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Oral immunisation against typhoid fever in Indonesia with Ty21a vaccine.
Lancet. 1991 Oct 26; 338(8774):1055-9.Lct

Abstract

When tested under conditions of moderate transmission of typhoid fever, a liquid formulation of the oral typhoid fever vaccine Ty21a had a protective efficacy of 96% in Egypt, and an enteric coated capsule formulation had an efficacy of 67% in Chile. We compared the two formulations under conditions of intense transmission of typhoid fever in Indonesia in a randomised, double-blind trial. 20,543 subjects (age range 3-44 years) received either three doses of enteric coated capsules containing placebo or live Ty21a, or three doses of lyophilised placebo or live Ty21a reconstituted with phosphate buffer. During 30 months of follow-up, the rate of blood-culture-positive typhoid fever among controls was 810/100,000 per year. Rates of typhoid fever were 379/100,000 per year for subjects who received the liquid formulation of vaccine and 468/100,000 per year for subjects who received enteric coated capsules. The protective efficacies of the liquid and enteric coated formulations were 53% and 42%, respectively. Neither formulation protected against infection with Salmonella paratyphi A. No major side-effects were noted, but the overall incidence of side-effects was greater in the vaccine groups. Under conditions of intense transmission, Ty21a protected against typhoid fever; however, because Ty21a will not protect all individuals, there is a need for additional approaches to prevent the disease.

Authors+Show Affiliations

Center for Infectious Diseases Research, National Institutes of Health Research and Development, Jakarta, Indonesia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

1681365

Citation

Simanjuntak, C H., et al. "Oral Immunisation Against Typhoid Fever in Indonesia With Ty21a Vaccine." Lancet (London, England), vol. 338, no. 8774, 1991, pp. 1055-9.
Simanjuntak CH, Paleologo FP, Punjabi NH, et al. Oral immunisation against typhoid fever in Indonesia with Ty21a vaccine. Lancet. 1991;338(8774):1055-9.
Simanjuntak, C. H., Paleologo, F. P., Punjabi, N. H., Darmowigoto, R., Soeprawoto, ., Totosudirjo, H., Haryanto, P., Suprijanto, E., Witham, N. D., & Hoffman, S. L. (1991). Oral immunisation against typhoid fever in Indonesia with Ty21a vaccine. Lancet (London, England), 338(8774), 1055-9.
Simanjuntak CH, et al. Oral Immunisation Against Typhoid Fever in Indonesia With Ty21a Vaccine. Lancet. 1991 Oct 26;338(8774):1055-9. PubMed PMID: 1681365.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oral immunisation against typhoid fever in Indonesia with Ty21a vaccine. AU - Simanjuntak,C H, AU - Paleologo,F P, AU - Punjabi,N H, AU - Darmowigoto,R, AU - Soeprawoto,, AU - Totosudirjo,H, AU - Haryanto,P, AU - Suprijanto,E, AU - Witham,N D, AU - Hoffman,S L, PY - 1991/10/26/pubmed PY - 1991/10/26/medline PY - 1991/10/26/entrez KW - Age Factors KW - Asia KW - Bacterial And Fungal Diseases--prevention and control KW - Biology KW - Clinical Research KW - Control Groups KW - Delivery Of Health Care KW - Demographic Factors KW - Developing Countries KW - Diseases KW - Double-blind Studies KW - Evaluation KW - Health KW - Health Services KW - Immunity KW - Immunization KW - Incidence KW - Indonesia KW - Infections KW - Measurement KW - Physiology KW - Population KW - Population Characteristics KW - Primary Health Care KW - Research Methodology KW - Southeastern Asia KW - Studies KW - Vaccination--side effects KW - Vaccines--administraction and dosage SP - 1055 EP - 9 JF - Lancet (London, England) JO - Lancet VL - 338 IS - 8774 N2 - When tested under conditions of moderate transmission of typhoid fever, a liquid formulation of the oral typhoid fever vaccine Ty21a had a protective efficacy of 96% in Egypt, and an enteric coated capsule formulation had an efficacy of 67% in Chile. We compared the two formulations under conditions of intense transmission of typhoid fever in Indonesia in a randomised, double-blind trial. 20,543 subjects (age range 3-44 years) received either three doses of enteric coated capsules containing placebo or live Ty21a, or three doses of lyophilised placebo or live Ty21a reconstituted with phosphate buffer. During 30 months of follow-up, the rate of blood-culture-positive typhoid fever among controls was 810/100,000 per year. Rates of typhoid fever were 379/100,000 per year for subjects who received the liquid formulation of vaccine and 468/100,000 per year for subjects who received enteric coated capsules. The protective efficacies of the liquid and enteric coated formulations were 53% and 42%, respectively. Neither formulation protected against infection with Salmonella paratyphi A. No major side-effects were noted, but the overall incidence of side-effects was greater in the vaccine groups. Under conditions of intense transmission, Ty21a protected against typhoid fever; however, because Ty21a will not protect all individuals, there is a need for additional approaches to prevent the disease. SN - 0140-6736 UR - https://www.unboundmedicine.com/medline/citation/1681365/Oral_immunisation_against_typhoid_fever_in_Indonesia_with_Ty21a_vaccine_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0140-6736(91)91910-M DB - PRIME DP - Unbound Medicine ER -