1. Prevention of Typhoid by Vi Conjugate Vaccine and Achievable Improvements in Household Water, Sanitation, and Hygiene: Evidence From a Cluster-Randomized Trial in Dhaka, Bangladesh
- Author
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Tadesse, Birkneh Tilahun, Khanam, Farhana, Ahmmed, Faisal, Im, Justin, Islam, Md Taufiqul, Kim, Deok Ryun, Kang, Sophie SY, Liu, Xinxue, Chowdhury, Fahima, Ahmed, Tasnuva, Binte Aziz, Asma, Hoque, Masuma, Park, Juyeon, Pak, Gideok, Zaman, Khalequ, Khan, Ashraful Islam, Pollard, Andrew J, Kim, Jerome H, Marks, Florian, Qadri, Firdausi, Clemens, John D, Tadesse, Birkneh Tilahun [0000-0003-4005-8605], and Apollo - University of Cambridge Repository
- Subjects
Microbiology (medical) ,Bangladesh ,Vaccines, Conjugate ,vaccine effectiveness ,Typhoid-Paratyphoid Vaccines ,Water ,Hygiene ,WASH ,Infectious Diseases ,Humans ,typhoid conjugate vaccine ,Typhoid Fever ,Sanitation ,Child - Abstract
Background Typhoid fever contributes to approximately 135 000 deaths annually. Achievable improvements in household water, sanitation, and hygiene (WASH) combined with vaccination using typhoid conjugate vaccines (TCVs) may be an effective preventive strategy. However, little is known about how improved WASH and vaccination interact to lower the risk of typhoid. Methods A total of 61 654 urban Bangladeshi children aged 9 months to Results The adjusted reduced risk of typhoid among all residents living in the clusters assigned to TCV was 55% (95% confidence interval [CI], 43%–65%; P < .001), and that of living in Better WASH households, regardless of cluster, was 37% (95% CI, 24%–48%; P < .001). The highest risk of typhoid was observed in persons living in households with Not Better WASH in the JE clusters. In comparison with these persons, those living in households with Better WASH in the TCV clusters had an adjusted reduced risk of 71% (95% CI, 59%–80%; P < .001). Conclusions Implementation of TCV programs combined with achievable and culturally acceptable household WASH practices were independently associated with a significant reduction in typhoid risk. Clinical Trials Registration ISRCTN11643110.
- Published
- 2022