The effects of school closures on influenza outbreaks and pandemics: systematic review of simulation studies.
The effects of school closures on influenza outbreaks and pandemics: systematic review of simulation studies.
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DOI：
10.1371/journal.pone.0097297
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Vynnycky E
中科院分区：
文献类型：
--
作者：
Jackson C;Mangtani P;Hawker J;Olowokure B;Vynnycky E
学校关闭是流感大流行期间的一种潜在干预措施，许多模拟研究都对此进行了调查。系统回顾模拟研究预测的学校停课对流感暴发的影响。我们在Medline和Embase上搜索2012年10月底发表的相关建模研究，并手工搜索关键期刊。我们总结了学校关闭对高峰和累积发病率以及疫情持续时间的预测影响。我们调查了这些预测如何依赖于基本的复制数量，关闭的时间和持续时间，以及学校关闭对接触模式的假设影响。通常预测，如果学校关闭导致接触接触大幅减少，如果传播率低(例如，基本繁殖数2)，如果儿童的发病率高于成人，那么关闭学校通常是最有效的。预计累积攻击率的变化小于峰值，但定量预测不同(例如，峰值的下降通常为20%-60%，但一些研究预测在某些假设下下降90%，甚至上升)。这在一定程度上反映了模型假设的差异，例如关于人口接触模式的假设。模拟研究表明，在流感大流行期间，关闭学校可能是一种有用的控制措施，特别是对于减少对卫生服务的高峰需求。然而，很难准确量化可能带来的好处。需要进一步研究学校被动关闭对接触模式的影响，以提高模型预测的准确性。
School closure is a potential intervention during an influenza pandemic and has been investigated in many modelling studies. To systematically review the effects of school closure on influenza outbreaks as predicted by simulation studies. We searched Medline and Embase for relevant modelling studies published by the end of October 2012, and handsearched key journals. We summarised the predicted effects of school closure on the peak and cumulative attack rates and the duration of the epidemic. We investigated how these predictions depended on the basic reproduction number, the timing and duration of closure and the assumed effects of school closures on contact patterns. School closures were usually predicted to be most effective if they caused large reductions in contact, if transmissibility was low (e.g. a basic reproduction number <2), and if attack rates were higher in children than in adults. The cumulative attack rate was expected to change less than the peak, but quantitative predictions varied (e.g. reductions in the peak were frequently 20–60% but some studies predicted >90% reductions or even increases under certain assumptions). This partly reflected differences in model assumptions, such as those regarding population contact patterns. Simulation studies suggest that school closure can be a useful control measure during an influenza pandemic, particularly for reducing peak demand on health services. However, it is difficult to accurately quantify the likely benefits. Further studies of the effects of reactive school closures on contact patterns are needed to improve the accuracy of model predictions.
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