Clinical manifestations of Rift Valley fever in humans: Systematic review and meta-analysis.
Clinical manifestations of Rift Valley fever in humans: Systematic review and meta-analysis.
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DOI：
10.1371/journal.pntd.0010233
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发表时间：
2022-03
影响因子：
3.8
通讯作者：
Elliott A
中科院分区：
文献类型：
--
作者：
Anywaine Z;Lule SA;Hansen C;Warimwe G;Elliott A
裂谷热(RVF)是一种新出现的、被忽视的、由蚊子传播的人畜共患病，具有显著的发病率、死亡率和不断扩大的地理范围。人类的临床症状和体征是非特异性的，病例定义各不相同。我们回顾和分析了人类裂谷热的临床表现。在这项系统回顾和荟萃分析中，我们搜索了不同日期的Embase(1947至2019年10月13日)、Medline(1946至2019年10月14日)、Global Health(1910至2019年10月15日)和Web of Science(1970至2019年10月15日)数据库。以英文发表的研究报告了人类症状的频率，以及实验室确认的裂谷热。动物研究，无症状志愿者的研究，以及无法估计比例的单一病例报告被排除在外。使用改进的Hoy和Brooks等人的工具进行质量评估，提取数据，并使用随机效应荟萃分析计算合并频率估计。在所检索的3765篇文章中，纳入系统综述和荟萃分析的文章不到1%(32篇)。报告了9种RVF临床综合征，包括全身发热、肾脏、胃肠、肝脏、出血、视觉、神经、心肺和产科综合征。最常见的临床表现包括发热(81%；95%可信区间(CI)69-91；[26项研究，1286名患者])，肾功能衰竭(41%；23-59；[4,327])，恶心(38%；12-67；[6,325])，黄疸(26%；16-36；[15,393])，出血性疾病(26%；17-36；[16,277])，部分失明(24%；7-45；[11,225])，脑炎(21%；11-33；[4,327])、咳嗽(4%；0-17；[4，11])和流产(54%)。死亡发生在21%的病例(95%可信区间14-29；[16项研究，328名患者])，其中大多数人住院治疗。这项研究将人类裂谷热疾病的复杂症状描述为综合征。这种方法可能会改善病例定义和发现率，影响暴发控制，提高公众对裂谷热的认识，并随后为“单一卫生”政策提供信息。这项研究提供了RVF临床表现比例的综合估计，并对临床症状进行了叙述性描述。然而，大多数综述的研究都是样本量较小的病例系列研究，主要纳入住院患者和门诊患者，并稀疏地或使用宽泛的类别术语捕获症状。裂谷热(RVF)是一种被忽视的虫媒病毒人畜共患病，在人类中引起严重和多样化的疾病表现。目前还没有用于人类的许可疫苗，对疾病负担的监测和估计也很有限，这在一定程度上是因为无法简明扼要地定义疾病。我们在Medline、Embase、Global Health和Web of Science上搜索有关裂谷热在人类中的临床表现的已发表报告。以英文发表的研究报告了人类症状的频率，以及实验室确认的裂谷热。我们排除了动物研究、在无症状志愿者中的研究和无法估计比例的单一病例报告。使用随机效应荟萃分析计算合并症状频率估计。这篇综述提供了症状相对频率的详细汇总，并描述了人类裂谷热的临床表现。以前的系统性审查提供了一种叙述性的描述，在其他地方性感染存在类似症状的地区，很难确定裂谷热疾病的最相关特征。这篇综述将完善临床诊断，改进病例检测，并提高公众对RVF在人类中表现的认识。
Rift Valley fever (RVF) is an emerging, neglected, mosquito-borne viral zoonosis associated with significant morbidity, mortality and expanding geographical scope. The clinical signs and symptoms in humans are non-specific and case definitions vary. We reviewed and analysed the clinical manifestations of RVF in humans. In this systematic review and meta-analysis we searched on different dates, the Embase (from 1947 to 13th October 2019), Medline (1946 to 14th October 2019), Global Health (1910 to 15th October 2019), and Web of Science (1970 to 15th October 2019) databases. Studies published in English, reporting frequency of symptoms in humans, and laboratory confirmed RVF were included. Animal studies, studies among asymptomatic volunteers, and single case reports for which a proportion could not be estimated, were excluded. Quality assessment was done using a modified Hoy and Brooks et al tool, data was extracted, and pooled frequency estimates calculated using random effects meta-analysis. Of the 3765 articles retrieved, less than 1% (32 articles) were included in the systematic review and meta-analysis. Nine RVF clinical syndromes were reported including the general febrile, renal, gastrointestinal, hepatic, haemorrhagic, visual, neurological, cardio-pulmonary, and obstetric syndromes. The most common clinical manifestations included fever (81%; 95% Confidence Interval (CI) 69–91; [26 studies, 1286 patients]), renal failure (41%; 23–59; [4, 327]), nausea (38%; 12–67; [6, 325]), jaundice (26%; 16–36; [15, 393]), haemorrhagic disease (26%; 17–36; [16, 277]), partial blindness (24%; 7–45; [11, 225]), encephalitis (21%; 11–33; [4, 327]), cough (4%; 0–17; [4, 11]), and miscarriage (54%) respectively. Death occurred in 21% (95% CI 14–29; [16 studies, 328 patients]) of cases, most of whom were hospitalised. This study delineates the complex symptomatology of human RVF disease into syndromes. This approach is likely to improve case definitions and detection rates, impact outbreak control, increase public awareness about RVF, and subsequently inform ‘one-health’ policies. This study provides a pooled estimate of the proportion of RVF clinical manifestations alongside a narrative description of clinical syndromes. However, most studies reviewed were case series with small sample sizes and enrolled mostly in-patients and out-patients, and captured symptoms either sparsely or using broad category terms. Rift Valley fever (RVF) is a neglected, arboviral zoonosis that causes severe and diverse disease manifestations in humans. Currently no licenced vaccines exist for use in humans and there is limited surveillance and estimation of disease burden which in part is due to the inability to concisely define the disease. We searched Medline, Embase, Global Health, and Web of Science for published reports on the clinical manifestations of RVF in humans. Studies published in English, reporting frequency of symptoms in humans, and laboratory confirmed RVF were included. We excluded animal studies, studies among asymptomatic volunteers and single case reports for which a proportion could not be estimated. Pooled symptom frequency estimates were calculated using random effects meta-analysis. This review provides a detailed aggregation of the relative frequency of symptoms, and a description of the RVF clinical manifestations in humans. Previous systematic reviews provided a narrative account and it was difficult to identify the most relevant features of RVF disease in areas where other endemic infections present with similar symptoms. This review will refine the clinical diagnosis, improve case detection, and increase public awareness about RVF presentation in humans.
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影响因子：
11.8
作者：
Buehler JW;Berkelman RL;Hartley DM;Peters CJ
通讯作者：
Peters CJ
DOI：
10.4269/ajtmh.2010.09-0293
发表时间：
2010-08-01
影响因子：
3.3
作者：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
Clements, Archie C. A.;Pfeiffe, Dirk U.;Otte, M. Joachim
通讯作者：
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