{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T11:06:01Z","timestamp":1779793561873,"version":"3.53.1"},"reference-count":89,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"unspecified","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,3,30]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In 2023, cholera caused over 95\u2009000 deaths globally, predominantly in low-income and conflict settings, and contributed to the wasting, stunting and malnutrition of millions in countries where the disease is endemic. Moreover, the frequency and magnitude of cholera outbreaks are rising. As a result, the demand for outbreak control interventions is quickly outpacing existing resources. Oral cholera vaccination (OCV) is one intervention among many used to limit further transmission. Since 2022, one-dose OCV (OCV1) has replaced the standard two-dose OCV due to limited global supply. However, only a handful of on-the-ground surveys of OCV1 effectiveness presently exist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to assess the transmission of cholera in outbreak settings using digital public health approaches and quantify OCV1 effectiveness in complement to on-the-ground surveys.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Using Haiti and Cameroon as natural case studies representing two disparate geographical and sociodemographic contexts, we employed computational digitisation techniques to extract weekly case counts from non\u2013machine-readable images of outbreak epidemic curves. We then leveraged the R package\n                      <jats:italic>EpiEstim<\/jats:italic>\n                      to derive estimates of the effective reproduction number (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sub>t<\/jats:sub>\n                      ). To assess OCV1 effectiveness in the two considered countries, we applied\n                      <jats:italic>VaxEstim<\/jats:italic>\n                      , an extension of\n                      <jats:italic>EpiEstim<\/jats:italic>\n                      requiring three inputs: the basic reproduction number (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sub>0<\/jats:sub>\n                      ),\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sub>t,<\/jats:sub>\n                      and vaccine coverage. Notably, our work provides the first known real-world application of\n                      <jats:italic>VaxEstim<\/jats:italic>\n                      in low-resource settings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Early in either outbreak, weekly estimates of\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sub>t<\/jats:sub>\n                      were elevated (Haiti, 2.60 (95% credible interval (CrI) 2.42 to 2.79); Cameroon, 1.90 (95% CrI 1.14 to 2.95)). Thereafter,\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sub>t<\/jats:sub>\n                      estimates oscillated around the critical threshold of 1 in both settings. Haiti exhibited marginally higher OCV1 effectiveness than Cameroon (75.3% (95% CrI 54.0 to 86.4%)\u2009versus 54.9% (95% CrI 18.9 to 84.9%)).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This study underscores the value of combining digitised case data with computational techniques and the utility of\n                      <jats:italic>VaxEstim<\/jats:italic>\n                      for rapid, inexpensive estimation of vaccine effectiveness in data-poor outbreak settings.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-113520","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T09:05:19Z","timestamp":1779786319000},"page":"e113520","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Estimating time-varying cholera transmission and oral cholera vaccine effectiveness in Haiti and Cameroon, 2021\u22122023"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0525-1856","authenticated-orcid":false,"given":"Erin N","family":"Hulland","sequence":"first","affiliation":[{"name":"Computational Health Informatics Program, Boston Children\u2019s Hospital & Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Comp Epi Dispersed Volunteer Research Network, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5786-2627","authenticated-orcid":false,"given":"Marie-Laure","family":"Charpignon","sequence":"additional","affiliation":[{"name":"Computational Health Informatics Program, Boston Children\u2019s Hospital & Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Comp Epi Dispersed Volunteer Research Network, Boston, Massachusetts, USA"},{"name":"Division of Research, Kaiser Permanente Northern California, Pleasanton, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghinwa Y","family":"Hayek","sequence":"additional","affiliation":[{"name":"Comp Epi Dispersed Volunteer Research Network, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5985-0614","authenticated-orcid":false,"given":"Lihong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Comp Epi Dispersed Volunteer Research Network, Boston, Massachusetts, USA"},{"name":"Department of Mathematics, Kennesaw State University, Marietta, Georgia, USA"},{"name":"Department of Mathematics, Virginia Tech, Blacksburg, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary","family":"Martoma","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Division of Pediatrics, Boston Children\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"KidsMates Inc, Boca Raton, Florida, USA"},{"name":"Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel N","family":"Desai","sequence":"additional","affiliation":[{"name":"Comp Epi Dispersed Volunteer Research Network, Boston, Massachusetts, USA"},{"name":"Department of Internal Medicine, Division of Infectious Diseases, Davis Health Medical Center, University of California Davis, Sacramento, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maimuna S","family":"Majumder","sequence":"additional","affiliation":[{"name":"Computational Health Informatics Program, Boston Children\u2019s Hospital & Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Comp Epi Dispersed Volunteer Research Network, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"2026052603465582000_16.5.e113520.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60436-X"},{"key":"2026052603465582000_16.5.e113520.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0003832","article-title":"Updated global burden of cholera in endemic countries","volume":"9","author":"Ali","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"key":"2026052603465582000_16.5.e113520.3","unstructured":"World Health Organization . 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Multi-country outbreak of cholera, external situation report #3. 2023. 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PAHO; 2023."},{"key":"2026052603465582000_16.5.e113520.56","doi-asserted-by":"crossref","unstructured":"Pick JL , Nakagawa S , Noble DWA . Reproducible, flexible and high throughput data extraction from primary literature: the metadigitise R package. 2018. doi:10.1101\/247775","DOI":"10.1101\/247775"},{"key":"2026052603465582000_16.5.e113520.57","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pcbi.1011439","article-title":"Estimating the epidemic reproduction number from temporally aggregated incidence data: A statistical modelling approach and software tool","volume":"19","author":"Nash","year":"2023","journal-title":"PLoS Comput Biol"},{"key":"2026052603465582000_16.5.e113520.58","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1001\/jamapediatrics.2015.0384","article-title":"Substandard vaccination compliance and the 2015 measles outbreak","volume":"169","author":"Majumder","year":"2015","journal-title":"JAMA Pediatr"},{"key":"2026052603465582000_16.5.e113520.59","article-title":"Modeling vaccination coverage during the 2022 central Ohio measles outbreak: a cross-sectional study","volume":"23","author":"Martoma","year":"2023","journal-title":"Lancet Reg Health Am"},{"key":"2026052603465582000_16.5.e113520.60","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/S1473-3099(25)00254-3","article-title":"Underimmunisation during the 2025 Texas measles outbreak","volume":"25","author":"Hulland","year":"2025","journal-title":"Lancet Infect Dis"},{"key":"2026052603465582000_16.5.e113520.61","unstructured":"R Core Team . R: a language and environment for statistical computing. 2023."},{"key":"2026052603465582000_16.5.e113520.62","doi-asserted-by":"crossref","unstructured":"Wickham H . ggplot2: elegant graphics for data analysis. 2016.","DOI":"10.1007\/978-3-319-24277-4_9"},{"key":"2026052603465582000_16.5.e113520.63","unstructured":"United nations . Department of economic and social affairs, population division. 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Available: https:\/\/www.mspp.gouv.ht\/sites\/default\/files\/2025-12\/SITREP%20CHOLERA%20jusqu%C3%A0%20la%2036%C3%A8me%20SE%202025.pdf"},{"key":"2026052603465582000_16.5.e113520.83","unstructured":"Centre for Health Protection . Department of health. Acute Diarrhoeal Diseases; 2025. Available: https:\/\/www.chp.gov.hk\/en\/healthtopics\/content\/24\/10.html"},{"key":"2026052603465582000_16.5.e113520.84","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.18.3.465-483.2005"},{"key":"2026052603465582000_16.5.e113520.85","doi-asserted-by":"crossref","first-page":"A13","DOI":"10.1016\/j.vaccine.2019.07.036","article-title":"Cholera surveillance and estimation of burden of cholera","volume":"38","author":"Ganesan","year":"2020","journal-title":"Vaccine (Auckl)"},{"key":"2026052603465582000_16.5.e113520.86","unstructured":"ReliefWeb . Haiti: severe climatic events - flash update # 1 (5 june 2023) - haiti. 2023. 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