Publications by authors named "D D Trach"

We report the coverage, safety, and logistics of a school-based typhoid fever immunization campaign that took place in Hue City, central Vietnam; a typhoid fever endemic area. A cluster-randomized evaluation-blinded controlled trial was designed where 68 schools (cluster) were randomly allocated the single dose Vi polysaccharide vaccine (Typherix) or the active control hepatitis A vaccine (Havrix). A safety surveillance system was implemented.

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Article Synopsis
  • Phase-III vaccine efficacy trials usually focus on individual randomization to measure direct vaccine effects, potentially overlooking the broader protective benefits of vaccines in public health.
  • The DOMI typhoid fever program seeks to address this gap by employing cluster randomized trials, aiming to gather relevant data for the introduction of the Vi polysaccharide vaccine in Asia, involving around 200,000 participants.
  • The study discusses the trial's rationale, design, and preliminary results that influenced trial strategies, highlighting key methodological and practical challenges associated with cluster randomized vaccine designs.
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Health information systems to monitor vaccine safety are used in industrialized countries to detect adverse medical events related to vaccinations or to prove the safety of vaccines. There are no such information systems in the developing world, but they are urgently needed. A large linked database for the monitoring of vaccine-related adverse events has been established in Khanh Hoa province, Viet Nam.

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We conducted a cross sectional survey of 3163 women and men in six Asian countries to examine willingness for children and adults to be vaccinated against shigellosis and other forms of dysentery. The six sites were clustered into three regions for ease of comparison. The regions are: Northeast Asia (China), Southeast Asia (Thailand, Vietnam, and Indonesia) and South Asia (Bangladesh and Pakistan).

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For 5 years, we have conducted sentinel surveillance for rotavirus at 6 hospitals in 4 cities in Vietnam. Stool samples obtained from >10,000 children <5 years old who were admitted to the hospital with diarrhea have been screened for rotavirus. Overall, 55% of samples were positive, and there was little variability in rates of detection of rotavirus between sites (44%-62%).

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