Institute for Population Health, Weill Cornell Medicine, Doha, Qatar.
Institute for Population Health, Weill Cornell Medicine, Doha, Qatar.
Int J Infect Dis. 2021 Mar;104:198-206. doi: 10.1016/j.ijid.2020.09.1434. Epub 2020 Sep 26.
Synthesis of the available evidence on the effectiveness of medical and cloth facemask use by the general public in community settings is required to learn lessons for future respiratory epidemics/pandemics.
Search terms relating to facemasks, infection and community settings were used for PubMed, the Cochrane Library Database and Google Scholar. A meta-analysis was conducted using a random-effects model.
The review included 12 primary studies on the effectiveness of medical facemask use to prevent influenza, influenza-like illness, SARS-CoV, and SARS-CoV-2 transmission. The meta-analysis demonstrated that facemask use significantly reduces the risk of transmitting these respiratory infections (pooled OR = 0.66, 95% CI 0.54-0.81). Of the 12 studies, 10 clinical trials suggested that respiratory infection incidence is lower with high medical facemask compliance, early use and use in combination with intensive hand hygiene. One cohort study conducted during the SARS-CoV-2 pandemic demonstrated that facemasks are effective in reducing SARS-CoV-2 transmission when used before those who are infected develop symptoms. One case-control study reported that controls used medical facemasks more often than cases infected with SARS-CoV (p < 0.05). No primary study on cloth facemask effectiveness to prevent respiratory infection transmission was found.
Based on the available evidence, medical facemask use by healthy and sick individuals is recommended for preventing respiratory infection transmission in community settings. Medical facemask effectiveness is dependent on compliance and utilization in combination with preventive measures such as intensive hand hygiene. No direct evidence is currently available in humans supporting the recommendation of cloth facemask use to prevent respiratory infection transmission.
需要综合现有证据，了解普通人群在社区环境中使用医用口罩和布制口罩预防感染的效果，以为未来的呼吸道传染病/大流行吸取经验教训。
使用与口罩、感染和社区环境相关的检索词，在 PubMed、考科蓝图书馆数据库和谷歌学术上进行检索。采用随机效应模型进行荟萃分析。
本综述纳入了 12 项关于医用口罩预防流感、流感样疾病、严重急性呼吸综合征冠状病毒、严重急性呼吸综合征冠状病毒 2 传播的有效性的原始研究。荟萃分析表明，口罩的使用显著降低了这些呼吸道感染的传播风险（汇总 OR=0.66，95%CI 0.54-0.81）。在这 12 项研究中，10 项临床试验表明，高医用口罩依从性、早期使用和与强化手部卫生相结合使用可降低呼吸道感染的发生率。一项在严重急性呼吸综合征冠状病毒 2 大流行期间进行的队列研究表明，在感染者出现症状之前使用口罩可以有效减少严重急性呼吸综合征冠状病毒 2 的传播。一项病例对照研究报告称，与感染严重急性呼吸综合征冠状病毒的病例相比，对照组更常使用医用口罩（p<0.05）。未发现关于布制口罩预防呼吸道感染传播效果的原始研究。
根据现有证据，建议健康人群和患病个体在社区环境中使用医用口罩来预防呼吸道感染的传播。医用口罩的有效性取决于使用的依从性和与预防措施（如强化手部卫生）的结合。目前尚无直接证据支持推荐使用布制口罩来预防呼吸道感染的传播。
