scholarly journals Face masks to prevent transmission of respiratory diseases: Systematic review and meta-analysis of randomized controlled trials*

2020 ◽  
Author(s):  
Hanna M. Ollila ◽  
Markku Partinen ◽  
Jukka Koskela ◽  
Riikka Savolainen ◽  
Anna Rotkirch ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Respiratory Infections ◽  
Meta Analysis ◽  
Age Groups ◽  
Face Mask ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Face ◽  
Intent To Treat

AbstractObjectiveTo examine the effect of face mask intervention in respiratory infections across different exposure settings and age groups.DesignSystematic review and meta-analysis.Data sourcesPubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science were searched for randomized controlled trials investigating the effect of face masks on respiratory infections published by November 18th 2020. Our reporting follows the PRISMA guidelines.Eligibility criteria for selecting studiesRandomized controlled trials investigating the effect of face masks in respiratory infections and influenza-like illness across different exposure settings and age groups. Two reviewers independently performed the search, extracted the data, and assessed the risk of bias. A random effects meta-analysis with risk ratio, risk difference, and number needed to treat were performed. Findings in exposure settings, age groups, and role of non-compliance were examined using a subgroup analysis.ResultsTotal of 17 studies were included, with N = 11, 601 individuals in intervention and N = 10, 286 in the control group with follow-up duration from 4 days to 19 months). 14 trials included adults (and children) and 3 included children only. 12 studies suffered from non-compliance in the treatment arm and 11 in the control arm. All studies were intent-to-treat analyses, and, thus, non-compliance can bias individual intent-to-treat estimates towards zero. Four out of seventeen studies supported use of face masks. A meta-analysis of all 17 studies found no association between face mask intervention and respiratory infections (RR = 0.9046 [0.777 - 1.053], p = 0.196, p fixed effect = 0.0006). However, a meta-analysis using odds ratios adjusted for age, sex, and vaccination (when available) suggests protective effect of the face mask intervention (17 studies, OR = 0.850 [0.736 - 0.982], p=0.027). A subgroup meta-analysis among adults with (unadjusted) risk ratios found a decrease in respiratory infections (14 studies, RR = 0.859 [0.750 - 0.983], p = 0.026, and 4 studies with a combined face masks and hand hygiene intervention RR = 0.782 [0.696 - 0.879], p < 0.0001). Finally, the face mask use is also supported by a meta-regression adjusting the effect estimates for non-compliance in the controls (17 studies RR = 0.87 [0.780 - 0.980], p = 0.017).ConclusionOur findings support the use of face masks to prevent respiratory infections.

Interventions to Reduce Alcohol Harms in Low and Middle Income Countries: a Systematic Review and Meta Analysis

2018 ◽  
Author(s):  
Joao Ricardo Nickenig Vissoci
Keyword(s):  
Systematic Review ◽  
Alcohol Use ◽  
Randomized Controlled Trials ◽  
Brain Stimulation ◽  
Meta Analysis ◽  
World Health ◽  
Controlled Trials ◽  
Middle Income ◽  
Brief Motivational Intervention ◽  
Randomized Controlled

BackgroundHarmful alcohol use leads to a large burden of disease and disability which disportionately impacts LMICs. The World Health Organization and the Lancet have issued calls for this burden to be addressed, but issues remain, primarily due to gaps in information. While a variety of interventions have been shown to be effective at reducing alcohol use in HICs, their efficacy in LMICs have yet to be assessed. This systematic review describes the current published literature on alcohol interventions in LMICs and conducts a meta analysis of clinical trials evaluating interventions to reduce alcohol use and harms in LMICs.MethodsIn accordance with PRISMA guidelines we searched the electronic databases Pubmed, EMBASE, Scopus,Web of Science, Cochrane, and Psych Info. Articles were eligible if they evaluated an intervention targeting alcohol-related harm in LMICs. After a reference and citation analysis, we conducted a quality assessment per PRISMA protocol. A meta-analysis was performed on the 39 randomized controlled trials that evaluated an alcohol-related outcome.ResultsOf the 3,801 articles from the literature search, 87 articles from 25 LMICs fit the eligibility and inclusion criteria. Of these studies, 39 randomized controlled trials were included in the meta-analysis. Nine of these studies focused specifically on medication, while the others focused on brief motivational intervention, brain stimulation, AUDIT-based brief interventions, WHO ASSIST-based interventions, group based education, basic screening and interventions, brief psychological or counseling, dyadic relapse prevention, group counseling, CBT, motivational + PTSD based interview, and health promotion/awareness. Conclusion Issues in determining feasible options specific to LMICs arise from unstandardized interventions, unequal geographic distribution of intervention implementation, and uncertain effectiveness over time. Current research shows that brain stimulation, psychotherapy, and brief motivational interviews have the potential to be effective in LMIC settings, but further feasibility testing and efforts to standardize results are necessary to accurately assess their effectiveness.

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