Impact of recurrent outbreaks of Ebola virus disease in Africa: a meta-analysis of case fatality rates
Impact of recurrent outbreaks of Ebola virus disease in Africa: a meta-analysis of case fatality rates
复制标题
DOI：
10.1016/j.puhe.2021.03.027
复制
发表时间：
2021-05-30
期刊：
影响因子：
5.2
通讯作者：
Yu, X.
中科院分区：
文献类型：
--
作者：
Kawuki, J.;Musa, T. H.;Yu, X.
目标：2010 年至 2020 年间，非洲爆发了多次埃博拉病毒病 (EVD) 疫情，每次疫情都带来了不同的病死率 (CFR) 和其他社会经济影响。本研究旨在总结病死率并确定影响非洲埃博拉病毒病疫情严重程度的潜在因素。研究设计：这是使用 Web of Science、Scopus 和 PubMed 数据库对 2010 年 1 月至 2020 年 3 月期间发表的埃博拉病毒病疫情进行的系统回顾和荟萃分析。方法：仅考虑英文文章和报告，包括非洲疫情期间的病例数和死亡人数。使用 Murad 的质量评估工具评估纳入文章的质量。使用 Stata（第 12 版）进行分析，使用随机效应模型计算汇总效应大小，并使用 I2 统计量测试异质性。结果：确定了 13 项涉及 32,300 例病例和 13,727 例死亡的研究，其汇总 CFR 为 60%（95% 置信区间 [CI]：47-73%）。受埃博拉病毒病影响最严重的国家是刚果民主共和国，爆发了 5 次疫情，合并病死率为 65%（95% CI：59-71%），其次是乌干达，爆发了 3 次疫情，病死率为 83%（95% CI：60-99%）。扎伊尔埃博拉病毒引起的疫情最多 (10 起)，病死率为 58% (95% CI: 45-71%)。此外，与病例数较多的疫情（51%，95% CI：33-69%）相比，病例数少于 1000 例的疫情报告的病死率（CFR）较高（65%，95% CI：54-75%）。结论：该研究揭示了非洲埃博拉病毒病反复暴发造成的病死率相当高。它还指出了预防和控制战略的实施差距，因此确定需要加强监测系统和应对机制，以便及早发现并及时控制未来的疫情爆发。 (C) 2021 英国皇家公共卫生学会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: Between 2010 and 2020, Africa witnessed several outbreaks of Ebola virus disease (EVD), each presenting with varying case fatality rate (CFR) and other socio-economic impacts. This study aims to summarize the CFR and identify potential factors that influenced the severity of EVD outbreaks in Africa.Study design: This was a systematic review and meta-analysis of EVD outbreaks published between January 2010 and March 2020, using Web of Science, Scopus, and PubMed databases.Methods: Only English-language articles and reports, including the number of cases and deaths during the outbreak in Africa, were considered. The quality of the included articles was assessed using Murad's quality assessment tool. The analysis was conducted using Stata (version 12), pooled effect sizes were calculated using the random-effects model, and heterogeneity was tested for using the I2 statistic.Results: Thirteen studies with 32,300 cases and 13,727 deaths were identified, whose pooled CFR was 60% (95% confidence interval [CI]: 47-73%). The most EVD-affected countries were the Democratic Republic of Congo with five outbreaks and a pooled CFR of 65% (95% CI: 59-71%), followed by Uganda with three outbreaks and CFR of 83% (95% CI: 60-99%). Zaire ebolavirus caused the most outbreaks (10), with a CFR of 58% (95% CI: 45-71%). Besides, outbreaks with fewer than 1000 cases reported a higher CFR rate (65%, 95% CI: 54-75%) compared with those with more cases (51%, 95% CI: 33-69%).Conclusion: The study has revealed a considerably high CFR caused by the recurrent EVD outbreaks in Africa. It also notes an implementation gap in the prevention and control strategies and thus identifies a need to strengthen the surveillance systems and response mechanisms to enable early detection and prompt control of future outbreaks. (C) 2021 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.