背景:包括梅毒在内的传染病,艾滋病毒,乙型肝炎是全世界孕产妇和新生儿发病率和死亡率的主要贡献者,特别是在低收入和中等收入国家(LMICs)。世界卫生组织已将消除这三种疾病的垂直传播列为优先事项。
目的:为了快速评估旨在提高梅毒产前筛查率的干预措施的影响,艾滋病毒,和中低收入国家的乙型肝炎,并确定未来实施研究的领域。
方法:对PubMed进行了全面搜索,Embase,还有EconLit,针对2013年1月1日至2023年6月27日之间发表的文章。
方法:我们用英语纳入了定量干预研究,涉及LMIC的孕妇(15岁或以上)。排除是基于高收入国家的研究,定性研究,或者那些研究诊断方法准确性的人。
方法:从最初的5549项潜在研究来看,在不同的筛选阶段后,最终确定了27个用于审查。数据提取涵盖了研究设计等方面,干预细节,和结果。研究结果在系统思维框架内进行了定性综合。
结果:评估的干预措施因地理位置而异,卫生保健系统水平,和模式。审查强调了社区健康干预措施等干预措施的有效性,服务质量改进,和财政激励。
结论:该研究强调了特定干预措施在提高LMIC产前筛查率方面的潜力。然而,关于乙型肝炎的研究存在明显的差距。研究结果强调了在公共卫生干预措施中加强能力建设和卫生系统的重要性。
BACKGROUND: Infectious diseases including syphilis, HIV, and hepatitis B are major contributors to maternal and neonatal morbidity and mortality worldwide, especially in low- and middle-income countries (LMICs). The World Health Organization has prioritized elimination of vertical transmission of these three diseases.
OBJECTIVE: To rapidly assess the impact of interventions designed to improve antenatal screening rates for syphilis, HIV, and hepatitis B in LMICs and to identify areas for future implementation research.
METHODS: A comprehensive search was conducted across PubMed, Embase, and EconLit, targeting articles published between January 1, 2013, and June 27, 2023.
METHODS: We included quantitative interventional studies in English, involving pregnant adults (15 years or older) from LMICs. Exclusions were studies based in high-income countries, qualitative studies, or those investigating accuracy of diagnostic methods.
METHODS: From an initial 5549 potential studies, 27 were finalized for review after various screening stages. Data extraction covered aspects such as study design, intervention details, and outcomes. Findings were qualitatively synthesized within a systems thinking framework.
RESULTS: The interventions assessed varied in terms of geographic locations, health care system levels, and modalities. The review highlighted the effectiveness of interventions such as community health interventions, service quality improvements, and financial incentives.
CONCLUSIONS: The study underscores the potential of specific interventions in enhancing antenatal screening rates in LMICs. However, there is a discernible research gap concerning hepatitis B. The findings emphasize the importance of capacity building and health systems strengthening in public health interventions.