Zhu Alice, Bruketa Eva, Svoboda Tomislav, Patel Jamie, Elmi Nika, El-Khechen Richandi Graziella, Baral Stefan, Orkin Aaron M
Population Health Service, Inner City Health Associates. Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, ON, Canada; Department of General Surgery, University of Toronto, Toronto, ON, Canada.
Population Health Service, Inner City Health Associates. Toronto, ON, Canada; Queen's University, School of Medicine, Kingston, ON, Canada.
Ann Epidemiol. 2023 Jan;77:127-135. doi: 10.1016/j.annepidem.2022.03.004. Epub 2022 Mar 24.
People experiencing homelessness (PEH) are at increased risk of respiratory infections and associated morbidity and mortality. To characterize optimal intervention strategies, we completed a systematic review of mitigation strategies for PEH to minimize the spread and impact of respiratory infectious disease outbreaks, including COVID-19.
The study protocol was registered in PROSPERO (#2020 CRD42020208964) and was consistent with the preferred reporting in systematic reviews and meta-analyses guidelines. A search algorithm containing keywords that were synonymous to the terms "Homeless" and "Respiratory Illness" was applied to the six databases. The search concluded on September 22, 2020. Quality assessment was performed at the study level. Steps were conducted by two independent team members.
A total of 4468 unique titles were retrieved with 21 meeting criteria for inclusion. Interventions included testing, tracking, screening, infection prevention and control, isolation support, and education. Historically, there has been limited study of intervention strategies specifically for PEH across the world.
Staff and organizations providing services for people experiencing homelessness face specific challenges in adhering to public health guidelines such as physical distancing, isolation, and routine hygiene practices. There is a discrepancy between the burden of infectious diseases among PEH and specific research characterizing optimal intervention strategies to mitigate transmission in the context of shelters. Improving health for people experiencing homelessness necessitates investment in programs scaling existing interventions and research to study new approaches.
无家可归者（PEH）面临呼吸道感染及相关发病和死亡风险增加的问题。为了确定最佳干预策略，我们对针对无家可归者的缓解策略进行了系统综述，以尽量减少呼吸道传染病暴发（包括2019冠状病毒病）的传播和影响。
该研究方案已在国际前瞻性系统评价注册库（PROSPERO，注册号#2020 CRD42020208964）登记，并符合系统评价和荟萃分析指南中的首选报告规范。将包含与“无家可归”和“呼吸道疾病”同义的关键词的搜索算法应用于六个数据库。搜索于2020年9月22日结束。在研究层面进行质量评估。步骤由两名独立的团队成员执行。
共检索到4468个独特标题，其中21个符合纳入标准。干预措施包括检测、追踪、筛查、感染预防与控制、隔离支持和教育。从历史上看，全球专门针对无家可归者的干预策略研究有限。
为无家可归者提供服务的工作人员和组织在遵守诸如保持社交距离、隔离和日常卫生习惯等公共卫生指南方面面临特殊挑战。无家可归者中的传染病负担与在收容所背景下确定最佳干预策略以减轻传播的具体研究之间存在差异。改善无家可归者的健康状况需要对扩大现有干预措施的项目进行投资，并开展研究以探索新方法。
