美洲梅毒：1980-2016 年四个高危人群梅毒流行率和发病率的系统评价方案。
Syphilis in the Americas: a protocol for a systematic review of syphilis prevalence and incidence in four high-risk groups, 1980-2016.
机构信息
Department of Medicine, Division of Infectious Diseases, UCLA South American Program in HIV Prevention Research (SAPHIR), David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, CHS 37-121, Los Angeles, CA, 90095, USA.
Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
出版信息
Syst Rev. 2017 Oct 10;6(1):195. doi: 10.1186/s13643-017-0595-3.
BACKGROUND
Syphilis infection has recently resurfaced as a significant public health problem. Although there has been a tremendous amount of research on the epidemiology of syphilis, there has been limited work done to synthesize the extensive body of research and systematically estimate patterns of disease within high-risk groups in the Americas. The purpose of this systematic review and meta-analysis is to (1) summarize recent patterns of syphilis infection in North and South America among four high-risk groups (MSM, transgender women, sex workers, and incarcerated individuals) from 1980 to 2016, (2) identify and differentiate regional geographic epidemiologic characteristics, and (3) compare the epidemics of the economically developed countries of North America from the developing countries and public health systems of Latin America and the Caribbean.
METHODS/DESIGN: Primary studies reporting syphilis prevalence and/or incidence in at least one of the four high-risk groups will be identified from Medline/PubMed, Embase, Lilacs, SciELO, The Cochrane Library, Web of Science, Scopus, ProQuest, CINAHL, Clase, and Periódica, as well as "gray" literature sources (conference abstracts, country reports, etc.). Studies published from 1980 through 2016 will be included. Data will be extracted from studies meeting inclusion and exclusion criteria and a random effects meta-analysis of prevalence and incidence estimates will be conducted. Heterogeneity, risk of bias, and publication bias will be assessed. Pooled prevalence and incidence estimates will be calculated for comparisons based on geographic region, risk factors, and time period.
DISCUSSION
Our systematic review and meta-analysis aims to contribute to an improved understanding of global epidemiologic patterns of syphilis infection in most-at-risk populations. Through systematic classification of the existing literature, and comparison of disease patterns across regional, temporal and socio-behavioral differences, we hope to improve public health surveillance and improve efforts to control the spread of disease across the Americas.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42016047306.
背景
梅毒感染最近重新成为一个重大的公共卫生问题。尽管已经有大量关于梅毒流行病学的研究，但在综合广泛的研究文献并系统地评估美洲高危人群中的疾病模式方面，所做的工作有限。本系统评价和荟萃分析的目的是：(1) 总结 1980 年至 2016 年期间，在北、南美洲，四个高危人群（男男性行为者、跨性别女性、性工作者和被监禁者）中梅毒感染的最新模式；(2) 确定并区分区域地理流行病学特征；(3) 比较北美经济发达国家与拉丁美洲和加勒比地区发展中国家公共卫生系统的梅毒流行情况。
方法/设计：将从 Medline/PubMed、Embase、Lilacs、SciELO、The Cochrane Library、Web of Science、Scopus、ProQuest、CINAHL、Clase 和 Periódica 以及“灰色”文献来源（会议摘要、国家报告等）中确定至少有一个高危人群报告梅毒患病率和/或发病率的原始研究。将纳入 1980 年至 2016 年期间发表的研究。将从符合纳入和排除标准的研究中提取数据，并对患病率和发病率估计值进行随机效应荟萃分析。将评估异质性、偏倚风险和发表偏倚。将根据地理位置、危险因素和时间段计算汇总的患病率和发病率估计值，以便进行比较。
讨论
我们的系统评价和荟萃分析旨在增进对高危人群中全球梅毒感染的流行病学模式的理解。通过对现有文献进行系统分类，并比较区域、时间和社会行为差异下的疾病模式，我们希望改善公共卫生监测，并加强努力控制疾病在美洲的传播。
系统评价注册
PROSPERO CRD42016047306。
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