Socio-cultural determinants of anticipated acceptance of an oral cholera vaccine in Western Kenya.

Determinants of anticipated acceptance of an oral cholera vaccine (OCV) were studied in urban and rural communities of Western Kenya. An explanatory model interview administered to 379 community residents assessed anticipated vaccine acceptance at various prices from no cost to full-cost recovery, socio-cultural features of cholera and social characteristics. Nearly all (99%) residents indicated willingness to accept a no-cost OCV, 95% at a price of US$ 0·8, 73% at US$ 4·2 and 59% at US$ 8·4. Logistic regression models analysed socio-cultural determinants of anticipated OCV acceptance. Prominence of non-specific symptoms for cholera was negatively associated with acceptance. A cholera-specific symptom (thirst), self-help referring to prayer, income and education were positively associated. In the high-cost model, education was no longer significant and reliance on herbal treatment was a significant determinant of vaccine non-acceptance. Findings suggest high motivation for OCVs, if affordable. Socio-cultural determinants are better predictors of anticipated acceptance than socio-demographic factors alone.

[Anticholera vaccines and vaccination]. / Vaccins et vaccination anticholériques.

Cholera is still an important diarrhoeal disease in developing countries. The impact of cholera out-break is tremendous for a country at human and economic level. WHO estimates that diarrhoeal diseases cause about 2.8 million deaths per year in developing countries. Officially, cholera is causing around 120,000 deaths per year. The poorest population (from slums and refugee camps) are the most vulnerable target for cholera infection. Development of simple cheap and effective vaccine is highly recommended. This article aims at giving an update on the currently available and future vaccines for the prevention of diarrhoea due to Vibrio cholerae O1 and O139.

[Cholera update at the dawn of the millenium]. / Actualités du choléra a l'aube du millénaire.

Cholera is an ancestral disease belonging to the mythology of numerous societies. In the last two centuries, seven pandemias have been recorded, in which the spatial and temporal modalities of disease transmission are related to the major technical revolutions of the period. The now ongoing seventh pandemia is by far the longest and most widespread with specific features that raise new challenges and hopes. The authors present the situation at the dawn of the third millennium based on a review of current epidemiological, clinical, therapeutic, diagnostic and vaccinal data. This update shows that the field is progressing and may indeed be standing on the verge of significant breakthroughs for management of the disease and vibrion endemicity.

Safety and immunogenicity of a genetically engineered human immunodeficiency virus vaccine.

A phase 1 trial of a candidate human immunodeficiency virus type 1 (HIV-1) vaccine was done in 25 healthy seronegative subjects. The antigen, env2-3 (SF2), was a nonglycosylated polypeptide representing the gp120 region of the env gene of the HIV-1(SF2) isolate. It was produced in genetically engineered yeast as a denatured molecule incapable of binding CD4. A synthetic lipophilic muramyl tripeptide (MTP-PE) was used as an adjuvant. Ten subjects received adjuvant alone and 15 received 50- or 250-micrograms doses of env2-3 (SF2) administered intramuscularly in two immunization regimens. In general, adjuvant and vaccine were well tolerated. Antibody responses to both the homologous antigen, env2-3 (SF2), and antigens from other highly divergent HIV isolates were elicited in the majority of vaccine recipients. However, antibody titers were low, without neutralizing activity. In 9 of 11 subjects who received the complete vaccine immunization series, a significant specific T lymphocyte response was observed.