背景:肺炎链球菌(Spn)一直是儿童细菌性脑膜炎的主要原因。对Spn脑膜炎全球负担的最新估计表明,通过实施肺炎球菌结合疫苗消除Spn的积极轨迹。然而,由于血清型替代的证据,有必要对疾病负担进行持续监测和评估,抗生素耐药性,以及最近COVID-19大流行的影响。
目的:本系统评价的目的是提供对儿童Spn脑膜炎的全球和区域负担的最新和重点评估,从而指导减轻疾病负担的政策和策略。
方法:从2000年1月1日至2022年1月1日发表的基于人群的研究从电子数据库PubMed进行了初步搜索,Embase,全球卫生(CABI),和CINAHLPlus没有任何语言限制。如果研究报告了发病率,患病率,死亡率,0-4岁儿童的Spn脑膜炎或病死率比(CFR);脑膜炎通过脑脊液培养得到证实;研究时间至少为1年;报告的病例数至少为10;该研究没有方法学上的歧义。文章筛选过程遵循PRISMA(系统评价和荟萃分析的首选报告项目)指南。特点包括学习期间,设置,世界卫生组织区域,收入水平,疫苗接种信息,和参与者数据(年龄,案件数量,死亡,后遗症,和风险因素)将从纳入的研究中提取。搜索结果将在最终确定数据提取之前更新并纳入我们的审查中。将进行广义线性混合模型荟萃分析以估计合并的发病率和CFR。我们将进一步评估偏差和异质性的风险,并将进行亚组和敏感性分析,以对肺炎球菌性脑膜炎的当前负担和文献提供有意义的解释。
结果:我们在2021年12月的初步搜索产生了9295篇文章。在根据我们的资格标准评估的275项研究中,共有117篇文章。数据提取和分析预计将于2025年1月完成。我们计划公布整个研究的结果,包括2024年更新的搜索,到2025年3月。
结论:鉴于Spn脑膜炎的主要负担影响5岁以下儿童,本系统综述将全面了解Spn脑膜炎在这一脆弱人群中的全球负担,历时20年.对发病率趋势的见解,地理空间分布,危险因素,后遗症对利益相关者来说是有价值的,政策制定者,和学术界。这些信息将有助于持续监测该疾病,并加强有针对性的疫苗计划,以进一步减轻该疾病对全球儿童的影响。
背景:PROSPEROCRD42021293110;https://tinyurl.com/kc3j5k4m.
■DERR1-10.2196/50678。
BACKGROUND: Streptococcus pneumoniae (Spn) has been a leading cause of bacterial meningitis in children. The most recent estimation of the global burden of Spn meningitis indicates a positive trajectory in eliminating Spn through the implementation of pneumococcal conjugate vaccines. However, continuous monitoring and assessment of the disease burden are necessary due to the evidence of serotype replacement, antibiotic resistance, and the impact of the recent COVID-19 pandemic.
OBJECTIVE: The aim of this systematic
review is to provide an updated and focused assessment of the global and regional burden of Spn meningitis in children, which can guide policies and strategies to reduce the disease burden.
METHODS: Population-based studies published from January 1, 2000, to January 1, 2022, were preliminarily searched from the electronic databases PubMed, Embase, Global Health (CABI), and CINAHL Plus without any language restrictions. Studies were included if they reported the incidence, prevalence, mortality, or case-fatality ratio (CFR) for Spn meningitis in children aged 0-4 years; meningitis was confirmed by cerebrospinal fluid culture; the study period was a minimum of 1 year; the number of reported cases was at least 10; and the study had no methodological ambiguities. The article screening process follows the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Characteristics including study period, setting, World Health Organization region, income level, vaccination information, and participant data (age, number of cases, deaths, sequelae, and risk factors) will be extracted from the included studies. Search results will be updated and incorporated into our
review prior to finalizing the extraction of data. Generalized linear mixed models meta-analysis will be performed to estimate the pooled incidence and CFR. We will further assess the risk of bias and heterogeneity, and will perform subgroup and sensitivity analyses to provide a meaningful interpretation of the current burden and literature for pneumococcal meningitis.
RESULTS: Our preliminary search in December 2021 yielded 9295 articles. Out of 275 studies that were assessed with our eligibility criteria, 117 articles were included. Data extraction and analysis are expected to be complete by January 2025. We plan to publish the results from the full study, including an updated search in 2024, by March 2025.
CONCLUSIONS: Given that the major burden of Spn meningitis affects children under the age of 5 years, this systematic
review will provide a thorough understanding of the global burden of Spn meningitis in this vulnerable population over a span of 2 decades. Insights into incidence trends, geospatial distribution, risk factors, and sequelae will be valuable for stakeholders, policy makers, and the academic community. This information will aid in the ongoing monitoring of the disease and in enhancing targeted vaccine programs to further mitigate the impact of the disease on children worldwide.
BACKGROUND: PROSPERO CRD42021293110; https://tinyurl.com/kc3j5k4m.
UNASSIGNED: DERR1-10.2196/50678.