title: Cholera vaccination campaign contributes to improved knowledge regarding cholera and improved practice relevant to waterborne disease in rural Haiti.
abstract: BACKGROUND
  Haiti's cholera epidemic has been devastating partly due to underlying weak infrastructure and limited clean water and sanitation. A comprehensive approach to cholera control is crucial, yet some have argued that oral cholera vaccination (OCV) might result in reduced hygiene practice among recipients. We evaluated the impact of an OCV campaign on knowledge and health practice in rural Haiti.
  
  
  RESULTS
  We administered baseline surveys on knowledge and practice relevant to cholera and waterborne disease to every 10th household during a census in rural Haiti in February 2012 (N = 811). An OCV campaign occurred from May-June 2012 after which we administered identical surveys to 518 households randomly chosen from the same region in September 2012. We compared responses pre- and post-OCV campaign. Post-vaccination, there was improved knowledge with significant increase in percentage of respondents with ≥ 3 correct responses on cholera transmission mechanisms (odds ratio[OR] 1.91; 95% confidence interval[CI] 1.52-2.40), preventive methods (OR 1.83; 95% CI 1.46-2.30), and water treatment modalities (OR 2.75; 95% CI 2.16-3.50). Relative to pre-vaccination, participants were more likely post-OCV to report always treating water (OR 1.62; 95% CI 1.28-2.05). Respondents were also more likely to report hand washing with soap and water >4 times daily post-vaccine (OR 1.30; 95% CI 1.03-1.64). Knowledge of treating water as a cholera prevention measure was associated with practice of always treating water (OR 1.47; 95% CI 1.14-1.89). Post-vaccination, knowledge was associated with frequent hand washing (OR 2.47; 95% CI 1.35-4.51).
  
  
  CONCLUSIONS
  An OCV campaign in rural Haiti was associated with significant improvement in cholera knowledge and practices related to waterborne disease. OCV can be part of comprehensive cholera control and reinforce, not detract from, other control efforts in Haiti.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.
authors.forename: Omowunmi
authors.initials: O
authors.lastname: Aibana
authors.forename: Molly F
authors.initials: MF
authors.lastname: Franke
authors.forename: Molly
authors.initials: M
authors.lastname: Franke
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Teng
authors.forename: Jessica
authors.initials: J
authors.lastname: Teng
authors.forename: Johanne
authors.initials: J
authors.lastname: Hilaire
authors.forename: Max
authors.initials: M
authors.lastname: Raymond
authors.forename: Louise C
authors.initials: LC
authors.lastname: Ivers
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology* / Q000517:prevention & control*; D022121:Cholera Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D005260:Female; D006205:Haiti / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D014611:Vaccination / Q000379:methods*; D055815:Young Adult
chemical_list: D022121:Cholera Vaccines