Table 1.

Site Selection Criteria for OCV Vaccination

Step 1: Study site selection

Cholera hotspots

Cholera case numbers (crude case numbers) Cholera incidence (crude incidence per 100 000 or per 1000) Persistent cases (cholera cases reported persistently during the last 3–5 consecutive years)

Previous exposure to OCV (exclusion criteria)

Areas/population with previous exposure to OCV in the last 3–5 years were excluded or less prioritized

Plan for future OCV introduction and other complementary cholera prevention measures

Multi-year OCV introduction roadmap in NCP was considered to ensure harmonization between various OCV vaccination plans and target areas in the next years Other cholera-preventive measures, such as WaSH intervention, were considered to ensure a comprehensive approach but also to target cholera hotspots with limited WaSH, facing a higher risk of cholera outbreaks

Feasibility

Security and safety context Accessibility to site Non-mobile population Proximity to existing functioning laboratories

Step 2: Subarea selection assumption and algorithm for vaccination

Assumption [25]

In cholera-endemic areas: 30% OCV coverage would result in a 76% (95% CI: 44–95) reduction in cholera incidence for population area covered 50% OCV coverage would result in 89% (95% CI: 72–98) reduction in cholera cases among unvaccinated and 93% (95% CI: 82–99) reduction overall in the entire population

Algorithm to predefine vaccination target population and subareas within sites selected

Estimate 30–50% of the total number of populations living in sites selected (in step 1) Identify subareas (kebelles) within the sites selected that meet the population size of 30–50% of the total population in those selected sites Clearly define vaccination target population and subareas with demarcation of boundaries of selected subareas

Abbreviations: CI, confidence interval; NCP, National Cholera Plan; OCV, oral cholera vaccine; WaSH, water, sanitation, and hygiene.