Department of Psychiatry, University of Oxford, Oxford, Oxfordshire, UK.
Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
BMJ Glob Health. 2020 Nov;5(11). doi: 10.1136/bmjgh-2020-003201.
There are reports of outbreaks of COVID-19 in prisons in many countries. Responses to date have been highly variable and it is not clear whether public health guidance has been informed by the best available evidence. We conducted a systematic review to synthesise the evidence on outbreaks of highly contagious diseases in prison.
We searched seven electronic databases for peer-reviewed articles and official reports published between 1 January 2000 and 28 July 2020. We included quantitative primary research that reported an outbreak of a given contagious disease in a correctional facility and examined the effects of interventions. We excluded studies that did not provide detail on interventions. We synthesised common themes using the Synthesis Without Meta-analysis (SWiM) guideline, identified gaps in the literature and critically appraised the effectiveness of various containment approaches.
We identified 28 relevant studies. Investigations were all based in high-income countries and documented outbreaks of tuberculosis, influenza (types A and B), varicella, measles, mumps, adenovirus and COVID-19. Several themes were common to these reports, including the public health implications of infectious disease outbreaks in prison, and the role of interagency collaboration, health communication, screening for contagious diseases, restriction, isolation and quarantine, contact tracing, immunisation programmes, epidemiological surveillance and prison-specific guidelines in addressing any outbreaks.
Prisons are high-risk settings for the transmission of contagious diseases and there are considerable challenges in managing outbreaks in them. A public health approach to managing COVID-19 in prisons is required.
CRD42020178827.
许多国家的监狱都有 COVID-19 爆发的报告。迄今为止的应对措施差异很大，目前尚不清楚公共卫生指南是否基于现有最佳证据。我们进行了一项系统评价，以综合有关监狱高度传染性疾病爆发的证据。
我们在七个电子数据库中搜索了 2000 年 1 月 1 日至 2020 年 7 月 28 日期间发表的同行评审文章和官方报告。我们纳入了定量的初级研究，这些研究报告了一个特定的传染病在惩教设施中的爆发，并研究了干预措施的效果。我们排除了未详细说明干预措施的研究。我们使用无荟萃分析的综合方法（SWiM）指南综合了常见主题，确定了文献中的差距，并批判性地评估了各种遏制方法的有效性。
我们确定了 28 项相关研究。这些研究均基于高收入国家，记录了结核病、流感（A 型和 B 型）、水痘、麻疹、腮腺炎、腺病毒和 COVID-19 的爆发。这些报告中有几个共同的主题，包括传染病在监狱中的爆发对公共卫生的影响，以及机构间合作、卫生宣传、传染性疾病筛查、限制、隔离和检疫、接触者追踪、免疫计划、流行病学监测和针对特定监狱的指南在应对任何爆发中的作用。
监狱是传染病传播的高风险场所，在管理监狱中的疫情爆发方面存在很大的挑战。需要采取公共卫生方法来管理监狱中的 COVID-19。
PROSPERO 注册号：CRD42020178827。
