淋巴丝虫病大规模药物治疗中从未治疗者的患病率及决定因素：系统综述与荟萃分析
Prevalence and Determinants of Never Treatment During Mass Drug Administration for Lymphatic Filariasis: A Systematic Review and Meta-Analysis.
文献信息
| PMID | 42793501 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Devi Das |
| 作者单位 | Department of Epidemiology, National Institute for Research in Bacterial Infections, Indian Council of Medical Research, Kolkata 700010, West Bengal, India. |
| 期刊 | Healthcare (Basel, Switzerland) |
| SCI 分区 | Q1 |
| IF | 3.3 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的：
“从未治疗”一词指在针对淋巴丝虫病（LF）的任何一轮大规模药物治疗（MDA）中自我报告从未服用药片者。本研究估算了LF的MDA中从未治疗者的合并患病率，并确定了与持续未治疗相关的因素。
方法：
本系统综述与荟萃分析已在PROSPERO注册[CRD420251270067]，并按照PRISMA 2020指南进行。通过检索PubMed、Scopus、Cochrane Central、Embase、Web of Science和Epistemonikos数据库（2000年1月至2025年12月）识别相关文献，仅纳入以英文发表的研究。使用AXIS工具评估研究质量。采用随机效应模型及95%CI估算合并患病率。进行亚组分析、留一法敏感性分析和荟萃回归分析以探讨异质性。
结果：
18项研究共纳入24,940人，显示所有MDA轮次中从未治疗的合并患病率为26%（95%CI：16%至37%，I2=99.7%，95%预测区间：0%至75%）。探索性亚组分析显示存在较大的地区和MDA轮次特异性差异。荟萃回归表明发表年份不能解释这种变异性。持续未治疗的常见原因包括害怕副作用、知识有限、吞咽药片困难以及药物分发时不在场。
结论：
持续从未治疗的人群可能代表LF消除的一个重要规划障碍。鉴于证据确定性极低、异质性极大以及潜在的发表偏倚，这些估计值应谨慎解读。未来研究应确保更广泛的地理代表性，包括城市和农村地区，并探索结构性、行为和社会文化决定因素，以更好地针对高风险群体。
英文摘要
OBJECTIVES: The term "never treated" refers to individuals who self-report having never ingested tablets during any round of Mass Drug Administration (MDA) against Lymphatic Filariasis (LF). This study estimated the pooled prevalence of never-treated individuals with MDA for LF and identified factors associated with persistent non-treatment.
METHODS: This systematic review and meta-analysis was registered in PROSPERO [CRD420251270067] and conducted in accordance with the PRISMA 2020 guidelines. Relevant literature was identified by searching databases, i.e., PubMed, Scopus, Cochrane Central, Embase, Web of Science, and Epistemonikos from January 2000 to December 2025, and only studies published in English were included. The AXIS tool was used to assess the study quality. A random-effects model with 95% CI was applied to estimate the pooled prevalence. Subgroup, leave-one-out sensitivity, and meta-regression analyses were conducted to explore the heterogeneity.
RESULTS: Eighteen studies including 24,940 individuals showed the pooled prevalence of never treatment during all MDA rounds at 26% (95% CI: 16% to 37%, I2 = 99.7%, 95% prediction interval: 0% to 75%). Exploratory subgroup analysis indicated wide regional and MDA round-specific variations. Meta-regression indicated that publication year did not explain the variability. Common reasons for persistent non-treatment included fear of side effects, limited knowledge, difficulty swallowing the pills, and absence during drug distribution.
CONCLUSIONS: Persistently never-treated populations may represent an important programmatic barrier to LF elimination. Given the very low certainty of evidence, extreme heterogeneity, and potential publication bias, these estimates should be interpreted cautiously. Future research should ensure broader geographical representation, including both urban and rural areas, and explore structural, behavioural, and socio-cultural determinants to better target high-risk groups.