2011—2020年中国狂犬病暴露人群流行病学与临床防治特征的系统评价

Systematic review on epidemiology and clinical prevention characteristics of rabies exposed population in China from 2011 to 2020

目的系统评价中国狂犬病暴露人群的流行病学与临床防治特征。方法计算机检索中国知网、万方、中国维普、中国生物医学文献服务系统等数据库,搜集关于中国狂犬病暴露人群的流行病学与临床防治特征的横断面研究,检索时限为2011年1月—2020年12月。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用R软件进行Meta分析。结果共纳入42个研究,包括2032341例狂犬病暴露患者。Meta分析结果:狂犬病暴露患者24 h内完成就诊和主动免疫率为87%[95%CI(83%,90%)];狂犬病暴露后规范化处置率为72%[95%CI(58%,86%)];Ⅲ级暴露患者被动免疫制剂使用率为36%[95%CI(29%,44%)];致伤动物疫苗接种率为18%[95%CI(10%,27%)]。结论中国狂犬病暴露人群呈逐年上升趋势,以接种狂犬病疫苗为主要干预方式的主动免疫发挥了重要作用,同时加强规范化处置、抗体检测和致伤动物的疫苗接种率至关重要。受纳入研究数量和质量限制,本研究结果尚需高质量的研究数据进一步佐证。

Objective To systematically review epidemiology and clinical prevention characteristics of rabies exposed population in China.Methods CNKI,Wanfang,VIP and China biomedical literature service system databases were searched by computer.A cross-sectional study on the epidemiological and clinical prevention and treatment characteristics of rabies exposed population in China was collected.The retrieval time limit was from January 2011 to December 2020.After two researchers independently screened the literature,extracted data and evaluated the risk of bias in study,R software was used for Meta analysis.Results A total of 42 studies were included,including 2032341 patients exposed to rabies.Meta analysis results showed that the rate of visits and active immunization within 24 hours of rabies exposed patients was 87%[95%CI(83%,90%)];the standardized treatment rate after rabies exposure was 72%[95%CI(58%,86%)];the use rate of passive immunization agents in the third-level exposure patients was 36%[95%CI(29%,44%)];the vaccination rate of injury related animals was 18%[95%CI(10%,27%)].Conclusion In recent years,the number of rabies exposed population in China has shown a rapid upward trend.Active immunization with rabies vaccination as a major intervention has played an important role.At the same time,it is important to strengthen standardized treatment,antibody testing,and vaccination rate of injury related animals.Limited by the number and quality of included studies,the results of this study still need high quality research data for further support.