Lessons learned from the deployment of oral cholera vaccine by maintaining the controlled temperature chain (CTC) in an urban setting, Bangladesh.
The controlled temperature chain (CTC) for oral cholera vaccine deployment allows storage at ambient temperatures for up to 14 days, potentially improving logistics and reducing costs.
Where it sits
this study against the rest of the melanotan i (mt-i) corpusSummary and findings
This study evaluated the experiences of participants using the controlled temperature chain (CTC) for oral cholera vaccine deployment in Dhaka, Bangladesh, compared to the standard cold chain (SCC). It involved six in-depth interviews with volunteers and four key informant interviews with policymakers. The findings indicated operational advantages of the CTC approach over the SCC.
Abstract
Cholera, caused by <i>Vibrio cholerae</i>, remains a significant public health issue, especially in regions prone to outbreaks. While the oral cholera vaccine (OCV) is an effective preventive tool, its use is often limited by the traditional cold chain requirements. The controlled temperature chain (CTC) provides an alternative by allowing vaccines to be stored at ambient temperatures for limited periods. This study explored participants' hands-on experiences with CTC compared with standard cold chain (SCC). This qualitative study during the March 2024 OCV campaign in Dhaka, Bangladesh, used purposive sampling, including six in-depth interviews (IDIs) with volunteers and four key informant interviews (KIIs) with policymakers. Volunteers were selected from two groups (Group A: SCC, and Group B: CTC) based on their vaccination, supervision, and record-keeping roles, while the policymakers were involved in planning during campaign deployment. The interviews observed frontline experiences and expert opinions on the feasibility, appropriateness, and logistical difficulties of both approaches. Compared to the SCC, the CTC strategy provided operational advantages, including reduced transportation costs, decreased refrigeration dependency, and easier management in the hard-to-reach areas. Participants highlighted that the vaccines could be stored at ambient temperatures for up to 14 d under CTC, enabling extended deployment with minimal wastage. Overall, the participants perceived the CTC strategy as more competent in vaccine deployment, requiring fewer resources. For improving vaccine deployment strategies in cholera prevention, this study provided practical insights by using the CTC approach.
Background
Cholera, caused by Vibrio cholerae, is a significant public health issue, particularly in outbreak-prone regions. The oral cholera vaccine (OCV) is an effective preventive measure, but its use is often constrained by cold chain requirements. This study matters as it explores an alternative approach, the controlled temperature chain (CTC), which could enhance vaccine deployment in challenging environments.
Methods
This qualitative study was conducted during the March 2024 OCV campaign in Dhaka, Bangladesh. It utilized purposive sampling, including six in-depth interviews with volunteers and four key informant interviews with policymakers, focusing on their experiences with CTC versus SCC. The study aimed to assess the feasibility, appropriateness, and logistical challenges of both vaccine deployment strategies.
Results
Participants reported that the CTC strategy allowed vaccines to be stored at ambient temperatures for up to 14 d, facilitating extended deployment with minimal wastage. The CTC approach was perceived as more competent in vaccine deployment, requiring fewer resources and offering operational advantages such as reduced transportation costs and decreased refrigeration dependency.
Interpretation
The findings suggest that the CTC approach may improve vaccine deployment in cholera prevention compared to traditional methods. However, the qualitative nature of the study limits the ability to generalize results, and the absence of quantitative data on vaccine efficacy or coverage diminishes the strength of the conclusions. Practitioners should consider these factors when evaluating the CTC strategy's applicability in their contexts.
Key findings
- Vaccines could be stored at ambient temperatures for up to 14 d under CTC.
- CTC provided reduced transportation costs compared to SCC.
- CTC decreased refrigeration dependency and facilitated easier management in hard-to-reach areas.
Limitations
- Qualitative study with small sample size (n=10).
- No quantitative data on vaccine efficacy or coverage.
- Limited to a single urban setting in Bangladesh.
- Not reported in abstract.