Population Health and Optimal Health Practices Research Unit, CHUQ Research Center, Laval University, Quebec, QC, Canada; Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec, QC, Canada.
Trop Med Int Health. 2013 Oct;18(10):1283-91. doi: 10.1111/tmi.12179. Epub 2013 Aug 24.
To assess the geometric mean of blood lead levels in children aged below 6 years living in sub-Saharan Africa.
Search strategies were developed in MEDLINE, Web of Science and Google scholar system, supplemented by screening of references from included papers and review articles. Studies including children younger than 6 years residing in sub-Saharan Africa (SSA) were eligible. The studies were assessed for quality of methods for blood collection, for participants' recruitment and for quality control for lead analyses. Data were extracted and synthetised by estimating the mean weighted by sample size.
A total of 11 148 published papers were identified with only 16 studies conducted in SSA. Only nine of them were relevant of inclusion criteria. The weighted mean of blood lead levels was 13.1 μg/dl. Five of included studies were classified as being less likely to present selection bias, having performed venipuncture and adequate quality control for lead analyses. The weighted mean from analyses involving only these studies was 16.2 μg/dl. Six of the included studies reported the prevalence of blood lead levels ≥10 μg/dl; levels ranged from 7.0% to 70.9%. Only one study reported the prevalence of blood lead levels ≥5 μg/dl (50%).
The geometric mean of blood lead levels in sub-Saharan African children is still elevated relative to the US children. The new standard from the Centers for Disease Control and Prevention (5 μg/dl) implies that important efforts should be directed towards the initiation (or reinforcement) of prevention programmes and thorough research studies in sub-Saharan Africa.
评估居住在撒哈拉以南非洲地区的 6 岁以下儿童的血铅水平的几何均数。
在 MEDLINE、Web of Science 和 Google scholar 系统中制定搜索策略，并辅以纳入文献和综述文章的参考文献筛选。符合条件的研究包括居住在撒哈拉以南非洲（SSA）的 6 岁以下儿童。这些研究评估了采血方法、参与者招募和铅分析质量控制的方法的质量。通过估计按样本量加权的平均值来提取和综合数据。
共确定了 11148 篇已发表的论文，其中只有 16 项研究是在 SSA 进行的。只有其中 9 项符合纳入标准。血铅水平的加权平均值为 13.1μg/dl。纳入的研究中有 5 项被归类为不太可能存在选择偏倚，因为它们进行了静脉穿刺和适当的铅分析质量控制。仅对这些研究进行分析的加权平均值为 16.2μg/dl。纳入的研究中有 6 项报告了血铅水平≥10μg/dl 的患病率；水平范围为 7.0%至 70.9%。只有一项研究报告了血铅水平≥5μg/dl（50%）的患病率。
撒哈拉以南非洲儿童的血铅水平几何均数仍然高于美国儿童。疾病控制与预防中心（CDC）的新标准（5μg/dl）意味着，应大力开展预防计划，并在撒哈拉以南非洲地区开展深入的研究。
