DataSheet_4_Effects of COVID-19 Non-Pharmacological Interventions on Dengue Infection: A Systematic Review and Meta-Analysis.docx

Non-pharmacological interventions (NPIs) implemented during the coronavirus disease 2019 (COVID-19) pandemic have demonstrated significant positive effects on other communicable diseases. Nevertheless, the response for dengue fever has been mixed. To illustrate the real implications of NPIs on dengue transmission and to determine the effective measures for preventing and controlling dengue, we performed a systematic review and meta-analysis of the available global data to summarize the effects comprehensively. We searched Embase, PubMed, and Web of Science in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines from December 31, 2019, to March 30, 2022, for studies of NPI efficacy on dengue infection. We obtained the annual reported dengue cases from highly dengue-endemic countries in 2015–2021 from the European Centre for Disease Prevention and Control to determine the actual change in dengue cases in 2020 and 2021, respectively. A random-effects estimate of the pooled odds was generated with the Mantel-Haenszel method. Between-study heterogeneity was assessed using the inconsistency index (I2) and subgroup analysis according to country (dengue-endemic or non-endemic) was conducted. This review was registered with PROSPERO (CRD42021291487). A total of 17 articles covering 32 countries or regions were included in the review. Meta-analysis estimated a pooled relative risk of 0.39 (95% CI: 0.28–0.55), and subgroup revealed 0.06 (95% CI: 0.02-0.25) and 0.55 (95% CI: 0.44-0.68) in dengue non-endemic areas and dengue-endemic countries, respectively, in 2020. The majority of highly dengue-endemic countries in Asia and Americas reported 0–100% reductions in dengue cases in 2020 compared to previous years, while some countries (4/20) reported a dramatic increase, resulting in an overall increase of 11%. In contrast, there was an obvious reduction in dengue cases in 2021 in almost all countries (18/20) studied, with an overall 40% reduction rate. The overall effectiveness of NPIs on dengue varied with region and time due to multiple factors, but most countries reported significant reductions. Travel-related interventions demonstrated great effectiveness for reducing imported cases of dengue fever. Internal movement restrictions of constantly varying intensity and range are more likely to mitigate the entire level of dengue transmission by reducing the spread of dengue fever between regions within a country, which is useful for developing a more comprehensive and sustainable strategy for preventing and controlling dengue fever in the future.

在2019冠状病毒病（COVID-19）大流行期间实施的非药物干预措施（non-pharmacological interventions, NPIs），已被证实对其他传染病具有显著的积极影响。然而，其对登革热的防控效果却参差不齐。为阐明非药物干预措施对登革热传播的实际影响，并明确登革热防控的有效手段，本研究对全球现有数据开展了系统综述与荟萃分析，以全面总结相关干预效果。本研究遵循系统综述与荟萃分析优先报告条目（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）指南，于2019年12月31日至2022年3月30日期间，在Embase、PubMed及Web of Science数据库中检索有关非药物干预措施对登革热感染防控效果的研究。本研究从欧洲疾病预防控制中心（European Centre for Disease Prevention and Control）获取了2015-2021年登革热高流行国家的年度报告登革热病例数，以分别明确2020年与2021年登革热病例数的实际变化情况。本研究采用Mantel-Haenszel法生成合并比值比的随机效应估计值，通过不一致性指数（I2）评估研究间异质性，并按照国家类型（登革热流行区或非流行区）开展亚组分析。本系统综述已在PROSPERO平台注册（注册号：CRD42021291487）。本综述共纳入17篇文献，涵盖32个国家或地区。荟萃分析结果显示，2020年所有纳入研究的合并相对风险为0.39（95%置信区间（Confidence Interval, CI）：0.28~0.55）；亚组分析则显示，登革热非流行区的合并相对风险为0.06（95%置信区间：0.02~0.25），登革热流行国家为0.55（95%置信区间：0.44~0.68）。2020年，亚洲与美洲的多数登革热高流行国家的登革热病例数较往年下降0~100%，但仍有4/20的国家报告病例数大幅上升，整体病例数较往年增长11%。与之相反，2021年纳入研究的几乎所有国家（18/20）的登革热病例数均显著下降，整体降幅达40%。受多种因素影响，非药物干预措施对登革热的整体防控效果因地区与时间而异，但多数国家报告病例数显著下降。与旅行相关的干预措施在减少登革热输入病例方面效果显著。强度与范围不断调整的国内流动限制措施，可通过减少一国境内不同地区间的登革热传播，更有效地降低整体登革热传播水平，这为未来制定更全面、可持续的登革热防控策略提供了参考。