Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; HIV Prevention Research Unit, South African Medical Research Council, Cape Town, South Africa.
S Afr Med J. 2021 Mar 2;111(3):227-233. doi: 10.7196/SAMJ.2021.v111i3.15119.
Evidence on mask use in the general population is needed to inform SARS-CoV-2 responses.
To assess the effectiveness of cloth and medical masks for preventing SARS-CoV-2 transmission in community settings.
Two rapid reviews were conducted searching three electronic databases (PubMed, Embase, Cochrane Library) and two clinical trials registries on 30 and 31 March 2020.
We screened 821 records and assessed nine full-text articles for eligibility. One and seven RCTs were included for cloth and medical mask reviews, respectively. No SARS-CoV-2-specific RCTs and no cloth mask RCTs in community settings were identified. A single hospital-based RCT provided indirect evidence that, compared with medical masks, cloth masks probably increase clinical respiratory illnesses (relative risk (RR) 1.56; 95% confidence interval (CI) 0.98 - 2.49) and laboratory-confirmed respiratory virus infections (RR 1.54; 95% CI 0.88 - 2.70). Evidence for influenza-like illnesses (ILI) was uncertain (RR 13.00; 95% CI 1.69 - 100.03). Two RCTs provide low-certainty evidence that medical masks may make little to no difference to ILI infection risk versus no masks (RR 0.98; 95% CI 0.81 - 1.19) in the community setting. Five RCTs provide low-certainty evidence that medical masks may slightly reduce infection risk v. no masks (RR 0.81; 95% CI 0.55 - 1.20) in the household setting.
Direct evidence for cloth and medical mask efficacy and effectiveness in the community is limited. Decision-making for mask use may consider other factors such as feasibility and SARS-CoV-2 transmission dynamics; however, well-designed comparative effectiveness studies are required.
需要有关于普通人群使用口罩的证据，以便为 SARS-CoV-2 应对措施提供信息。
评估布制口罩和医用口罩在社区环境中预防 SARS-CoV-2 传播的效果。
我们于 2020 年 3 月 30 日和 31 日在三个电子数据库（PubMed、Embase、Cochrane Library）和两个临床试验注册处进行了两次快速审查。
我们筛选了 821 条记录，并评估了 9 篇全文文章的资格。分别纳入了一项和七项 RCT 进行布制口罩和医用口罩审查。没有发现针对 SARS-CoV-2 的特定 RCT 以及在社区环境中使用布制口罩的 RCT。一项基于医院的 RCT 提供了间接证据，表明与医用口罩相比，布制口罩可能会增加临床呼吸道疾病（相对风险（RR）1.56；95%置信区间（CI）0.98 - 2.49）和实验室确诊的呼吸道病毒感染（RR 1.54；95%CI 0.88 - 2.70）。关于流感样疾病（ILI）的证据不确定（RR 13.00；95%CI 1.69 - 100.03）。两项 RCT 提供了低确定性证据，表明在社区环境中，医用口罩与不戴口罩相比，对 ILI 感染风险的影响可能很小或没有（RR 0.98；95%CI 0.81 - 1.19）。五项 RCT 提供了低确定性证据，表明在家庭环境中，医用口罩可能会略微降低感染风险，与不戴口罩相比（RR 0.81；95%CI 0.55 - 1.20）。
关于布制口罩和医用口罩在社区中的疗效和效果的直接证据有限。决策是否使用口罩时可能会考虑其他因素，例如可行性和 SARS-CoV-2 传播动态；但是，需要进行精心设计的比较有效性研究。
