Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK.
Epicentre, Paris, France.
Lancet Infect Dis. 2021 Mar;21(3):e37-e48. doi: 10.1016/S1473-3099(20)30479-5. Epub 2020 Oct 20.
Globally, cholera epidemics continue to challenge disease control. Although mass campaigns covering large populations are commonly used to control cholera, spatial targeting of case households and their radius is emerging as a potentially efficient strategy. We did a Scoping Review to investigate the effectiveness of interventions delivered through case-area targeted intervention, its optimal spatiotemporal scale, and its effectiveness in reducing transmission. 53 articles were retrieved. We found that antibiotic chemoprophylaxis, point-of-use water treatment, and hygiene promotion can rapidly reduce household transmission, and single-dose vaccination can extend the duration of protection within the radius of households. Evidence supports a high-risk spatiotemporal zone of 100 m around case households, for 7 days. Two evaluations separately showed reductions in household transmission when targeting case households, and in size and duration of case clusters when targeting radii. Although case-area targeted intervention shows promise for outbreak control, it is critically dependent on early detection capacity and requires prospective evaluation of intervention packages.
全球范围内，霍乱疫情仍持续对疾病防控构成挑战。尽管针对大量人群的大规模运动通常被用于控制霍乱，但针对病例家庭及其半径的空间靶向方法正成为一种潜在有效的策略。我们进行了范围综述，以调查通过病例地区靶向干预措施实施的干预措施的有效性、其最佳时空尺度，以及在减少传播方面的效果。共检索到 53 篇文章。我们发现，抗生素化学预防、现场水处理和卫生促进措施可以迅速减少家庭传播，单剂疫苗接种可以延长家庭半径内的保护持续时间。有证据支持在病例家庭周围 100 米的高风险时空区域内，持续 7 天。两项评估分别表明，针对病例家庭进行靶向干预可以降低家庭传播，针对半径进行靶向干预可以降低病例集群的规模和持续时间。尽管病例地区靶向干预在疫情控制方面显示出一定的前景，但它严重依赖于早期检测能力，需要对干预措施包进行前瞻性评估。
