Barth Dylan D, Mayosi Bongani M, Jabar Ardil, Engel Mark E
Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
BMJ Open. 2015 Aug 27;5(8):e008646. doi: 10.1136/bmjopen-2015-008646.
The true burden of group A streptococcal (GAS) disease in Africa is not known. GAS is a significant cause of mortality and morbidity on the global scale and in developing countries. According to Carapetis et al, the prevalence of severe GAS disease is at least 18.1 million cases with an incidence of at least 1.78 million cases per year.
We aim to provide a systematic review of studies measuring the prevalence of GAS infection among people in North and Sub-Saharan African countries. A comprehensive literature search of a number of databases will be undertaken, using an African search filter, to identify GAS prevalence studies that have been published. Full copies of articles will be identified by a defined search strategy and will be considered for inclusion against predefined criteria. Statistical analysis will include two steps: (1) identification of data sources and documenting of estimates, and (2) the application of the random-effects and fixed-effects meta-analysis model to aggregate prevalence estimates, and to account for between study variability in calculating the overall pooled estimates and 95% CI for GAS prevalence. Heterogeneity will be evaluated using the I(2) statistic to determine the extent of variation in effect estimates that is due to heterogeneity rather than chance. This systematic review protocol was prepared according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocols (PRISMA-P) 2015 Statement. This review will provide updated evidence of a review published in 2009. Our data will have implications for the development of a GAS vaccine.
Ethics approval is not required for this study given that this is a protocol for a systematic review of published studies. The results of this study will be disseminated through a peer-reviewed publication and conference presentation.
PROSPERO CRD4201401290 0. (http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014012900).
非洲A组链球菌（GAS）疾病的实际负担尚不清楚。GAS是全球范围内以及发展中国家死亡率和发病率的重要原因。根据卡拉佩蒂斯等人的研究，严重GAS疾病的患病率至少为1810万例，每年发病率至少为178万例。
我们旨在对测量北非和撒哈拉以南非洲国家人群中GAS感染患病率的研究进行系统综述。将使用非洲搜索过滤器对多个数据库进行全面的文献检索，以识别已发表的GAS患病率研究。文章的完整副本将通过既定的搜索策略进行识别，并将根据预先定义的标准考虑纳入。统计分析将包括两个步骤：（1）识别数据来源并记录估计值，以及（2）应用随机效应和固定效应荟萃分析模型汇总患病率估计值，并在计算GAS患病率的总体合并估计值和95%置信区间时考虑研究间的变异性。将使用I(2)统计量评估异质性，以确定效应估计值中由于异质性而非偶然性导致的变异程度。本系统综述方案是根据《系统评价与荟萃分析方案的首选报告项目》（PRISMA-P）（2015年声明）编写的。本综述将提供2009年发表的一篇综述的更新证据。我们的数据将对GAS疫苗的开发产生影响。
鉴于本研究是对已发表研究的系统综述方案，因此无需伦理批准。本研究结果将通过同行评审出版物和会议报告进行传播。
PROSPERO CRD42014012900。（http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014012900）
