Effectiveness of non-pharmaceutical public health interventions against COVID-19: A systematic review and meta-analysis.
Effectiveness of non-pharmaceutical public health interventions against COVID-19: A systematic review and meta-analysis.
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DOI：
10.1371/journal.pone.0260371
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Pashazadeh F
中科院分区：
文献类型：
--
作者：
Iezadi S;Gholipour K;Azami-Aghdash S;Ghiasi A;Rezapour A;Pourasghari H;Pashazadeh F
不同国家已使用非药物公共卫生干预措施（NPHI）来控制COVID-19的传播。尽管有关于NPHSs有效性的证据，但对于政策制定者如何信任这些结果仍然没有达成共识。关于国家公共卫生服务有效性的研究是在特定社区进行的单项研究。因此，他们无法单独证明这些干预措施是否有效地减少了感染的传播及其不良健康后果。在这项系统性综述中，我们的目的是研究NPHIs对COVID-19病例增长率、死亡增长率、重症监护病房（ICU）入院率和实施NPHIs的国家的生殖数量的影响。我们检索了相关电子数据库，包括Medline（通过PubMed）、Scopus、CINAHL、Web of Science等，检索时间为2019年12月下旬至2021年2月1日。关键术语主要来自医学主题词（MeSh和Emtree）、文献综述和专家意见。同行评审的准实验研究也包括在审查中。PROSPERO注册号为CRD 42020186855。干预措施是NPHIs，分为封锁，呆在家里的命令，社交距离和其他干预措施（戴口罩，接触者追踪和学校关闭）。我们使用PRISMA 2020指南提取数据，并使用科克伦有效实践和实践组织（EPOC）偏倚风险工具对研究进行质量评价。采用Hartung-Knapp-Sidik-Jonkman随机效应模型。主要结果包括COVID-19病例增长率（每日变化百分比）、COVID-19死亡率增长率（每日变化百分比）、COVID-19 ICU入院（每日变化百分比）和COVID-19生殖数量变化。我们在主要数据库中的检索策略产生了12，523个结果，在消除重复后减少到7，540篇文章。最终，35篇文献符合纳入系统评价的条件，其中23篇研究纳入荟萃分析。虽然研究来自低收入和高收入国家，但其中大多数来自美国（13项研究）和中国（5项研究）。荟萃分析的结果显示，采用NPHI导致4.68%的（95% CI，-6.94至-2.78）每日病例增长率下降4.8%（95 CI，-8.34至-1.40）每日死亡增长率下降1.90 COVID-19繁殖数量减少（95%CI，-2.23至-1.58），COVID-19每日ICU入院人数减少16.5%（95%CI，-19.68至-13.32）。少数研究显示，在发病率不高的情况下，提早实施封城有助缩短封城时间及减低封城后的个案增长率。大部分非公共卫生设施对抑制COVID-19传播有积极作用。由于普遍获得疫苗及其有效性方面仍然存在问题，并考虑到全国封锁和其他严厉限制对经济和人民生活的巨大影响，应通过采取其他非公共卫生措施来减轻此类干预措施，例如大规模佩戴口罩，患者/疑似病例隔离策略和接触者追踪。研究需要解决NPHIs对COVID-19以外的人口其他健康问题的影响。
Non-Pharmaceutical Public Health Interventions (NPHIs) have been used by different countries to control the spread of the COVID-19. Despite available evidence regarding the effectiveness of NPHSs, there is still no consensus about how policymakers can trust these results. Studies on the effectiveness of NPHSs are single studies conducted in specific communities. Therefore, they cannot individually prove if these interventions have been effective in reducing the spread of the infection and its adverse health outcomes. In this systematic review, we aimed to examine the effects of NPHIs on the COVID-19 case growth rate, death growth rate, Intensive Care Unit (ICU) admission, and reproduction number in countries, where NPHIs have been implemented. We searched relevant electronic databases, including Medline (via PubMed), Scopus, CINAHL, Web of Science, etc. from late December 2019 to February 1, 2021. The key terms were primarily drawn from Medical Subject Heading (MeSh and Emtree), literature review, and opinions of experts. Peer-reviewed quasi-experimental studies were included in the review. The PROSPERO registration number is CRD42020186855. Interventions were NPHIs categorized as lockdown, stay-at-home orders, social distancing, and other interventions (mask-wearing, contact tracing, and school closure). We used PRISMA 2020 guidance for abstracting the data and used Cochrane Effective Practice and Organization of Practice (EPOC) Risk of Bias Tool for quality appraisal of the studies. Hartung-Knapp-Sidik-Jonkman random-effects model was performed. Main outcomes included COVID-19 case growth rate (percentage daily changes), COVID-19 mortality growth rate (percentage daily changes), COVID-19 ICU admission (percentage daily changes), and COVID-19 reproduction number changes. Our search strategies in major databases yielded 12,523 results, which decreased to 7,540 articles after eliminating duplicates. Finally, 35 articles qualified to be included in the systematic review among which 23 studies were included in the meta-analysis. Although studies were from both low-income and high-income countries, the majority of them were from the United States (13 studies) and China (five studies). Results of the meta-analysis showed that adoption of NPHIs has resulted in a 4.68% (95% CI, -6.94 to -2.78) decrease in daily case growth rates, 4.8% (95 CI, -8.34 to -1.40) decrease in daily death growth rates, 1.90 (95% CI, -2.23 to -1.58) decrease in the COVID-19 reproduction number, and 16.5% (95% CI, -19.68 to -13.32) decrease in COVID-19 daily ICU admission. A few studies showed that, early enforcement of lockdown, when the incidence rate is not high, contributed to a shorter duration of lockdown and a lower increase of the case growth rate in the post-lockdown era. The majority of NPHIs had positive effects on restraining the COVID-19 spread. With the problems that remain regarding universal access to vaccines and their effectiveness and considering the drastic impact of the nationwide lockdown and other harsh restrictions on the economy and people’s life, such interventions should be mitigated by adopting other NPHIs such as mass mask-wearing, patient/suspected case isolation strategies, and contact tracing. Studies need to address the impact of NPHIs on the population’s other health problems than COVID-19.
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影响因子：
3.7
作者：
Iezadi S;Azami-Aghdash S;Ghiasi A;Rezapour A;Pourasghari H;Pashazadeh F;Gholipour K
通讯作者：
Gholipour K
影响因子：
7.4
作者：
Ebrahim S;Ashworth H;Noah C;Kadambi A;Toumi A;Chhatwal J
通讯作者：
Chhatwal J
影响因子：
4.6
作者：
Khataee H;Scheuring I;Czirok A;Neufeld Z
通讯作者：
Neufeld Z
影响因子：
3.8
作者：
Clark, Eva;Fredricks, Karla;Weatherhead, Jill
通讯作者：
Weatherhead, Jill
影响因子：
3.5
作者：
Alimohamadi Y;Holakouie-Naieni K;Sepandi M;Taghdir M
通讯作者：
Taghdir M