The impact and cost-effectiveness of controlling cholera through the use of oral cholera vaccines in urban Bangladesh: A disease modeling and economic analysis

摘要

Author summary While oral cholera vaccines are increasingly being used in the past few years, mainly to curtail or preempt cholera outbreaks, they have yet to be used on a large scale to control endemic cholera in a high-burden country like Bangladesh. This study examines the potential impact on disease and value of vaccinating slum dwellers in Dhaka (and by extension in other cities), who are among those at highest-risk of getting the disease. This analysis suggests that, despite the modest efficacy and limited duration of protection of existing vaccines, mass cholera vaccination can have a significant impact on reducing cholera incidence in the entire population-including those not vaccinated-as a result of herd effects-and can be a cost-effective means of controlling the disease, especially until more long-term measures, such as improved water and sanitation infrastructure, are put in place. These results should assist policymakers and potential donors in determining whether and how to use these vaccines in Bangladesh to control the disease amongst its most vulnerable populations.