预防结核病的干预措施的比较有效性:对干预研究的系统审查和网络元分析
Alemneh Mekuriaw Liyew1,2,3, Beth Gilmour2,3, Archie C A Clements3,4
1Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
EClinicalMedicine
|September 21, 2023
概括
预防性治疗是减少结核病 (TB) 发病率的最有效的干预措施,超过了接种疫苗等其他方法. 在结核病预防治疗中,异化加上 estreptomycin 的疗效是最高的.
科学领域:
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
- 预防医学 预防医学
背景情况:
- 结核病 (TB) 仍然是全球主要的传染性死亡原因.
- 现有的结核病预防措施缺乏关于其有效性的强有力的证据.
- 迫切需要确定最佳干预措施来减少结核病发病率.
研究的目的:
- 系统地识别和比较旨在减少结核病发病率的各种干预措施的有效性.
- 为了对不同的预防策略的有效性进行排名,包括治疗,营养,查和疫苗接种.
主要方法:
- 在五个主要科学数据库中进行了全面的系统文献搜索.
- 贝叶斯网络元分析 (NMA) 用于合成来自82项纳入研究的数据.
- 亚组分析的重点是评估特定结核病预防治疗的有效性.
主要成果:
- 预防性治疗,BCG疫苗接种和结核病候选疫苗显示出比安慰剂或没有干预更大的有效性.
- 当所有活跃策略进行比较时,预防性治疗被确定为最有效的干预措施.
- 在特定的预防性治疗中,异化加上 estreptomycin 显示出最高的疗效 (OR=0.12,95% CrI 0.02-0.55).
结论:
- 预防性治疗成为减少结核病发病率的主要干预措施,伊索尼亚齐德加上链杆菌素是最有效的治疗方法.
- 调查结果为决策者提供了关键的数据,以告知基于证据的结核病预防策略的决策.
- 在实施选择的预防干预措施时,考虑当地资源和能力至关重要.
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