撒哈拉以南非洲地区男男性行为者中淋病奈瑟菌和沙眼衣原体感染的流行情况：系统评价和荟萃分析。
Prevalence of gonococcal and chlamydial infections among men who have sex with men in sub-Saharan Africa: a systematic review and meta-analysis.
机构信息
School of Clinical Medicine Laboratory, College of Health Science, Mandela School of Medicine, University of KwaZulu-Natal, NelsonDurban, South Africa.
School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
出版信息
Syst Rev. 2024 Nov 16;13(1):282. doi: 10.1186/s13643-024-02704-z.
BACKGROUND
Men who have sex with men (MSM) are disproportionately affected by sexually transmitted infections (STI) including Neisseria gonorrhoeae (Ng) and Chlamydia trachomatis (Ct). The lack of robust data on STIs among African MSM has limited the development of evidence-based screening strategies. This study aimed at documenting the pooled prevalence of Ng/Ct among MSM in sub-Saharan Africa (SSA).
METHODS
This systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) 2020 guidelines. Relevant articles from the following databases were searched: PubMed, Scopus, ISI Web of Science, and the Directory of Open Access Journals (DOAJ). Eligible studies reported on the prevalence of Ng/Ct among the MSM population in SSA. Publication bias was assessed using the Hoy tool, Doi plot, and LFK ratio. Due to heterogeneity among studies, subgroup analyses were performed using the MetaXL add-on tool for Microsoft Excel.
RESULTS
Of 525 articles screened, 20 were selected for inclusion. Six were cross-sectional, four had a prospective cohort study design, and one was an epidemiological study. The pooled prevalence of Ng/Ct in MSM was 27% (95% CI, 19-39%), with an I of 98% signifying heterogeneity among the studies. Subgroup analysis by country revealed South Africa had the highest prevalence (38%).
DISCUSSION
Interpretation The high prevalence of Ng/Ct infection among MSM in SSA is of concern. Limitations Due to limited data available on Ng/Ct prevalence, the true prevalence of SSA and its associated risk factors is uncertain.
CONCLUSION
As the first study to systematically review the available literature on STI prevalence among the MSM population in SSA, it showed the burden of Ng/Ct is higher than in other regions, warranting the strengthening of health systems to improve education, testing, and treatment in MSM population.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42022327095.
背景
男男性行为者（MSM）受到性传播感染（STI）的影响不成比例，包括淋病奈瑟菌（Ng）和沙眼衣原体（Ct）。由于缺乏关于非洲 MSM 中 STI 的可靠数据，限制了基于证据的筛查策略的制定。本研究旨在记录撒哈拉以南非洲（SSA）中 MSM 中 Ng/Ct 的合并流行率。
方法
本系统评价根据《系统评价和荟萃分析的首选报告项目》（PRISMA）2020 指南进行。从以下数据库中搜索相关文章：PubMed、Scopus、ISI Web of Science 和开放获取期刊目录（DOAJ）。符合条件的研究报告了 SSA 中 MSM 人群中 Ng/Ct 的流行率。使用 Hoy 工具、Doi 图和 LFK 比评估发表偏倚。由于研究之间存在异质性，因此使用 Microsoft Excel 的 MetaXL 附加工具进行了亚组分析。
结果
在筛选出的 525 篇文章中，有 20 篇被选入研究。其中 6 篇为横断面研究，4 篇为前瞻性队列研究，1 篇为流行病学研究。MSM 中 Ng/Ct 的合并流行率为 27%（95%CI，19-39%），研究之间的 I²为 98%，表明存在高度异质性。按国家进行的亚组分析显示，南非的流行率最高（38%）。
讨论
解释 SSA 中 MSM 中 Ng/Ct 感染的高流行率令人担忧。局限性由于关于 Ng/Ct 流行率的可用数据有限，因此 SSA 的真实流行率及其相关风险因素尚不确定。
结论
作为第一项系统评价 SSA 中 MSM 人群中 STI 流行率的研究，它表明 Ng/Ct 的负担高于其他地区，因此需要加强卫生系统，以改善 MSM 人群的教育、检测和治疗。
系统评价注册
PROSPERO CRD42022327095。
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