Real-world Effectiveness of Oral Cholera Vaccines in Preventing Cholera in Mozambique - REOP

Cholera, a poverty-related disease, is associated with significant mortality and morbidity in lower- and middle-income countries. Climate change events contribute to the occurrence of cholera outbreaks in countries like Mozambique. Safe and effective oral cholera vaccines (OCV) are available, however, scarcity of real-world vaccine effectiveness data hampered uptake of these vaccines by national stakeholders. Evidence on the value of OCVs and contemporaneous updating of cholera hotspots offer actionable data for policymakers in the targeted roll out of OCVs. In this proposal, two key objectives will be addressed: 1) update the already existing cholera hotspots maps defined 2017-2021; and 2) real-world effectiveness of OCVs in preventing cholera outbreaks. These objectives will be evaluated as part of three planned cholera vaccination campaigns by the Ministry of Health of Mozambique from 2024 to 2025. Enhanced cholera surveillance with laboratory confirmation will be employed at sentinel sites in three provinces. The existing integrated community engagement and disease detection systems will be strengthened. Outcomes of this study will have critical value in informing countries on the impact of OCV in preventing and controlling cholera outbreaks. Key words: Cholera hotspots, Oral cholera vaccine, Vaccine effectiveness.