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撒哈拉以南非洲地区数据系统与经济学在支持气候敏感型传染病优先级设定方面的差距与机遇:一项快速范围综述

Gaps and opportunities for data systems and economics to support priority setting for climate-sensitive infectious diseases in sub-Saharan Africa: A rapid scoping review.

作者信息

Delight Ellie A, Brunn Ariel A, Ruiz Francis, Gerard Jessica, Falconer Jane, Liu Yang, Bah Bubacarr, Bett Bernard, Uzochukwu Benjamin, Oloko Oladeji K, Njuguna Esther, Murray Kris A

机构信息

Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom.

Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.

出版信息

PLOS Glob Public Health. 2025 Jun 11;5(6):e0003814. doi: 10.1371/journal.pgph.0003814. eCollection 2025.

Abstract

Climate change alters risks associated with climate-sensitive infectious diseases (CSIDs) with pandemic potential. This poses additional threats to already vulnerable populations, further amplified by social factors such as gender inequalities. Currently, critical evidence gaps, along with inadequate institutional and governance mechanisms, hinder African states' ability to prevent, detect and respond to CSIDs. Effective responses require transparent and evidence-based decision-making processes, supported by fit-for-purpose data systems and robust economic analyses. The aim of this study was to explore the role of data systems and economics in priority setting for CSID pandemic preparedness in sub-Saharan Africa. We conducted a rapid scoping review following PRISMA-ScR guidelines. A literature search was performed across six bibliographic databases in November 2023. A list of 14 target CSIDs was produced, informed by the World Health Organization's Public Health Emergencies of International Concern and R&D Blueprint Pathogen lists, and a database of CSIDs. Studies were included if published between 2010 and 2023, were relevant to sub-Saharan Africa, pandemic preparedness, and a target CSID, and applied or assessed economic evaluations or data systems. Extracted data were synthesised using bibliometric analysis, topic categorisation, and a narrative synthesis including the application of a gender lens. We identified 68 relevant studies. Data system studies (n = 50) showed broad coverage across target CSIDs and the WHO AFRO region but also a high degree of heterogeneity, which may indicate a lack of clearly defined standards or research priorities. Economic studies (n = 18) primarily focused on COVID-19 or Ebola and mostly originated from South Africa. Both data system and economic studies identified limited interoperability across sectors and showed a notable absence of gendered considerations. These gaps present important opportunities to strengthen priority setting during pandemics and may contribute to improved and equitable health outcomes.

摘要

气候变化改变了与具有大流行潜力的气候敏感型传染病(CSIDs)相关的风险。这对本就脆弱的人群构成了额外威胁,而性别不平等之类的社会因素进一步加剧了这种威胁。目前,关键的证据空白以及制度和治理机制的不足,阻碍了非洲国家预防、发现和应对气候敏感型传染病的能力。有效的应对措施需要透明且基于证据的决策过程,并要有适用的数据系统和有力的经济分析作为支撑。本研究的目的是探讨数据系统和经济学在撒哈拉以南非洲地区气候敏感型传染病大流行防范的优先事项设定中的作用。我们按照PRISMA-ScR指南进行了快速范围综述。2023年11月在六个文献数据库中进行了文献检索。依据世界卫生组织的国际关注的突发公共卫生事件及研发蓝图病原体清单以及气候敏感型传染病数据库,列出了14种目标气候敏感型传染病。若研究发表于2010年至2023年之间,与撒哈拉以南非洲地区、大流行防范以及一种目标气候敏感型传染病相关,且应用或评估了经济评估或数据系统,则纳入研究范围。提取的数据通过文献计量分析、主题分类以及包括应用性别视角在内的叙述性综合进行综合分析。我们确定了68项相关研究。数据系统研究(n = 50)显示出对目标气候敏感型传染病和世卫组织非洲区域办事处地区的广泛覆盖,但也存在高度异质性,这可能表明缺乏明确界定的标准或研究重点。经济研究(n = 18)主要集中在新冠病毒病或埃博拉病毒病,且大多源自南非。数据系统研究和经济研究均发现各部门之间 interoperability 有限,并且明显缺乏性别方面的考虑。这些差距为加强大流行期间的优先事项设定提供了重要机遇,可能有助于改善健康结果并实现公平。 (注:原文中“interoperability”未翻译,可能是拼写有误,推测应为“互操作性”之类的意思,可根据实际情况进一步确认。)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1f2/12157337/5bef9f7c03fe/pgph.0003814.g001.jpg

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