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Abstract：
Accurate data on the Lassa virus (LASV) human case fatality rate (CFR) and the prevalence of LASV in humans, rodents and other mammals are needed for better planning of actions that will ultimately reduce the burden of LASV infection in sub-Saharan Africa. In this systematic review with meta-analysis, we searched PubMed, Scopus, Africa Journal Online, and African Index Medicus from 1969 to 2020 to obtain studies that reported enough data to calculate LASV infection CFR or prevalence. Study selection, data extraction, and risk of bias assessment were conducted independently. We extracted all measures of current, recent, and past infections with LASV. Prevalence and CFR estimates were pooled using a random-effect meta-analysis. Factors associated with CFR, prevalence, and sources of between-study heterogeneity were determined using subgroup and metaregression analyses. This review was registered with PROSPERO, CRD42020166465. We initially identified 1,399 records and finally retained 109 reports that contributed to 291 prevalence records from 25 countries. The overall CFR was 29.7% (22.3-37.5) in humans. Pooled prevalence of LASV infection was 8.7% (95% confidence interval: 6.8-10.8) in humans, 3.2% (1.9-4.6) in rodents, and 0.7% (0.0-2.3) in other mammals. Subgroup and metaregression analyses revealed a substantial statistical heterogeneity explained by higher prevalence in tissue organs, in case-control, in hospital outbreak, and surveys, in retrospective studies, in urban and hospital setting, in hospitalized patients, and in West African countries. This study suggests that LASV infections is an important cause of death in humans and that LASV are common in humans, rodents and other mammals in sub-Saharan Africa. These estimates highlight disparities between sub-regions, and population risk profiles. Western Africa, and specific key populations were identified as having higher LASV CFR and prevalence, hence, deserving more attention for cost-effective preventive interventions.
摘要：
拉沙病毒（LASV）人类病死率（CFR）和LASV在人类中的流行率的准确数据，需要啮齿动物和其他哺乳动物更好地规划行动，最终减轻撒哈拉以南非洲地区LASV感染的负担。在这篇带有荟萃分析的系统综述中，我们搜索了PubMed,Scopus,非洲在线杂志，和非洲指数药物从1969年到2020年获得的研究报告了足够的数据来计算LASV感染CFR或患病率。研究选择，数据提取,并独立进行偏倚风险评估。我们提取了电流的所有度量，最近，以及过去的LASV感染。使用随机效应荟萃分析汇总患病率和CFR估计值。与CFR相关的因素，患病率,并使用亚组和回归分析确定研究间异质性的来源。这篇评论在PROSPERO注册，CRD42020166465。我们最初确定了1,399条记录，最终保留了来自25个国家的291条流行记录的109份报告。人类的总体CFR为29.7%(22.3-37.5)。人类LASV感染的合并患病率为8.7％（95％置信区间：6.8-10.8），啮齿动物占3.2％（1.9-4.6），其他哺乳动物为0.7%(0.0-2.3)。亚组和回归分析显示，组织器官患病率较高解释了实质性的统计异质性。在病例控制中，在医院爆发时，和调查，在回顾性研究中，在城市和医院环境中，在住院患者中，在西非国家。这项研究表明，LASV感染是人类死亡的重要原因，并且LASV在人类中很常见，撒哈拉以南非洲的啮齿动物和其他哺乳动物。这些估计突出了次区域之间的差异，和人口风险概况。西非,特定的关键人群被确定为具有较高的LASVCFR和患病率，因此，值得更多关注具有成本效益的预防性干预措施。
