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[减轻新冠疫情对移民的影响:干预措施效果的系统评价]

[Reducing the impact of COVID-19 in immigrants: a systematic review of the efficacy of interventions].

作者信息

Cernigliaro Achille, Giorgi Rossi Paolo, Di Napoli Anteo, Milli Caterina, Petrelli Alessio, Scondotto Salvatore, D'Amato Stefania, Mondello Stefania

机构信息

Dipartimento per le Attività Sanitarie e Osservatorio Epidemiologico (DASOE), Assessorato della Salute, Regione Siciliana, Palermo.

Unità Operativa Complessa di Patologia Clinica, Dipartimento dei Servizi e delle Scienze Radiologiche, Presidio Ospedaliero Sant'Antonio Abate, Azienda Sanitaria Provinciale di Trapani, Erice (TP).

出版信息

Epidemiol Prev. 2024 Jul-Oct;48(4-5):75-84. doi: 10.19191/EP24.4-5.S1.116.

Abstract

BACKGROUND

the spread of SARS-CoV-2 in the population has amplified the effects of health inequalities, particularly in the most vulnerable groups such as immigrants and refugees. An assessment of the intervention to contain the COVID-19 in these population groups was essential to define new strategies for more equitable, inclusive, and effective health policies to on health.

OBJECTIVES

to provide a systematic synopsis of the impact of interventions to contain the spread of SARS-CoV-2 in immigrants.

METHODS

data sources included major bibliographic databases. Using a study protocol, already shared with the international scientific community, two independent researchers reviewed the citations, selected and evaluated the interventions studies. Due to the heterogeneity of the interventions, a narrative synthesis was carried out.

RESULTS

three eligible studies were identified. The first study modelled the incidence of the disease in a refugee camp in Greece, based on an intervention of sectorialization of people that accessed to services, the use of masks, the early identification and isolation of cases and their family members, and the limitation of movements within the camp. The second evaluated the impact of preventive pharmacological interventions such as the use of hydroxychloroquine, ivermectin, povidone-iodine, zinc, and vitamin C, in different dosages and combinations, to a group of immigrant workers in a city dormitory in Singapore. The third study evaluated an intervention to increase vaccination coverage within a Latino immigrant community in the United States, moving the location of vaccine supply throughout the most frequented contexts by the immigrant community to access the city services. The results of the first and second studies suggest impacts for some of the proposed interventions even if they have been partially overcome due to the use of mass vaccination. The third showed a reduction in vaccine hesitancy and an increase in vaccination uptake and a snowball effect.

CONCLUSIONS

the systematic review identified few heterogeneous studies, preventing any generalization of the results. Probably, the low scientific production does not reflect the successful experiences implemented. In the case of a possible resumption of the epidemic or new emergencies, it will be necessary to rely on indirect evidence and the scientific community should consider more the responsibility to evaluate and make available the experiences gained in the field. A constant monitoring activity of the evidence that will be necessary to updating the results for suggest consolidated prevention measures to for controlling the incidence of COVID-19 in immigrants during a possible resumption of the epidemic and for application in other similarly emergency contexts.

摘要

背景

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)在人群中的传播加剧了健康不平等现象的影响,尤其是在移民和难民等最弱势群体中。评估针对这些人群控制新型冠状病毒肺炎(COVID-19)的干预措施对于制定更公平、包容和有效的卫生政策以促进健康至关重要。

目的

系统概述控制SARS-CoV-2在移民中传播的干预措施的影响。

方法

数据来源包括主要的文献数据库。使用已与国际科学界共享的研究方案,两名独立研究人员对文献进行了审查,选择并评估了干预措施研究。由于干预措施的异质性,进行了叙述性综合分析。

结果

确定了三项符合条件的研究。第一项研究基于对获得服务的人员进行分区、使用口罩、早期识别和隔离病例及其家庭成员以及限制营地内人员流动等干预措施,对希腊一个难民营中的疾病发病率进行了建模。第二项研究评估了预防性药物干预措施的影响,如使用不同剂量和组合的羟氯喹、伊维菌素、聚维酮碘、锌和维生素C,对新加坡一个城市宿舍中的一组移民工人的影响。第三项研究评估了一项在美国拉丁裔移民社区提高疫苗接种覆盖率的干预措施,将疫苗供应地点转移到移民社区最常前往的场所,以便他们获得城市服务。第一项和第二项研究的结果表明,尽管由于大规模疫苗接种部分抵消了一些拟议干预措施的影响,但仍有一定效果。第三项研究表明,疫苗犹豫现象减少,疫苗接种率提高,并产生了滚雪球效应。

结论

系统评价发现相关异质性研究较少,无法对结果进行任何概括。科学产出低可能并不反映已实施的成功经验。在疫情可能再次出现或出现新的紧急情况时,将有必要依靠间接证据,科学界应更多地考虑有责任评估并提供该领域获得的经验。持续监测证据对于更新结果以提出巩固的预防措施至关重要,这些措施可用于在疫情可能再次出现期间控制移民中COVID-19的发病率,并应用于其他类似的紧急情况。

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