Journal Article > ResearchFull Text
Lancet. 18 January 1997; Volume 349 (Issue 9046); DOI:10.1016/S0140-6736(05)60961-0
Boelaert M, Henkens M
Lancet. 18 January 1997; Volume 349 (Issue 9046); DOI:10.1016/S0140-6736(05)60961-0
Journal Article > CommentaryAbstract Only
Science. 12 September 2014; Volume 345 (Issue 6202); 1290-1292.; DOI:10.1126/science.1254164
Ager A, Burnham G, Checchi F, Gayer M, Grais RF, et al.
Science. 12 September 2014; Volume 345 (Issue 6202); 1290-1292.; DOI:10.1126/science.1254164
Given the growing scale and complexity of responses to humanitarian crises, it is important to develop a stronger evidence base for health interventions in such contexts. Humanitarian crises present unique challenges to rigorous and effective research, but there are substantial opportunities for scientific advance. Studies need to focus where the translation of evidence from noncrisis scenarios is not viable and on ethical ways of determining what happens in the absence of an intervention. Robust methodologies suited to crisis settings have to be developed and used to assess interventions with potential for delivery at scale. Strengthening research capacity in the low- to middle-income countries that are vulnerable to crises is also crucial.
Journal Article > ResearchFull Text
Trop Med Int Health. 1 June 1996; Volume 1 (Issue 3); 385-392.; DOI:10.1046/j.1365-3156.1996.d01-49.x
Haelterman E, Boelaert M, Suetens C, Blok L, Henkens M, et al.
Trop Med Int Health. 1 June 1996; Volume 1 (Issue 3); 385-392.; DOI:10.1046/j.1365-3156.1996.d01-49.x
Serogroup A meningococcus epidemics occurred in refugee populations in Zaire in August 1994. The paper analyses the public health impact of a mass vaccination campaign implemented in a large refugee camp. We compared meningitis incidence rates from 2 similar camps. In Kibumba camp, vaccination was implemented early in the course of the epidemic whilst in the control camp (Katale), vaccination was delayed. At a threshold of 15 cases per 100 000 population per week an immunization campaign was implemented. Attack rates were 94 and 134 per 100,000 in Kibumba and Katale respectively over 2 months. In Kibumba, one week after crossing the threshold, 121,588 doses of vaccine were administered covering 76% of all refugees. Vaccination may have prevented 68 cases (30% of the expected cases). Despite its rapid institution and the high coverage achieved, the vaccination campaign had a limited impact on morbidity due to meningitis. In the early phase in refugee camps, the relative priorities of meningitis vaccination and case management need to be better defined.
Journal Article > ResearchFull Text
Lancet. 1 May 2018; Volume 391 (Issue 10133); DOI:10.1016/S0140-6736(17)33050-7
Lessler J, Moore SM, Luquero FJ, McKay H, Grais RF, et al.
Lancet. 1 May 2018; Volume 391 (Issue 10133); DOI:10.1016/S0140-6736(17)33050-7
Cholera remains a persistent health problem in sub-Saharan Africa and worldwide. Cholera can be controlled through appropriate water and sanitation, or by oral cholera vaccination, which provides transient (∼3 years) protection, although vaccine supplies remain scarce. We aimed to map cholera burden in sub-Saharan Africa and assess how geographical targeting could lead to more efficient interventions.
Journal Blog > Perspective
Chua AC, Piriou E, Tran E, de Smet M, Henkens M
2 July 2020
Journal Article > ResearchAbstract Only
Science. 10 November 2017; Volume 358 (Issue 6364); 785-789.; DOI:10.1126/science.aad5901
Weill FX, Domman D, Njamkepo E, Tarr C, Rauzier J, et al.
Science. 10 November 2017; Volume 358 (Issue 6364); 785-789.; DOI:10.1126/science.aad5901
The seventh cholera pandemic has heavily affected Africa, although the origin and continental spread of the disease remain undefined. We used genomic data from 1070 Vibrio cholerae O1 isolates, across 45 African countries and over a 49-year period, to show that past epidemics were attributable to a single expanded lineage. This lineage was introduced at least 11 times since 1970, into two main regions, West Africa and East/Southern Africa, causing epidemics that lasted up to 28 years. The last five introductions into Africa, all from Asia, involved multidrug-resistant sublineages that replaced antibiotic-susceptible sublineages after 2000. This phylogenetic framework describes the periodicity of lineage introduction and the stable routes of cholera spread, which should inform the rational design of control measures for cholera in Africa.
Journal Article > ResearchFull Text
Trop Med Int Health. 8 July 2008; Volume 13 (Issue 8); DOI:10.1111/j.1365-3156.2008.02106.x
Caudron JM, Ford NP, Henkens M, Macé C, Kiddle-Monroe R, et al.
Trop Med Int Health. 8 July 2008; Volume 13 (Issue 8); DOI:10.1111/j.1365-3156.2008.02106.x
The circulation of substandard medicines in the developing world is a serious clinical and public health concern. Problems include under or over concentration of ingredients, contamination, poor quality ingredients, poor stability and inadequate packaging. There are multiple causes. Drugs manufactured for export are not regulated to the same standard as those for domestic use, while regulatory agencies in the less-developed world are poorly equipped to assess and address the problem. A number of recent initiatives have been established to address the problem, most notably the WHO pre-qualification programme. However, much more action is required. Donors should encourage their partners to include more explicit quality requirements in their tender mechanisms, while purchasers should insist that producers and distributors supply drugs that comply with international quality standards. Governments in rich countries should not tolerate the export of substandard pharmaceutical products to poor countries, while developing country governments should improve their ability to detect substandard medicines.
Journal Article > ResearchFull Text
Vaccine. 10 September 2019; Volume 38 Suppl 1; A132-A140.; DOI:10.1016/j.vaccine.2019.08.086
Pezzoli L, Cavailler P, Mengel M, Matzger H, Lorenson T, et al.
Vaccine. 10 September 2019; Volume 38 Suppl 1; A132-A140.; DOI:10.1016/j.vaccine.2019.08.086
Vaccination is a key intervention to prevent and control cholera in conjunction with water, sanitation and hygiene activities. An oral cholera vaccine (OCV) stockpile was established by the World Health Organization (WHO) in 2013. We reviewed its use from July 2013 to all of 2018 in order to assess its role in cholera control. We computed information related to OCV deployments and campaigns conducted including setting, target population, timelines, delivery strategy, reported adverse events, coverage achieved, and costs. In 2013–2018, a total of 83,509,941 OCV doses have been requested by 24 countries, of which 55,409,160 were approved and 36,066,010 eventually shipped in 83 deployments, resulting in 104 vaccination campaigns in 22 countries. OCVs had in general high uptake (mean administrative coverage 1st dose campaign at 90.3%; 2nd dose campaign at 88.2%; mean survey-estimated two-dose coverage at 69.9%, at least one dose at 84.6%) No serious adverse events were reported. Campaigns were organized quickly (five days median duration). In emergency settings, the longest delay was from the occurrence of the emergency to requesting OCV (median: 26 days). The mean cost of administering one dose of vaccine was 2.98 USD. The OCV stockpile is an important public health resource. OCVs were generally well accepted by the population and their use demonstrated to be safe and feasible in all settings. OCV was an inexpensive intervention, although timing was a limiting factor for emergency use. The dynamic created by the establishment of the OCV stockpile has played a role in the increased use of the vaccine by setting in motion a virtuous cycle by which better monitoring and evaluation leads to better campaign organization, better cholera control, and more requests being generated. Further work is needed to improve timeliness of response and contextualize strategies for OCV delivery in the various settings.
Journal Article > LetterFull Text
Lancet. 17 June 1995; Volume 345 (Issue 8964); 1567-1568.
Boelaert M, Suetens C, van Soest M, Henkens M, Rigal J, et al.
Lancet. 17 June 1995; Volume 345 (Issue 8964); 1567-1568.