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Larivière Y, Garcia-Fogeda I, Zola Matuvanga T, Isekah Osang'ir B, Milolo S, Meta R, Kimbulu P, Robinson C, Katwere M, McLean C, Hens N, Matangila J, Maketa V, Mitashi P, Muhindo-Mavoko H, Van geertruyden JP, Van Damme P. Safety and Immunogenicity of the Heterologous 2-Dose Ad26.ZEBOV, MVA-BN-Filo Vaccine Regimen in Health Care Providers and Frontliners of the Democratic Republic of the Congo. J Infect Dis 2024; 229:1068-1076. [PMID: 37673423 PMCID: PMC11011182 DOI: 10.1093/infdis/jiad350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/21/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND In response to recent Ebola epidemics, vaccine development against the Zaire ebolavirus (EBOV) has been fast-tracked in the past decade. Health care providers and frontliners working in Ebola-endemic areas are at high risk of contracting and spreading the virus. METHODS This study assessed the safety and immunogenicity of the 2-dose heterologous Ad26.ZEBOV, MVA-BN-Filo vaccine regimen (administered at a 56-day interval) among 699 health care providers and frontliners taking part in a phase 2, monocentric, randomized vaccine trial in Boende, the Democratic Republic of Congo. The first participant was enrolled and vaccinated on 18 December 2019. Serious adverse events were collected up to 6 months after the last received dose. The EBOV glycoprotein FANG ELISA (Filovirus Animal Nonclinical Group enzyme-linked immunosorbent assay) was used to measure the immunoglobulin G-binding antibody response to the EBOV glycoprotein. RESULTS The vaccine regimen was well tolerated with no vaccine-related serious adverse events reported. Twenty-one days after the second dose, an EBOV glycoprotein-specific binding antibody response was observed in 95.2% of participants. CONCLUSIONS The 2-dose vaccine regimen was well tolerated and led to a high antibody response among fully vaccinated health care providers and frontliners in Boende.
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Affiliation(s)
- Ynke Larivière
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk
| | - Irene Garcia-Fogeda
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
| | - Trésor Zola Matuvanga
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Bernard Isekah Osang'ir
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk
| | - Solange Milolo
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Rachel Meta
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Primo Kimbulu
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | | | | | - Niel Hens
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
- Data Science Institute, Interuniversity Institute for Biostatistics and statistical Bioinformatics, UHasselt, Diepenbeek, Belgium
| | - Junior Matangila
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Vivi Maketa
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Patrick Mitashi
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Hypolite Muhindo-Mavoko
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean-Pierre Van geertruyden
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk
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Zola Matuvanga T, Larivière Y, Lemey G, Isekah Osang'ir B, Mariën J, Milolo S, Meta R, Matangila J, Maketa V, Mitashi P, Van Geertruyden JP, Muhindo-Mavoko H, Van Damme P. Longitudinal assessment of an Ebola vaccine trial understanding among healthcare providers in the Democratic Republic of the Congo. Vaccine 2024; 42:481-488. [PMID: 38163747 DOI: 10.1016/j.vaccine.2023.12.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/09/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The long-term retention of information disclosed during the informed consent in clinical trials lasting over a year cannot be guaranteed for all volunteers. This study aimed to assess the level of participants' retention and understanding of the trial information after two years of participation in a vaccine trial. METHODS In total, 699 health care providers (HCPs) and frontline workers were enrolled in the EBL2007 vaccine trial conducted between February 2019 and September 2022 in the Health District of Boende, Democratic Republic of the Congo (DRC). Individual scores obtained from a questionnaire (test of understanding, TOU), specifically designed to assess the understanding of the consent at baseline, were collected before the clinical trial started and at one-year and two-year intervals. RESULTS TOU scores were high in the beginning of the trial (median TOU = 10/10), but significantly decreased in both the first and second years following (median TOU = 8/10 in year 1 and median TOU = 9/10 in year 2, p-value < 0.0001). The decrease in scores was significantly higher among individuals with occupations requiring shorter education such as midwives (median TOU = 7/10 in year 1 and 8/10 in year 2, pvalue = 0.025). Furthermore, older participants exhibited poorer retention of information compared to younger individuals (median TOU = 8/10 vs 9/10, p-value = 0.007). CONCLUSION We observed a significant decline in the informational knowledge of informed consent, specifically in terms of basic knowledge on the study vaccine and trial procedures. As participant safety and understanding is a paramount ethical concern for researchers, it is crucial for participants to fully comprehend the study's objectives and potential risks. Therefore, our findings suggest the need for clinical researchers to re-explain participants to optimize the protection of their rights and wellbeing during the research.
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Affiliation(s)
- Trésor Zola Matuvanga
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium; Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium; Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo.
| | - Ynke Larivière
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium; Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium
| | - Gwen Lemey
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium; Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium
| | - Bernard Isekah Osang'ir
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium; Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium
| | - Joachim Mariën
- Department of Biology, Evolutionairy Ecology group, University of Antwerp, Wilrijk, Belgium; Department of Biology, Royal Museum for Central Africa, Tervuren, Belgium
| | - Solange Milolo
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo
| | - Rachel Meta
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo
| | - Junior Matangila
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo
| | - Vivi Maketa
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo
| | - Patrick Mitashi
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo
| | - Jean-Pierre Van Geertruyden
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium
| | | | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium
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Larivière Y, Matuvanga TZ, Lemey G, Osang'ir BI, Vermeiren PP, Milolo S, Meta R, Kimbulu P, Esanga E, Matangila J, Van Geertruyden JP, Van Damme P, Maketa V, Muhindo-Mavoko H, Mitashi P. Conducting an Ebola vaccine trial in a remote area of the Democratic Republic of the Congo: Challenges, mitigations, and lessons learned. Vaccine 2023; 41:7587-7597. [PMID: 37993355 DOI: 10.1016/j.vaccine.2023.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/14/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Abstract
Conducting a vaccine trial in a low- and middle-income country (LMIC) can present unique challenges and lessons learned. This Ebola vaccine trial, enrolling 699 healthcare providers and frontliners and jointly set up by the University of Antwerp (Sponsor) and the University of Kinshasa (Principal Investigator (PI)), was conducted in Boende, a remote city in the Democratic Republic of the Congo (DRC), between December 2019 and October 2022 (ClinicalTrials.gov: NCT04186000). While being bound by strict ICH-GCP and international funder regulations, this trial, exemplary for being a public-private partnership, required collaboration between several international stakeholders (e.g., two universities, a pharmaceutical company, and a clinical research organization), local communities and government agencies. Here we address several logistical and administrative challenges, cultural differences, language barriers and regulatory, political, and ethical considerations over the trial's 2.5-year duration, while tailoring and adapting the study to the specific local context. Lessons learned include the importance of clear communication with participants in all phases of the study, but also within the study team and among different stakeholders. Challenges, mitigations, and lessons learned are presented in nine categories (e.g., safety management; trial documentation, tools, and materials; communication, staff training and community engagement/sensitization; financial and administrative hurdles; and more). Ultimately, to reach the successful end of the vaccine trial in this remote Ebola endemic area in the DRC, careful planning, collaboration, and great flexibility and adaptability was often required from all involved partners. Despite the encountered challenges, the vaccine trial discussed in this paper was able to obtain high participant retention rates (i.e., 92% of participants completed the study). We hope that other international teams aspiring to conduct similar trials in remote areas of LMICs can learn from the way our challenges were addressed, mitigations developed, and lessons were learned.
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Affiliation(s)
- Ynke Larivière
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium; Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium
| | - Trésor Zola Matuvanga
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium; Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium; Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo, The.
| | - Gwen Lemey
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium; Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium
| | - Bernard Isekah Osang'ir
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium; Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium
| | - Paul Peter Vermeiren
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium; Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium
| | - Solange Milolo
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo, The
| | - Rachel Meta
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo, The
| | - Primo Kimbulu
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo, The
| | - Emmanuel Esanga
- Division Provinciale de la Santé de la Tshuapa, Democratic Republic of the Congo, The
| | - Junior Matangila
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo, The
| | - Jean-Pierre Van Geertruyden
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium
| | - Vivi Maketa
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo, The
| | - Hypolite Muhindo-Mavoko
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo, The
| | - Patrick Mitashi
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo, The
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Zola Matuvanga T, Mariën J, Larivière Y, Osang’ir BI, Milolo S, Meta R, Esanga E, Maketa V, Matangila J, Mitashi P, Ahuka Mundeke S, Muhindo-Mavoko H, Muyembe Tamfum JJ, Van Damme P, Van Geertruyden JP. Low seroprevalence of Ebola virus in health care providers in an endemic region (Tshuapa province) of the Democratic Republic of the Congo. PLoS One 2023; 18:e0286479. [PMID: 37656725 PMCID: PMC10473486 DOI: 10.1371/journal.pone.0286479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/16/2023] [Indexed: 09/03/2023] Open
Abstract
INTRODUCTION A serosurvey among health care providers (HCPs) and frontliners of an area previously affected by Ebola virus disease (EVD) in the Democratic Republic of the Congo (DRC) was conducted to assess the seroreactivity to Ebola virus antigens. METHODS Serum samples were collected in a cohort of HCPs and frontliners (n = 698) participants in the EBL2007 vaccine trial (December 2019 to October 2022). Specimens seroreactive for EBOV were confirmed using either the Filovirus Animal Nonclinical Group (FANG) ELISA or a Luminex multiplex assay. RESULTS The seroreactivity to at least two EBOV-Mayinga (m) antigens was found in 10 (1.4%: 95% CI, 0.7-2.6) samples for GP-EBOV-m + VP40-EBOV-m, and 2 (0.3%: 95% CI, 0.0-1.0) samples for VP40-EBOV-m + NP-EBOV-m using the Luminex assay. Seroreactivity to GP-EBOV-Kikwit (k) was observed in 59 (8.5%: 95%CI, 6.5-10.9) samples using FANG ELISA. CONCLUSION In contrast to previous serosurveys, a low seroprevalence was found in the HCP and frontline population participating in the EBL2007 Ebola vaccine trial in Boende, DRC. This underscores the high need for standardized antibody assays and cutoffs in EBOV serosurveys to avoid the broad range of reported EBOV seroprevalence rates in EBOV endemic areas.
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Affiliation(s)
- Trésor Zola Matuvanga
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Kinshasa, Democratic Republic of the Congo
- Vaccine and Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp, Wilrijk, Antwerp, Belgium
- Department of Family Medicine and Population Health, Global Health Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Joachim Mariën
- Department of Biology, Evolutionary Ecology Group, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Ynke Larivière
- Vaccine and Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp, Wilrijk, Antwerp, Belgium
- Department of Family Medicine and Population Health, Global Health Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Bernard Isekah Osang’ir
- Vaccine and Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp, Wilrijk, Antwerp, Belgium
- Department of Family Medicine and Population Health, Global Health Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Solange Milolo
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Rachel Meta
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Emmanuel Esanga
- Division Provinciale de la Santé de la Tshuapa, Ministry of Health Hygiene and Prevention, Boende, Tshuapa, Democratic Republic of the Congo
| | - Vivi Maketa
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Junior Matangila
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Patrick Mitashi
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Steve Ahuka Mundeke
- Department of Virology, Institut National de Recherches Biomedicales, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Hypolite Muhindo-Mavoko
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean-Jacques Muyembe Tamfum
- Department of Virology, Institut National de Recherches Biomedicales, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Pierre Van Damme
- Vaccine and Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Jean-Pierre Van Geertruyden
- Department of Family Medicine and Population Health, Global Health Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
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Garcia-Fogeda I, Besbassi H, Larivière Y, Ogunjimi B, Abrams S, Hens N. Within-host modeling to measure dynamics of antibody responses after natural infection or vaccination: A systematic review. Vaccine 2023:S0264-410X(23)00422-X. [PMID: 37198016 DOI: 10.1016/j.vaccine.2023.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 04/08/2023] [Accepted: 04/10/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Within-host models describe the dynamics of immune cells when encountering a pathogen, and how these dynamics can lead to an individual-specific immune response. This systematic review aims to summarize which within-host methodology has been used to study and quantify antibody kinetics after infection or vaccination. In particular, we focus on data-driven and theory-driven mechanistic models. MATERIALS PubMed and Web of Science databases were used to identify eligible papers published until May 2022. Eligible publications included those studying mathematical models that measure antibody kinetics as the primary outcome (ranging from phenomenological to mechanistic models). RESULTS We identified 78 eligible publications, of which 8 relied on an Ordinary Differential Equations (ODEs)-based modelling approach to describe antibody kinetics after vaccination, and 12 studies used such models in the context of humoral immunity induced by natural infection. Mechanistic modeling studies were summarized in terms of type of study, sample size, measurements collected, antibody half-life, compartments and parameters included, inferential or analytical method, and model selection. CONCLUSIONS Despite the importance of investigating antibody kinetics and underlying mechanisms of (waning of) the humoral immunity, few publications explicitly account for this in a mathematical model. In particular, most research focuses on phenomenological rather than mechanistic models. The limited information on the age groups or other risk factors that might impact antibody kinetics, as well as a lack of experimental or observational data remain important concerns regarding the interpretation of mathematical modeling results. We reviewed the similarities between the kinetics following vaccination and infection, emphasising that it may be worth translating some features from one setting to another. However, we also stress that some biological mechanisms need to be distinguished. We found that data-driven mechanistic models tend to be more simplistic, and theory-driven approaches lack representative data to validate model results.
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Affiliation(s)
- Irene Garcia-Fogeda
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.
| | - Hajar Besbassi
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Ynke Larivière
- Global Health Institute (GHI), Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium; Centre for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Benson Ogunjimi
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Antwerp Unit for Data Analysis and Computation in Immunology and Sequencing (AUDACIS), Antwerp, Belgium; Antwerp Center for Translational Immunology and Virology (ACTIV), Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Department of Paediatrics, University Hospital Antwerp, Antwerp, Belgium
| | - Steven Abrams
- Global Health Institute (GHI), Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium; Data Science Institute (DSI), Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), UHasselt, Hasselt, Belgium
| | - Niel Hens
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Data Science Institute (DSI), Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), UHasselt, Hasselt, Belgium
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Crèvecoeur J, Hens N, Neyens T, Larivière Y, Verhasselt B, Masson H, Theeten H. Change in COVID19 outbreak pattern following vaccination in long-term care facilities in Flanders, Belgium. Vaccine 2022; 40:6218-6224. [PMID: 36127210 PMCID: PMC9472804 DOI: 10.1016/j.vaccine.2022.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/01/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022]
Abstract
Introduction Long term care facilities for elderly (LTCFs) in Europe encountered a high disease burden at the start of the COVID-19 pandemic. Therefore, these facilities were the first to receive COVID-19 vaccines in many European countries. A limited COVID-19 vaccine supply early 2021 resulted in a majority of residents and healthcare workers (HCWs) in LTCFs being vaccinated compared to a minority in the general population. This study exploits this imbalance to assess the efficiency of COVID-19 vaccination in containing outbreaks in LTCFs. Methods Exploratory statistics were performed using data from a COVID-19 surveillance system covering all 842 LTCFs in Flanders (the northern region of Belgium). The number and size of COVID-19 outbreaks in LTCFs were compared (1) before and after introducing vaccines and (2) with the status of the pandemic in the general population. Based on individual data from 15 LTCFs, the infection rate and symptoms of vaccinated and unvaccinated residents and HCWs were compared during a COVID-19 outbreak. Results 95.8% of the residents and 90.9% of the HCWs in Flemish LTCFs were vaccinated before May 30, 2021. Before vaccine introduction, residents in LTCFs were 10 times more likely to test positive for COVID-19 than the general population of Flanders. This ratio reversed after vaccination. Furthermore, after vaccination fewer and shorter outbreaks were observed involving fewer residents. During these outbreaks, vaccinated and unvaccinated residents were equally likely to test positive, but positive vaccinated residents were less likely to develop severe symptoms. In contrast, unvaccinated HCWs were more likely to test positive. Conclusion In the first half of 2021, two-dose vaccination was highly efficient in preventing and containing outbreaks in LTCFs, reducing COVID-19 hospitalizations and deaths. The high likelihood of unvaccinated HCWs to be involved in COVID-19 outbreaks in vaccinated LTCFs emphasizes the importance of vaccinating HCWs.
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Affiliation(s)
- Jonas Crèvecoeur
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), Data Science Institute, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium; Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat), Faculty of Medicine, KU Leuven, Kapucijnenvoer 35, building D, box 7001, 3000 Leuven, Belgium.
| | - Niel Hens
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), Data Science Institute, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium; Vaccine and Infectious Disease Institute, VAXINFECTIO, Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium.
| | - Thomas Neyens
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), Data Science Institute, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium; Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat), Faculty of Medicine, KU Leuven, Kapucijnenvoer 35, building D, box 7001, 3000 Leuven, Belgium.
| | - Ynke Larivière
- Vaccine and Infectious Disease Institute, VAXINFECTIO, Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium.
| | - Bruno Verhasselt
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.
| | - Hanna Masson
- Prevention Department, Agentschap Zorg en Gezondheid Vlaanderen, 1030 Brussels, Belgium.
| | - Heidi Theeten
- Vaccine and Infectious Disease Institute, VAXINFECTIO, Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium; Prevention Department, Agentschap Zorg en Gezondheid Vlaanderen, 1030 Brussels, Belgium.
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Larivière Y, Zola T, Stoppie E, Maketa V, Matangila J, Mitashi P, De Bie J, Muhindo-Mavoko H, Van Geertruyden JP, Van Damme P. Open-label, randomised, clinical trial to evaluate the immunogenicity and safety of a prophylactic vaccination of healthcare providers by administration of a heterologous vaccine regimen against Ebola in the Democratic Republic of the Congo: the study protocol. BMJ Open 2021; 11:e046835. [PMID: 34588237 PMCID: PMC8479954 DOI: 10.1136/bmjopen-2020-046835] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION This article describes the protocol of an Ebola vaccine clinical trial which investigates the safety and immunogenicity of a two-dose prophylactic Ebola vaccine regimen comprised of two Ebola vaccines (Ad26.ZEBOV and MVA-BN-Filo) administered 56 days apart, followed by a booster vaccination with Ad26.ZEBOV offered at either 1 year or 2 years (randomisation 1:1) after the first dose. This clinical trial is part of the EBOVAC3 project (an Innovative Medicines Initiative 2 Joint Undertaking), and is the first to evaluate the safety and immunogenicity of two different booster vaccination arms in a large cohort of adults. METHODS AND ANALYSIS This study is an open-label, monocentric, phase 2, randomised vaccine trial. A total of 700 healthcare providers and frontliners are planned to be recruited from the Tshuapa province in the Democratic Republic of the Congo (DRC). The primary and secondary objectives of the study assess the immunogenicity of the first (Ad26.ZEBOV), second (MVA-BN-Filo) and booster (Ad26.ZEBOV) dose. Immunogenicity is assessed through the evaluation of EBOV glycoprotein binding antibody responses after vaccination. Safety is assessed through the collection of serious adverse events from the first dose until 6 months post booster vaccination and the collection of solicited and unsolicited adverse events for 1 week after the booster dose. ETHICS AND DISSEMINATION The protocol was approved by the National Ethics Committee of the Ministry of Health of the DRC (n°121/CNES/BN/PMMF/2019). The clinical trial was registered on 4 December 2019 on ClinicalTrials.gov. Trial activities are planned to finish in October 2022. All participants are required to provide written informed consent and no study-related procedures will be performed until consent is obtained. The results of the trial will be added on ClinicalTrials.gov, published in peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER NCT04186000; Pre-results.
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Affiliation(s)
- Ynke Larivière
- Centre for Evaluation of Vaccination, University of Antwerp, Wilrijk, Belgium
- Global Health Institute, University of Antwerp, Wilrijk, Belgium
| | - Trésor Zola
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Elke Stoppie
- Centre for Evaluation of Vaccination, University of Antwerp, Wilrijk, Belgium
- Global Health Institute, University of Antwerp, Wilrijk, Belgium
| | - Vivi Maketa
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Junior Matangila
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Patrick Mitashi
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Jessie De Bie
- Centre for Evaluation of Vaccination, University of Antwerp, Wilrijk, Belgium
- Global Health Institute, University of Antwerp, Wilrijk, Belgium
| | - Hypolite Muhindo-Mavoko
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | | | - Pierre Van Damme
- Centre for Evaluation of Vaccination, University of Antwerp, Wilrijk, Belgium
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Zola Matuvanga T, Johnson G, Larivière Y, Esanga Longomo E, Matangila J, Maketa V, Lapika B, Mitashi P, Mc Kenna P, De Bie J, Van Geertruyden JP, Van Damme P, Muhindo Mavoko H. Use of Iris Scanning for Biometric Recognition of Healthy Adults Participating in an Ebola Vaccine Trial in the Democratic Republic of the Congo: Mixed Methods Study. J Med Internet Res 2021; 23:e28573. [PMID: 34378545 PMCID: PMC8386356 DOI: 10.2196/28573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/11/2021] [Accepted: 06/30/2021] [Indexed: 11/23/2022] Open
Abstract
Background A partnership between the University of Antwerp and the University of Kinshasa implemented the EBOVAC3 clinical trial with an Ebola vaccine regimen administered to health care provider participants in Tshuapa Province, Democratic Republic of the Congo. This randomized controlled trial was part of an Ebola outbreak preparedness initiative financed through Innovative Medicines Initiative-European Union. The EBOVAC3 clinical trial used iris scan technology to identify all health care provider participants enrolled in the vaccine trial, to ensure that the right participant received the right vaccine at the right visit. Objective We aimed to assess the acceptability, accuracy, and feasibility of iris scan technology as an identification method within a population of health care provider participants in a vaccine trial in a remote setting. Methods We used a mixed methods study. The acceptability was assessed prior to the trial through 12 focus group discussions (FGDs) and was assessed at enrollment. Feasibility and accuracy research was conducted using a longitudinal trial study design, where iris scanning was compared with the unique study ID card to identify health care provider participants at enrollment and at their follow-up visits. Results During the FGDs, health care provider participants were mainly concerned about the iris scan technology causing physical problems to their eyes or exposing them to spiritual problems through sorcery. However, 99% (85/86; 95% CI 97.1-100.0) of health care provider participants in the FGDs agreed to be identified by the iris scan. Also, at enrollment, 99.0% (692/699; 95% CI 98.2-99.7) of health care provider participants accepted to be identified by iris scan. Iris scan technology correctly identified 93.1% (636/683; 95% CI 91.2-95.0) of the participants returning for scheduled follow-up visits. The iris scanning operation lasted 2 minutes or less for 96.0% (656/683; 95% CI 94.6-97.5), and 1 attempt was enough to identify the majority of study participants (475/683, 69.5%; 95% CI 66.1-73.0). Conclusions Iris scans are highly acceptable as an identification tool in a clinical trial for health care provider participants in a remote setting. Its operationalization during the trial demonstrated a high level of accuracy that can reliably identify individuals. Iris scanning is found to be feasible in clinical trials but requires a trained operator to reduce the duration and the number of attempts to identify a participant. Trial Registration ClinicalTrials.gov NCT04186000; https://clinicaltrials.gov/ct2/show/NCT04186000
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Affiliation(s)
- Trésor Zola Matuvanga
- Department of Tropical Medicine, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo.,Global Health Institute, University of Antwerp, Antwerp, Belgium.,Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium
| | - Ginger Johnson
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ynke Larivière
- Global Health Institute, University of Antwerp, Antwerp, Belgium.,Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium
| | - Emmanuel Esanga Longomo
- Division Provinciale de la Santé de la Province de la Tshuapa, Boende, the Democratic Republic of the Congo
| | - Junior Matangila
- Department of Tropical Medicine, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| | - Vivi Maketa
- Department of Tropical Medicine, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| | - Bruno Lapika
- Department of Anthropology, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| | - Patrick Mitashi
- Department of Tropical Medicine, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| | | | - Jessie De Bie
- Global Health Institute, University of Antwerp, Antwerp, Belgium.,Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium
| | | | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium
| | - Hypolite Muhindo Mavoko
- Department of Tropical Medicine, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo
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Lemey G, Larivière Y, Zola TM, Maketa V, Matangila J, Mitashi P, Vermeiren P, Thys S, De Bie J, Muhindo HM, Ravinetto R, Van Damme P, Van Geertruyden JP. Algorithm for the support of non-related (serious) adverse events in an Ebola vaccine trial in the Democratic Republic of the Congo. BMJ Glob Health 2021; 6:bmjgh-2021-005726. [PMID: 34183329 PMCID: PMC8240587 DOI: 10.1136/bmjgh-2021-005726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/13/2021] [Indexed: 01/10/2023] Open
Abstract
Implementing an Ebola vaccine trial in a remote area in the Democratic Republic of the Congo (DRC), and being confronted with a dysfunctional health care system and acute unmet health needs of participants, ethical considerations were made regarding the ancillary care obligations of the sponsor and researchers. Spurred by the occurrence of non-related (serious) adverse events (NR-SAEs), the Universities of Antwerp and Kinshasa jointly developed an algorithm, accompanied by an algorithm policy. The algorithm consists of a set of consecutive questions with binary response options, leading to structured, non-arbitrary and consistent support and management for each NR-SAE. It is the result of dialogue and collaboration between the sponsor (University of Antwerp) and the principal investigator (University of Kinshasa), consultation of literature, and input of research ethics and social sciences experts. The characteristics of the project and its budgetary framework were taken into account, as well as the local socioeconomic and healthcare situation. The algorithm and related policy have been approved by the relevant ethics committee (EC), so field implementation will begin when the study activities resume in November 2021. Lessons learnt will be shared with the relevant stakeholders within and outside DRC. If NR-SAEs are not covered by a functioning social welfare system, sponsors and researchers should develop a feasible, standardised and transparent approach to the provision of ancillary care. National legislation and contextualised requirements are therefore needed, particularly in low/middle-income countries, to guide researchers and sponsors in this process. Protocols, particularly of clinical trials conducted in areas with ‘access to care’ constraints, should include adequate ancillary care arrangements. Furthermore, it is essential that local ECs systematically require ancillary care provisions to enhance the well-being and protection of the rights of research participants. This project was funded by the European Union’s Horizon 2020 research and innovation programme, European Federation of Pharmaceutical Industries and Associations, and the Coalition for Epidemic Preparedness Innovations.
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Affiliation(s)
- Gwen Lemey
- Global Health Institute, University of Antwerp, Antwerpen, Belgium .,Centre for the Evaluation of Vaccination, University of Antwerp, Antwerpen, Belgium
| | - Ynke Larivière
- Global Health Institute, University of Antwerp, Antwerpen, Belgium.,Centre for the Evaluation of Vaccination, University of Antwerp, Antwerpen, Belgium
| | - Trésor Matuvanga Zola
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Vivi Maketa
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Junior Matangila
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Patrick Mitashi
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Peter Vermeiren
- Global Health Institute, University of Antwerp, Antwerpen, Belgium.,Centre for the Evaluation of Vaccination, University of Antwerp, Antwerpen, Belgium
| | - Séverine Thys
- Global Health Institute, University of Antwerp, Antwerpen, Belgium.,Centre for the Evaluation of Vaccination, University of Antwerp, Antwerpen, Belgium
| | - Jessie De Bie
- Global Health Institute, University of Antwerp, Antwerpen, Belgium.,Centre for the Evaluation of Vaccination, University of Antwerp, Antwerpen, Belgium
| | - Hypolite Mavoko Muhindo
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Raffaella Ravinetto
- Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerpen, Belgium
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Orije MRP, Larivière Y, Herzog SA, Mahieu LM, Van Damme P, Leuridan E, Maertens K. Breast milk antibody levels in Tdap vaccinated women after preterm delivery. Clin Infect Dis 2021; 73:e1305-e1313. [PMID: 33768227 DOI: 10.1093/cid/ciab260] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 03/22/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION/BACKGROUND & AIMS Enrichment of breast milk (BM) with immunoglobin (Ig)A and IgG, through maternal vaccination, could help young infants combat targeted pathogens. However, evidence on this effect after preterm delivery is lacking. This study investigated the total and anti-pertussis toxin (anti-PT) specific IgA and IgG production in BM after term or preterm delivery in the presence of maternal Tdap (tetanus, diphtheria, acellular pertussis) vaccination. METHODS Serum and BM samples of lactating women, who delivered at term or prematurely and did or did not receive Tdap vaccine (Boostrix®, GSK Biologicals) during pregnancy, were collected as part of a clinical study (N=234, NCT02511327). Anti-PT IgA/IgG (IBL®; MSD®) and Total IgA/IgG (Thermofisher®, on BM samples only) immunosorbent assays were performed on all samples collected at 72 hours, 4, 8, and 12 weeks postpartum. RESULTS BM after preterm delivery contained anti-PT IgA and IgG geometric mean concentrations (GMCs) comparable to those after term delivery (e.g. colostrum anti-PT IgA: 5.39 International Units per milliliter (IU/mL) vs 6.69 IU/mL, respectively). Maternal Tdap vaccination induced significantly higher anti-PT IgG GMC's in colostrum of vaccinated compared to unvaccinated women delivering at term (0.110 IU/mL vs 0.027 IU/mL, p=0.009). Compliance with postpartum vaccination led to no differences in BM after 4 weeks postpartum. Anti-PT antibodies persisted up to 12 weeks postpartum. CONCLUSIONS This study provides evidence that maternal Tdap vaccination induces high Ig levels in BM after both term and preterm delivery and that these antibodies remain abundantly present throughout lactation, possibly offering additional mucosal protection during the most vulnerable period in early life.
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Affiliation(s)
- Marjolein R P Orije
- Centre for the Evaluation of Vaccination (CEV); Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Ynke Larivière
- Centre for the Evaluation of Vaccination (CEV); Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Sereina A Herzog
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID); Vaccine & Infectious Diseases Institute (VAXINFECTIO); University of Antwerp, Antwerp, Belgium
| | - Ludo M Mahieu
- Department of Paediatrics, Division of Neonatology; University Hospital Antwerp, University of Antwerp, Antwerp, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination (CEV); Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Elke Leuridan
- Centre for the Evaluation of Vaccination (CEV); Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Kirsten Maertens
- Centre for the Evaluation of Vaccination (CEV); Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
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Inaç Y, Larivière Y, Hoque M, Van Hal G. Risk factors for hazardous drinking in university students from South Africa and Belgium: a cross-cultural comparison study. Afr Health Sci 2021; 21:123-131. [PMID: 34394289 PMCID: PMC8356575 DOI: 10.4314/ahs.v21i1.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Previous studies have associated certain risk factors with hazardous drinking in students. However, big cultural and geographical differences exist regarding alcohol use. Objectives To determine whether or not there was a difference in hazardous drinking between Belgian and South African university students and to establish the risk factors that contribute to hazardous drinking in university students (calculated using the AUDIT-C) from a developing country (South Africa) and a developed country (Belgium). Methods An online survey assessing hazardous drinking among university students in South Africa (University of KwaZulu-Natal, UKZN) and Belgium (University of Antwerp, UoA) was conducted, using the shortened version of the Alcohol Use Disorder Identification Test (AUDIT-C). Risk factors in males and females for hazardous drinking were explored using multivariate logistic regression analysis. Results In total, 499 students were included in the study (250 UoA and 249 UKZN students). A significant higher amount of male (94.8%) as well as female (92.4%) UoA students drank alcohol in the last year compared to the male (66.2%) and female (67.8%) UKZN students (p<0.001). Additionally, a significant higher amount of UoA students were hazardous drinkers, compared to the UKZN students (p<0.001). Multivaiate analysis showed that male UoA students were almost 6 times more likely to be hazardous drinkers than male UKZN students (OR=5.611, p=0.005). Female UoA students were more than twice as likely to be hazardous drinkers than female UKZN students (OR=2.371, p=0.016). Conclusion This study found a significant difference in hazardous drinking between Belgian and South African university students.
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Affiliation(s)
- Yasemin Inaç
- University of Antwerp Faculty of Medicine and Health Sciences, Department of Epidemiology and Social Medicine
| | - Ynke Larivière
- University of Antwerp, Department of Epidemiology and Social Medicine
| | - Muhammad Hoque
- Senior Research Associate, Management College of Southern Africa, Durban, South Africa
| | - Guido Van Hal
- University of Antwerp, Department of Epidemiology and Social Medicine
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Hal GV, Larivière Y, Inaç Y, Hoque M. Risk factors for hazardous drinking in university students from South Africa and Belgium. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Previous studies have associated certain risk factors with hazardous drinking in students. However, big cultural and geographical differences exist regarding alcohol use. In this study, we compare the alcohol use and hazardous drinking in Belgian (BE) and South African (SA) university students.
Methods
An online survey assessing alcohol use among university students in South Africa (University of KwaZulu-Natal) and Belgium (University of Antwerp) was conducted, using the shortened version of the Alcohol Use Disorder Identification Test (AUDIT-C). For male students a cut-off point of 5 was used for hazardous drinking and for female students a score of 4. In total, 499 students were included in the study (250 BE and 249 SA students). A comparative analysis between both universities was performed for men and women separately with a Pearson chi-square test or Mann-Whitney U test. Furthermore, the association between hazardous drinking and several exposure variables was explored using multivariable logistic regression analysis.
Results
A significant higher amount of male (94.8%) as well as female (92.4%) BE students drank alcohol in the last year compared to the male (66.2%) and female (67.8%) SA students (p < 0.001). Additionally, a significant higher amount of BE students were hazardous drinkers, compared to the SA students (p < 0.001). Multivariate analysis showed that male BE students were approximately five times more likely to be hazardous drinkers than male SA students (OR = 5.057, 95% CI 1.378-18.556; p = 0.015). Female BE students were over twice more likely to be hazardous drinkers than female SA students (OR = 2.371, 95% CI 0.846-6.644; p = 0.099).
Conclusions
BE students drink significantly more alcohol and a significant higher proportion of BE students were hazardous drinkers compared to SA students. Qualitative research in both groups has been conducted to get more insight into the reasons of these differences and will also be presented at the Conference.
Key messages
When studying alcohol use (disorders) in university students, it is of utmost importance to take into account the socio-cultural context. After finding quantitatively assessed differences in alcohol use (disorder) across different socio-cultural settings, it is evenly important to find out about the reasons why.
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Affiliation(s)
- G Van Hal
- Social Epidemiology and Health Policy, University of Antwerp, Antwerp, Belgium
| | - Y Larivière
- Social Epidemiology and Health Policy, University of Antwerp, Antwerp, Belgium
| | - Y Inaç
- Social Epidemiology and Health Policy, University of Antwerp, Antwerp, Belgium
| | - M Hoque
- Graduate School of Business and Leadership, University of KwaZulu-Natal, Durban, South Africa
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