Measures implemented in the school setting to contain the COVID-19 pandemic: a scoping review.
Measures implemented in the school setting to contain the COVID-19 pandemic: a scoping review.
复制标题
在学校环境中实施的遏制 COVID-19 大流行的措施：范围界定审查。
DOI：
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发表时间：
2020
影响因子：
8.4
通讯作者：
J. Burns
中科院分区：
文献类型：
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作者：
S. Krishnaratne;L. Pfadenhauer;Michaela Coenen;K. Geffert;C. Jung;Carmen Klinger;S. Kratzer;H. Littlecott;A. Movsisyan;Julia E Rabe;E. Rehfuess;K. Sell;B. Strahwald;J. Stratil;Stephan Voss;Katharina Wabnitz;J. Burns
背景
为应对SARS-CoV-2的传播和COVID-19的影响，国家和地方政府采取了各种措施，以控制病毒和相关疾病的传播。虽然这些措施是为了控制流行病而实施的，但它们也在社会层面上产生了严重的心理、社会和经济影响。受这些措施严重影响的一个环境是学校环境。截至2020年4月中旬，已有192个国家关闭了学校，影响了全球90%以上的学生。考虑到学校关闭的不利后果，世界上许多国家在最初关闭后的几个月里重新开放了学校。为了安全地重新开放学校并保持开放，各国政府实施了一系列措施。然而，关于这些措施的证据是异质的，评估了大量的研究设计、人群、环境、干预措施和结局。为了理解这种异质性，我们进行了快速范围审查（2020年10月8日至11月5日）。这一快速范围界定审查旨在作为系统性有效性审查的先导，为世界卫生组织（世卫组织）发布的准则提供信息。本综述按照系统性综述和荟萃分析首选报告项目扩展范围综述（PRISMA-ScR）清单进行报告，并在开放科学框架中注册。
目标
识别并全面绘制评估在SARS-CoV-2/COVID-19大流行期间在学校环境中实施的重新开放学校或保持学校开放或两者兼而有之的措施的影响的证据，特别关注在不同学校环境中实施的措施类型，用于衡量其影响的结果以及用于评估这些影响的研究类型。
搜索方法
我们于2020年10月8日检索了科克伦COVID-19研究登记册、MEDLINE、Embase、CDC COVID-19研究文章下载数据库的预印本以及WHO COVID-19全球冠状病毒病文献。
选择标准
我们纳入了评估在学校环境中实施的措施的影响的研究。符合条件的人群是有感染SARS-CoV-2或发生COVID-19疾病或两者兼而有之风险的人群，包括直接和间接受到干预措施影响的人，包括学生、教师、其他学校工作人员和这些群体的接触者，以及更广泛的社区。我们考虑了所有类型的实证研究，这些研究定量评估了影响，包括流行病学研究、建模研究、混合方法研究和诊断研究，这些研究评估了诊断测试准确性之外的相关干预措施的影响。关注的广泛结局类别包括传染病传播相关结局、其他有害或有益的健康相关结局以及社会、经济和生态影响。
数据收集和分析
我们以标准化的方式从纳入的研究中提取数据，并在可能的情况下将其映射到我们的先验逻辑模型中的类别。在不可能的地方，我们归纳开发了新的类别。根据范围界定审查的标准预期，该审查提供了现有证据的概述，无论方法学质量或偏倚风险如何，并且不旨在综合有效性数据、评估偏倚风险或表征证据强度（GRADE）。
主要结果
我们纳入了42项评估学校环境中实施的措施的研究。大多数研究使用数学建模设计（n = 31），而9项研究使用观察设计，2项研究使用实验或准实验设计。在真实世界背景下或使用真实的数据进行的研究集中于世卫组织欧洲区域（欧元; n = 20）、世卫组织美洲区域（AMR; n = 13）、西太平洋区域（WPR; n = 6）和世卫组织东地中海区域（EMR; n = 1）。一项研究进行了全球评估，另一项研究没有报告来自特定国家或适用于特定国家的数据。从纳入的研究中出现了三大干预类别：减少SARS-CoV-2传播的组织措施（n = 36），减少SARS-CoV-2传播的结构/环境措施（n = 11），以及检测SARS-CoV-2感染的监测和应对措施（n = 19）。大多数研究评估了SARS-CoV-2传播相关结局（n = 29），而其他研究评估了医疗保健利用（n = 8），其他健康结局（n = 3）以及社会，经济和生态结局（n = 5）。研究评估了所有结果类别的有害和有益结果。
作者的结论
我们确定了一个异构和复杂的证据基础的措施，在学校环境中实施。这一审查是了解现有证据的重要第一步，并将为关于这一主题的快速审查的发展提供信息。
BACKGROUND
In response to the spread of SARS-CoV-2 and the impact of COVID-19, national and subnational governments implemented a variety of measures in order to control the spread of the virus and the associated disease. While these measures were imposed with the intention of controlling the pandemic, they were also associated with severe psychosocial, societal, and economic implications on a societal level. One setting affected heavily by these measures is the school setting. By mid-April 2020, 192 countries had closed schools, affecting more than 90% of the world's student population. In consideration of the adverse consequences of school closures, many countries around the world reopened their schools in the months after the initial closures. To safely reopen schools and keep them open, governments implemented a broad range of measures. The evidence with regards to these measures, however, is heterogeneous, with a multitude of study designs, populations, settings, interventions and outcomes being assessed. To make sense of this heterogeneity, we conducted a rapid scoping review (8 October to 5 November 2020). This rapid scoping review is intended to serve as a precursor to a systematic review of effectiveness, which will inform guidelines issued by the World Health Organization (WHO). This review is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist and was registered with the Open Science Framework.
OBJECTIVES
To identify and comprehensively map the evidence assessing the impacts of measures implemented in the school setting to reopen schools, or keep schools open, or both, during the SARS-CoV-2/COVID-19 pandemic, with particular focus on the types of measures implemented in different school settings, the outcomes used to measure their impacts and the study types used to assess these.
SEARCH METHODS
We searched the Cochrane COVID-19 Study Register, MEDLINE, Embase, the CDC COVID-19 Research Articles Downloadable Database for preprints, and the WHO COVID-19 Global literature on coronavirus disease on 8 October 2020.
SELECTION CRITERIA
We included studies that assessed the impact of measures implemented in the school setting. Eligible populations were populations at risk of becoming infected with SARS-CoV-2, or developing COVID-19 disease, or both, and included people both directly and indirectly impacted by interventions, including students, teachers, other school staff, and contacts of these groups, as well as the broader community. We considered all types of empirical studies, which quantitatively assessed impact including epidemiological studies, modelling studies, mixed-methods studies, and diagnostic studies that assessed the impact of relevant interventions beyond diagnostic test accuracy. Broad outcome categories of interest included infectious disease transmission-related outcomes, other harmful or beneficial health-related outcomes, and societal, economic, and ecological implications.
DATA COLLECTION AND ANALYSIS
We extracted data from included studies in a standardized manner, and mapped them to categories within our a priori logic model where possible. Where not possible, we inductively developed new categories. In line with standard expectations for scoping reviews, the review provides an overview of the existing evidence regardless of methodological quality or risk of bias, and was not designed to synthesize effectiveness data, assess risk of bias, or characterize strength of evidence (GRADE).
MAIN RESULTS
We included 42 studies that assessed measures implemented in the school setting. The majority of studies used mathematical modelling designs (n = 31), while nine studies used observational designs, and two studies used experimental or quasi-experimental designs. Studies conducted in real-world contexts or using real data focused on the WHO European region (EUR; n = 20), the WHO region of the Americas (AMR; n = 13), the West Pacific region (WPR; n = 6), and the WHO Eastern Mediterranean Region (EMR; n = 1). One study conducted a global assessment and one did not report on data from, or that were applicable to, a specific country. Three broad intervention categories emerged from the included studies: organizational measures to reduce transmission of SARS-CoV-2 (n = 36), structural/environmental measures to reduce transmission of SARS-CoV-2 (n = 11), and surveillance and response measures to detect SARS-CoV-2 infections (n = 19). Most studies assessed SARS-CoV-2 transmission-related outcomes (n = 29), while others assessed healthcare utilization (n = 8), other health outcomes (n = 3), and societal, economic, and ecological outcomes (n = 5). Studies assessed both harmful and beneficial outcomes across all outcome categories.
AUTHORS' CONCLUSIONS
We identified a heterogeneous and complex evidence base of measures implemented in the school setting. This review is an important first step in understanding the available evidence and will inform the development of rapid reviews on this topic.
影响因子：
3.8
作者：
Worby CJ;Chaves SS;Wallinga J;Lipsitch M;Finelli L;Goldstein E
通讯作者：
Goldstein E
影响因子：
7.2
作者：
Baernighausen, Till;Tugwell, Peter;Atun, Rifat
通讯作者：
Atun, Rifat
影响因子：
3.8
作者：
España G;Cavany S;Oidtman R;Barbera C;Costello A;Lerch A;Poterek M;Tran Q;Wieler A;Moore S;Perkins TA
通讯作者：
Perkins TA