Journal Article > ResearchFull Text
Vaccine: X. 1 October 2024; Volume 20; 100555.; DOI:10.1016/j.jvacx.2024.100555
Briskin E, Bateyi Mustafa SH, Mahamba R, Kabunga D, Kubuya J, et al.
Vaccine: X. 1 October 2024; Volume 20; 100555.; DOI:10.1016/j.jvacx.2024.100555
BACKGROUND
In 2019–2020, preventative Oral Cholera Vaccine campaigns were conducted in 24/32 non-contiguous health areas of Goma, DR Congo. In August 2022, we measured coverage and factors potentially influencing success of the delivery strategy.
METHODS
We used random geo-sampled stratified cluster survey to estimate OCV coverage and assess population movement, diarrhea history, and reasons for non-vaccination.
RESULTS
603 households were visited. Coverage with at least one dose was 46.4 % (95 %CI: 41.8–51.0), and 50.1 % (95 %CI: 45.4–54.8) in areas targeted by vaccination compared to 26.3 % (95 %CI: 19.2–34.9) in non-targeted areas. Additionally, 7.0 % of participants reported moving from outside Goma since 2019, and 5.4 % reported history of severe diarrhea. Absence and unawareness were the main reasons for non-vaccination.
CONCLUSION
Results suggest that targeting non-contiguous urban areas had a coverage-diluting effect. Targeting entire geographically contiguous areas, adapted distribution, and regular catch-up campaigns are operational recommendations to reach higher coverages arising from the study.
Conference Material > Poster
Broban A, Meakin S, Mukadi D, Mahamba R, Roederer T, et al.
Epicentre Scientific Day 2024. 23 May 2024
Conference Material > Poster
Moser W, Broban A, Welo PO, Mukadi D, Gerstl S, et al.
Epicentre Scientific Day 2024. 23 May 2024
Journal Article > ResearchFull Text
Viruses. 8 August 2023; Volume 15 (Issue 8); 1707.; DOI: 10.3390/v15081707
Broban A, Olive MM, Tantely ML, Dorsemans AC, Rakotomanana F, et al.
Viruses. 8 August 2023; Volume 15 (Issue 8); 1707.; DOI: 10.3390/v15081707
Arboviruses have been shown to circulate in Madagascar, including West Nile, dengue, and chikungunya viruses, though the extent of their circulation remains poorly documented. We estimated the seroprevalence of these three arboviruses in Madagascar and determined risk factors associated with seropositivity. Serum samples obtained from 1680 individuals surrounding the Sentinel Health Centers network in all regions of the country were analyzed using ELISA and hemagglutination inhibition assays for dengue, chikungunya, and West Nile viruses IgG antibodies, and multivariate logistic regression models were run. Overall, 6.5% [IC 95% 3.2–9.9] were seropositive for dengue virus, predominantly of Dengue serotype 1, 13.7% [IC 95% 6.5–20.9] for chikungunya virus, and 12.7% [IC 95% 9.0–16.5] for West Nile virus. There was no association with age, showing that dengue and chikungunya viruses were likely recently introduced. Eastern and Northern parts were more affected by dengue and chikungunya viruses, while West Nile virus seemed to circulate in all parts of the country. Dengue and chikungunya seropositivity were notably associated with high levels of vegetation, as well as frequent work in the forest, and West Nile seropositivity with the presence of cultivated areas, as well as standard of living. This analysis gives a new insight into arboviruses circulation and transmission patterns in Madagascar.
Conference Material > Video
Broban A
Epicentre Scientific Day Paris 2023. 8 June 2023
English
Français
Conference Material > Abstract
Broban A
Epicentre Scientific Day Paris 2023. 8 June 2023
CONTEXT
In the context of cholera resurgence, the Oral Cholera Vaccine (OCV) constitutes an important control strategy, including in endemic areas. Preventive OCV campaigns are now increasingly used; cholera transmission and the impact of OCV in such zones need to be better understood.
METHODS
This is a multi-study project underway in two sites in the Democratic Republic of the Congo: Goma (urban) and Bukama (rural). The project includes data collection at the suspect patient level (clinical surveillance), community level (vaccination coverage surveys and serial seroprevalence surveys), and household level (follow-up over time of positive patients and their household members). Preliminary clinical surveillance and vaccination coverage results are presented, as data collection is still ongoing.
RESULTS
In Goma, vaccine coverage two years after last vaccination is lower than expected at 49.5% in the targeted zones. Over 8000 suspect cases were included in clinical surveillance in Goma, with cases reported across most of the city. In Bukama, high levels of vaccination coverage were reported through a community approach survey, with most areas reporting 80 to 90% coverage. Close to 1000 cases were reported, and while an epidemic was ongoing at the time of vaccination, notification levels have remained low and stable ever since. In Goma, drinking surface or tank-delivered water appeared to be a risk factor for cholera infection, while in Bukama, the associated risk was the public distribution system
CONCLUSION
The study sites present different pictures in terms of their OCV campaigns as well as their cholera surveillance profile and transmission. Preliminary results offer elements to guide the implementation of vaccination campaigns. In Goma, for instance, patchy vaccination targets and population movements may have diluted coverage. Early findings illustrate risk factors for cholera transmission, providing operational insights to enhance control strategies. Future results will incorporate other types of data and help design efficient vaccination strategies.
KEY MESSAGE
This project aims to evaluate cholera transmission and the impact of OCV in endemic zones. Preliminary results offer elements to guide cholera control and vaccination strategies.
This abstract is not to be quoted for publication.
In the context of cholera resurgence, the Oral Cholera Vaccine (OCV) constitutes an important control strategy, including in endemic areas. Preventive OCV campaigns are now increasingly used; cholera transmission and the impact of OCV in such zones need to be better understood.
METHODS
This is a multi-study project underway in two sites in the Democratic Republic of the Congo: Goma (urban) and Bukama (rural). The project includes data collection at the suspect patient level (clinical surveillance), community level (vaccination coverage surveys and serial seroprevalence surveys), and household level (follow-up over time of positive patients and their household members). Preliminary clinical surveillance and vaccination coverage results are presented, as data collection is still ongoing.
RESULTS
In Goma, vaccine coverage two years after last vaccination is lower than expected at 49.5% in the targeted zones. Over 8000 suspect cases were included in clinical surveillance in Goma, with cases reported across most of the city. In Bukama, high levels of vaccination coverage were reported through a community approach survey, with most areas reporting 80 to 90% coverage. Close to 1000 cases were reported, and while an epidemic was ongoing at the time of vaccination, notification levels have remained low and stable ever since. In Goma, drinking surface or tank-delivered water appeared to be a risk factor for cholera infection, while in Bukama, the associated risk was the public distribution system
CONCLUSION
The study sites present different pictures in terms of their OCV campaigns as well as their cholera surveillance profile and transmission. Preliminary results offer elements to guide the implementation of vaccination campaigns. In Goma, for instance, patchy vaccination targets and population movements may have diluted coverage. Early findings illustrate risk factors for cholera transmission, providing operational insights to enhance control strategies. Future results will incorporate other types of data and help design efficient vaccination strategies.
KEY MESSAGE
This project aims to evaluate cholera transmission and the impact of OCV in endemic zones. Preliminary results offer elements to guide cholera control and vaccination strategies.
This abstract is not to be quoted for publication.
Conference Material > Video
Broban A
Epicentre Scientific Day Paris 2021. 4 August 2021
Conference Material > Abstract
Broban A
Epicentre Scientific Day Paris 2021. 10 June 2021
Data on patient’s profiles and characteristics in MSF were gathered from intersectional initiative to standardize data collection. The profile of MSF patients is globally consistent with other observations worldwide, though it varies across contexts and regions.
BACKGROUND
As of 26th of May, about 167 million COVID-19 cases and over 3.5 million deaths were reported worldwide. MSF did intervene with COVID19 projects in multiple countries with humanitarian contexts.
METHODS
Intersectional linelisting initiative to standardize data collection was led by Epicentre, information was gathered from different data sources and analyzed weekly. Patient’s profiles and characteristics in MSF were analyzed using individual data related to suspect, probable and confirmed cases, gathered for all operational centers.
FINDINGS
Within MSF, 150 sites reported data, representing all OCs and 40 countries. Over 78,000 patients were recorded, including over 11,000 confirmed. The number of patients recorded in MSF interventions have reached peaks in two distinct periods, during June/July 2020 and April 2021. MSF COVID-19 patients were relatively young (median age 32 years), being older in Americas, Europe and Middle-East. Over 19% of patients presented with at least one other condition, with higher proportion of patients reporting comorbidities like diabetes or hypertension in Middle-East and Europe, and more co-infections reported in Africa. About 20% of these patients were hospitalized, 14% being critical and 27% severe. Overall, the CFR was 19% and varied across continents.
CONCLUSION
The profile of MSF patients is globally consistent with other observations worldwide. It however varies across contexts and regions. The data collection system set up in MSF allows to monitor interventions and characteristics of patients. Nevertheless, more detailed analysis are needed at project or country level in order to best understand a specific context.
This abstract is not to be quoted for publication.
BACKGROUND
As of 26th of May, about 167 million COVID-19 cases and over 3.5 million deaths were reported worldwide. MSF did intervene with COVID19 projects in multiple countries with humanitarian contexts.
METHODS
Intersectional linelisting initiative to standardize data collection was led by Epicentre, information was gathered from different data sources and analyzed weekly. Patient’s profiles and characteristics in MSF were analyzed using individual data related to suspect, probable and confirmed cases, gathered for all operational centers.
FINDINGS
Within MSF, 150 sites reported data, representing all OCs and 40 countries. Over 78,000 patients were recorded, including over 11,000 confirmed. The number of patients recorded in MSF interventions have reached peaks in two distinct periods, during June/July 2020 and April 2021. MSF COVID-19 patients were relatively young (median age 32 years), being older in Americas, Europe and Middle-East. Over 19% of patients presented with at least one other condition, with higher proportion of patients reporting comorbidities like diabetes or hypertension in Middle-East and Europe, and more co-infections reported in Africa. About 20% of these patients were hospitalized, 14% being critical and 27% severe. Overall, the CFR was 19% and varied across continents.
CONCLUSION
The profile of MSF patients is globally consistent with other observations worldwide. It however varies across contexts and regions. The data collection system set up in MSF allows to monitor interventions and characteristics of patients. Nevertheless, more detailed analysis are needed at project or country level in order to best understand a specific context.
This abstract is not to be quoted for publication.
Conference Material > Video
Broban A
Epicentre Scientific Day Paris 2020. 24 September 2020
Journal Article > ResearchFull Text
PLOS One. 4 August 2020; Volume 15 (Issue 8); e0237060.; DOI:10.1371/journal.pone.0237060
Broban A, Van der Bergh R, Russell W, Benedetti G, Caluwaerts A, et al.
PLOS One. 4 August 2020; Volume 15 (Issue 8); e0237060.; DOI:10.1371/journal.pone.0237060
BACKGROUND
Often neglected, male-directed sexual violence (SV) has recently gained recognition as a significant issue. However, documentation of male SV patients, assaults and characteristics of presentation for care remains poor. Médecins Sans Frontières (MSF) systematically documented these in all victims admitted to eleven SV clinics in seven African countries between 2011 and 2017, providing a unique opportunity to describe SV patterns in male cases compared to females, according to age categories and contexts, thereby improving their access to SV care.
METHODS AND FINIDNGS
This was a multi-centric, cross-sectional study using routine program data. The study included 13550 SV cases, including 1009 males (7.5%). Proportions of males varied between programs and contexts, with the highest being recorded in migratory contexts (12.7%). Children (<13yrs) represented 34.3% of males. Different SV patterns appeared between younger and older males; while male children and adolescents were more often assaulted by known civilians, without physical violence, adult males more often endured violent assault, perpetrated by authority figures. Male patients presented more frequently to clinics providing integrated care (medical and psychological) for victims of violence (odds ratio 3.3, 95%CI 2.4-4.6), as compared to other types of clinics where SV disclosure upon admission was necessary. Males, particularly adults, were disproportionately more likely to suffer being compelled to rape (odds ratio 12.9, 95%CI 7.6-21.8).Retention in SV care was similar for males and females.
CONCLUSIONS
Patterns of male-directed SV varied considerably according to contexts and age categories. A key finding was the importance of the clinic setup; integrated medical and SV clinics, where initial disclosure was not necessary to access care, appeared more likely to meet males' needs, while accommodating females' ones. All victims' needs should be considered when planning SV services, with an emphasis on appropriately trained and trauma-informed medical staff, health promotion activities and increased psychosocial support.
Often neglected, male-directed sexual violence (SV) has recently gained recognition as a significant issue. However, documentation of male SV patients, assaults and characteristics of presentation for care remains poor. Médecins Sans Frontières (MSF) systematically documented these in all victims admitted to eleven SV clinics in seven African countries between 2011 and 2017, providing a unique opportunity to describe SV patterns in male cases compared to females, according to age categories and contexts, thereby improving their access to SV care.
METHODS AND FINIDNGS
This was a multi-centric, cross-sectional study using routine program data. The study included 13550 SV cases, including 1009 males (7.5%). Proportions of males varied between programs and contexts, with the highest being recorded in migratory contexts (12.7%). Children (<13yrs) represented 34.3% of males. Different SV patterns appeared between younger and older males; while male children and adolescents were more often assaulted by known civilians, without physical violence, adult males more often endured violent assault, perpetrated by authority figures. Male patients presented more frequently to clinics providing integrated care (medical and psychological) for victims of violence (odds ratio 3.3, 95%CI 2.4-4.6), as compared to other types of clinics where SV disclosure upon admission was necessary. Males, particularly adults, were disproportionately more likely to suffer being compelled to rape (odds ratio 12.9, 95%CI 7.6-21.8).Retention in SV care was similar for males and females.
CONCLUSIONS
Patterns of male-directed SV varied considerably according to contexts and age categories. A key finding was the importance of the clinic setup; integrated medical and SV clinics, where initial disclosure was not necessary to access care, appeared more likely to meet males' needs, while accommodating females' ones. All victims' needs should be considered when planning SV services, with an emphasis on appropriately trained and trauma-informed medical staff, health promotion activities and increased psychosocial support.