Bardach Ariel, Alconada Tomás, Palermo Carolina, Rojas-Roque Carlos, Sandoval María Macarena, Gomez Jorge, Pinto Thatiana, Ciapponi Agustin
Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina.
GSK, Buenos Aires, Argentina.
Infect Dis Ther. 2023 Jun;12(6):1505-1525. doi: 10.1007/s40121-023-00814-0. Epub 2023 Jun 1.
Neisseria gonorrhoeae causes gonorrhoea, a globally neglected but increasing disease. This systematic review and meta-analysis reviewed the epidemiology and economic burden of gonorrhoea in Latin America and the Caribbean (LAC).
We searched PubMed, EMBase, Cochrane Library, EconLIT, CINAHL, CRD, LILACS, Global Health, Global Dissertations and Theses, SciELO, Web of Science databases, countries' ministries of health, and the IHME's Global Burden of Disease databases. Studies published in the last 10 years (20 years for economic studies) were included if conducted in any LAC country, without language restrictions. The main outcome measures were incidence/prevalence, proportion of co-infections, case fatality rates, specific mortality/hospitalisation rates, direct/indirect costs, and impact of gonorrhoea on quality of life. To assess evidence quality, we used a checklist developed by the US National Heart, Lung, and Blood Institute for observational studies and trial control arms, the Cochrane Effective Practice Organization of Care Group tool for randomised controlled trials, and the CICERO checklist for economic studies.
We identified 1290 articles; 115 included epidemiological studies and one included an economic study. Ministry of health data from Argentina, Brazil, Chile, Colombia, Mexico, and Uruguay were identified. Gonorrhoea prevalence was 1.46% (95% confidence interval [CI] 1.00-2.00%) from 48 studies and 5.68% (95% CI 4.23-7.32%) from 58 studies for non-high-risk and high-risk populations, respectively. Cumulative incidence for the high-risk population was 2.05 cases per 100 persons/year. Few published studies were rated as "good" in the risk of bias assessments. Variations in the methodology of the sources and limited information found in the countries' surveillance systems hinder the comparison of data.
The burden of gonorrhoea in LAC is not negligible. Our results provide public health and clinical decision support to assess potential interventions to prevent gonorrhoea.
The protocol is registered on PROSPERO (CRD42021253342). The study was funded by GlaxoSmithKline Biologicals SA (GSK study identifier VEO-000025).
淋病奈瑟菌可引发淋病，这是一种在全球范围内受到忽视但发病率不断上升的疾病。本系统评价和荟萃分析回顾了拉丁美洲和加勒比地区（LAC）淋病的流行病学和经济负担。
我们检索了PubMed、EMBase、Cochrane图书馆、EconLIT、CINAHL、CRD、LILACS、全球卫生、全球学位论文数据库、科学电子图书馆在线（SciELO）、科学引文索引数据库，各国卫生部以及健康指标与评估研究所（IHME）的全球疾病负担数据库。纳入过去10年发表的研究（经济研究为20年），研究需在任何拉丁美洲和加勒比地区国家进行，无语言限制。主要结局指标为发病率/患病率、合并感染比例、病死率、特定死亡率/住院率、直接/间接成本以及淋病对生活质量的影响。为评估证据质量，我们使用了美国国家心肺血液研究所制定的观察性研究和试验对照臂清单、Cochrane有效实践护理组织小组用于随机对照试验的工具以及经济研究的CICERO清单。
我们共识别出1290篇文章；其中115篇纳入流行病学研究，1篇纳入经济研究。还识别出了来自阿根廷、巴西、智利、哥伦比亚、墨西哥和乌拉圭的卫生部数据。48项研究显示非高危人群淋病患病率为1.46%（95%置信区间[CI]1.00 - 2.00%），58项研究显示高危人群淋病患病率为5.68%（95%CI 4.23 - 7.32%）。高危人群的累积发病率为每100人/年2.05例。在偏倚风险评估中，很少有已发表的研究被评为“良好”。数据来源方法的差异以及各国监测系统中发现的信息有限阻碍了数据的比较。
拉丁美洲和加勒比地区淋病的负担不可忽视。我们的结果为评估预防淋病的潜在干预措施提供了公共卫生和临床决策支持。
该方案已在国际前瞻性系统评价注册库（PROSPERO）注册（注册号CRD42021253342）。该研究由葛兰素史克生物制品公司资助（GSK研究标识符VEO - 000025）。
Zotero 插件