Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Division of Laboratory Systems and Networks, Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
PLoS One. 2023 Nov 29;18(11):e0292085. doi: 10.1371/journal.pone.0292085. eCollection 2023.
In Africa, little is known about the role of telephone hotlines in outbreak response. We systematically reviewed the role and effectiveness of hotlines on outbreak response in Africa.
We used the Cochrane handbook and searched five databases. The protocol was registered on PROSPERO (CRD42021247141). Medline, Embase, PsycINFO, Global Health and Web of Science were searched from 30 June 2020 to August 2020 for studies on the use of telephone hotlines in outbreak response in Africa published between January 1995 and August 2020. The search was also repeated on 16 September 2022. Data on effectiveness (alerts generated, cases confirmed) were extracted from peer-reviewed studies. Meta-analysis of alerts generated, and proportion of cases confirmed was done using the random effects model. The quality of studies was assessed using the Joanna Briggs Institute (JBI) tools. The heterogeneity and publication bias were assessed using the Galbraith and funnel plots, respectively.
Our search yielded 1251 non-duplicate citations that were assessed. 41 full texts were identified, and 21 studies were included in the narrative synthesis, while 12 were included in the meta-analysis. The hotlines were local (seven studies) or national (three studies). A combination of a local and national hotline was used in one study. The hotlines were set up for unusual respiratory events (one study), polio (one study), Ebola (10 studies), COVID-19 (two studies), malaria (one study), influenza-like illnesses (ILI) (one study) and rift valley fever in livestock (one study). Hotlines were mainly used for outbreak surveillance at the local level. A total of 332,323 alerts were generated, and 67,658 met the case definition, corresponding to an overall pooled proportion of alerts generated(sensitivity) of 38% (95%CI: 24-52%). The sensitivity was 41% (95% CI: 24-59%) for local hotlines and 26%(95%CI:5-47%) for national hotlines. Hotlines were also used for surveillance of rift valley fever in livestock (one study) vaccination promotion (one study), death reporting (five studies), rumour tracking and fighting misinformation (two studies) and community engagement (five studies). The studies were of low to moderate quality with high publication bias and heterogeneity(I2 = 99%). The heterogeneity was not explained by the sample size.
These data suggest that telephone hotlines can be effective in outbreak disease surveillance in Africa. Further implementation research is needed to scale up telephone hotlines in rural areas.
在非洲，人们对电话热线在疫情应对中的作用知之甚少。我们系统地回顾了热线在非洲疫情应对中的作用和效果。
我们使用 Cochrane 手册并搜索了五个数据库。该方案已在 PROSPERO（CRD42021247141）上注册。2020 年 6 月 30 日至 2020 年 8 月，我们检索了 Medline、Embase、PsycINFO、全球卫生和 Web of Science，以获取 1995 年 1 月至 2020 年 8 月期间在非洲使用电话热线应对疫情的研究报告。2022 年 9 月 16 日，我们也进行了重复搜索。从同行评议的研究中提取了有关有效性（警报生成、确诊病例）的数据。使用随机效应模型对警报生成的比例和确诊病例的比例进行了荟萃分析。使用 Joanna Briggs 研究所（JBI）工具评估研究的质量。使用 Galbraith 和漏斗图分别评估异质性和发表偏倚。
我们的搜索产生了 1251 条非重复引用，对其进行了评估。确定了 41 篇全文，21 项研究纳入叙述性综述，12 项研究纳入荟萃分析。热线是本地的（7 项研究）或国家的（3 项研究）。一项研究结合了本地和国家热线。热线是为不寻常的呼吸道事件（一项研究）、小儿麻痹症（一项研究）、埃博拉（10 项研究）、COVID-19（两项研究）、疟疾（一项研究）、流感样疾病（一项研究）和裂谷热在牲畜中（一项研究）而设立的。热线主要用于地方一级的疫情监测。共产生了 332323 次警报，其中 67658 次符合病例定义，总体汇总的警报生成比例（敏感性）为 38%（95%CI：24-52%）。本地热线的敏感性为 41%（95%CI：24-59%），国家热线的敏感性为 26%（95%CI：5-47%）。热线还用于牲畜裂谷热监测（一项研究）、疫苗推广（一项研究）、死亡报告（五项研究）、谣言追踪和打击错误信息（两项研究）以及社区参与（五项研究）。这些研究的质量为低到中等，发表偏倚和异质性高（I2=99%）。异质性不能用样本量来解释。
这些数据表明，电话热线在非洲的疫情疾病监测中可能是有效的。需要进一步开展实施研究，以在农村地区扩大电话热线的使用。
