{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:26:31Z","timestamp":1788780391482,"version":"build-2803163510"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Oral cholera vaccine (OCV) and incremental improvements in household water, sanitation, and hygiene (WASH) within cholera-endemic areas can reduce cholera risk. However, we lack empiric evaluation of their combined impact.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We evaluated a cluster-randomized, placebo-controlled trial of OCV (Shanchol) in Kolkata, India. The study population included 108 777 individuals, and 106 879 nonpregnant individuals &amp;gt;1 year of age were eligible to receive 2 doses of OCV or placebo. We measured cholera risk in all household members assigned to OCV vs placebo and in all members of households with \u201cBetter\u201d vs \u201cNot Better\u201d WASH, where WASH was classified according to validated criteria. Protection was measured by Cox proportional hazard models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Residence in an OCV household was associated with protective effectiveness (PE) of 54% (95% CI, 42%\u201364%; P &amp;lt; .001) and was similar regardless of Better (PE, 57%; 95% CI, 26%\u201375%; P = .002) or Not Better (PE, 53%; 95% CI, 40%\u201364%; P &amp;lt; .001) household WASH. Better WASH household residence was associated with PE of 30% (95% CI, 5%\u201348%; P = .023) and was similar in OCV (PE, 24%; 95% CI, \u221226% to 54%; P = .293) and placebo (PE, 29%; 95% CI, \u22123% to 51%; P = .069) households. When assessed conjointly, residence in OCV households with Better WASH was associated with the greatest PE against cholera at 69% (95% CI, 49%\u201381%; P &amp;lt; .001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These findings suggest that the combination of a vaccine policy and improved WASH reduces cholera risk more than either would alone, although the magnitude of either intervention was not affected by the other. Future randomized trials investigating OCV and WASH interventions separately and together are recommended to further understand the interaction between OCV and WASH.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofad701","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T23:18:23Z","timestamp":1704928703000},"source":"Crossref","is-referenced-by-count":6,"title":["Do Oral Cholera Vaccine and Water, Sanitation, and Hygiene Combine to Provide Greater Protection Against Cholera? Results From a Cluster-Randomized Trial of Oral Cholera Vaccine in Kolkata, India"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3762-084X","authenticated-orcid":false,"given":"Justin","family":"Im","sequence":"first","affiliation":[{"name":"International Vaccine Institute , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Taufiqul","family":"Islam","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal","family":"Ahmmed","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deok Ryun","family":"Kim","sequence":"additional","affiliation":[{"name":"International Vaccine Institute , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birkneh Tilahun","family":"Tadesse","sequence":"additional","affiliation":[{"name":"International Vaccine Institute , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Kang","sequence":"additional","affiliation":[{"name":"International Vaccine Institute , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4158-5995","authenticated-orcid":false,"given":"Farhana","family":"Khanam","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahima","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasnuva","family":"Ahmed","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Golam","family":"Firoj","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0203-5744","authenticated-orcid":false,"given":"Asma Binte","family":"Aziz","sequence":"additional","affiliation":[{"name":"International Vaccine Institute , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masuma","family":"Hoque","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyon Jin","family":"Jeon","sequence":"additional","affiliation":[{"name":"International Vaccine Institute , Seoul , Republic of Korea"},{"name":"Cambridge Institute of Therapeutic Immunology and Infectious Disease, School of Clinical Medicine, University of Cambridge , Cambridge , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suman","family":"Kanungo","sequence":"additional","affiliation":[{"name":"ICMR\u2013National Institute of Cholera and Enteric Diseases , Kolkata , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanta","family":"Dutta","sequence":"additional","affiliation":[{"name":"ICMR\u2013National Institute of Cholera and Enteric Diseases , Kolkata , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalequ","family":"Zaman","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraful Islam","family":"Khan","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6043-7170","authenticated-orcid":false,"given":"Florian","family":"Marks","sequence":"additional","affiliation":[{"name":"International Vaccine Institute , Seoul , Republic of Korea"},{"name":"Cambridge Institute of Therapeutic Immunology and Infectious Disease, School of Clinical Medicine, University of Cambridge , Cambridge , UK"},{"name":"Madagascar Institute for Vaccine Research, University of Antananarivo , Antananarivo , Madagascar"},{"name":"Heidelberg Institute of Global Health, University of Heidelberg , Heidelberg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome H","family":"Kim","sequence":"additional","affiliation":[{"name":"International Vaccine Institute , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firdausi","family":"Qadri","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D","family":"Clemens","sequence":"additional","affiliation":[{"name":"International Vaccine Institute , Seoul , Republic of Korea"},{"name":"International Centre for Diarrheal Disease Research , Dhaka , Bangladesh"},{"name":"Fielding School of Public Health , University of California\u2013Los Angeles, Los Angeles, California , USA"},{"name":"Vaccine Innovation Center, School of Medicine, Korea University , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,10]]},"reference":[{"key":"2024020218181902300_ofad701-B1","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1016\/S1473-3099(13)70273-1","article-title":"5 Year efficacy of a bivalent killed whole-cell oral cholera vaccine in Kolkata, India: a cluster-randomised, double-blind, placebo-controlled trial","volume":"13","author":"Bhattacharya","year":"2013","journal-title":"Lancet Infect Dis"},{"key":"2024020218181902300_ofad701-B2","doi-asserted-by":"crossref","first-page":"S137","DOI":"10.1093\/infdis\/jiy486","article-title":"Global cholera epidemiology: opportunities to reduce the burden of cholera by 2030","volume":"218","author":"Legros","year":"2018","journal-title":"J Infect Dis"},{"key":"2024020218181902300_ofad701-B3","doi-asserted-by":"crossref","first-page":"ofad535","DOI":"10.1093\/ofid\/ofad535","article-title":"Better existing water, sanitation, 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