Identification and Susceptibility Testing","score":0.020800000056624413,"subfieldId":"1308","subfield":"Clinical Biochemistry","fieldId":"13","field":"Biochemistry, Genetics and Molecular Biology"},{"id":"T10873","name":"Bacterial Infections and Vaccines","score":0.0015999999595806003,"subfieldId":"2404","subfield":"Microbiology","fieldId":"24","field":"Immunology and Microbiology"}],"sources":["openalex"],"id":"openalex:W2138887417"},{"ids":{"openalex":"W2101101987","doi":"10.4161/hv.4.2.5122","pmid":"18414029"},"title":"Cholera vaccines for the developing world","abstract":"Cholera remains as a global public health threat affecting most of the developing world. In endemic areas, young children are most affected. Outbreaks are reported increasingly from more countries. Improvements in water and sanitation may be the mainstays of cholera prevention but in the short term, vaccines provide an alternative in cholera control. Since 1999, the World Health Organization has advocated the use of oral cholera vaccines as an adjunct in the control of cholera. Although internationally available, oral cholera vaccines are not extensively used in public health settings in developing countries where they are most needed. We review oral cholera vaccines that are currently available and in the pipeline including the need for policies that will ensure more extensive usage of these vaccines.","authors":[{"name":"Anna Lena Lopez","id":"openalex:A5004233631","orcid":"https://orcid.org/0000-0003-0013-620X","affiliation":"International Vaccine Institute","institutionId":"I1309827724","institutionUrl":"https://ror.org/02yfanq70","affiliations":["International Vaccine Institute, Seoul, Korea. anlopez@ivi.int"]},{"name":"John David Clemens","id":"openalex:A5101679953","orcid":"https://orcid.org/0009-0005-3763-6074"},{"name":"Jacqueline L. 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