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首页> 外文期刊>Risk analysis >Systematic Review of the Manifestations of Congenital Rubella Syndrome in Infants and Characterization of Disability-Adjusted Life Years (DALYs)
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Systematic Review of the Manifestations of Congenital Rubella Syndrome in Infants and Characterization of Disability-Adjusted Life Years (DALYs)

机译：婴儿先天性风疹综合症表现的系统评价和伤残调整生命年（DALYs）的特征

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摘要

Congenital rubella syndrome (CRS) continues to cause disability among unvaccinated populations in countries with no or insufficient rubella vaccine coverage to prevent transmission. We systematically reviewed the literature on birth outcomes associated with CRS to estimate the duration, severity, and frequency of combinations of morbidities. We searched PubMed, the Science Citation Index, and references from relevant articles for studies in English with primary data on the frequency of CRS manifestations for 20 cases and identified 65 studies representing 66 study populations that met our inclusion criteria. We abstracted available data on CRS cases with one or more hearing, heart, and/or eye defect following maternal rubella infection during the period of 0-20 weeks since the last menstrual period. We assessed the quality and weight of the available evidence using a modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Most of the evidence originates from studies in developed countries of cohorts of infants identified with CRS in the 1960s and 1970s, prior to the development of standardized definitions for CRS and widespread use of vaccine. We developed estimates of undiscounted disability-adjusted life years (DALYs) lost per CRS case for countries of different income levels. The estimates ranged from approximately 19 to 39 for high-income countries assuming optimal treatment and from approximately 29 to 39 DALYs lost per CRS case in low- and lower- middle-income countries assuming minimal treatment, with the lower bound based on 2010 general global burden of disease disability weights and the upper bound based on 1990 age-specific and treatment-specific global burden of disease disability weights. Policymakers and analysts should appreciate the significant burden of disability caused by CRS as they evaluate opportunities to manage rubella.
机译：在没有或没有足够的风疹疫苗覆盖率以防止传播的国家中，先天性风疹综合症（CRS）继续在未接种人群中造成残疾。我们系统地回顾了与CRS相关的出生结局的文献，以估计病程，病程和合并症的发生频率。我们检索了PubMed，Science Citation Index和相关文章的参考文献，以英语进行研究，并获得了20例CRS表现频率的主要数据，并确定了代表66个研究人群的65项研究符合我们的纳入标准。我们从最后一次月经期开始的0-20周内，提取了母亲风疹感染后伴有一个或多个听力，心脏和/或眼部缺陷的CRS病例的可用数据。我们使用改进的建议书评估，发展和评估等级（GRADE）方法评估了可用证据的质量和权重。大多数证据来自发达国家对CRS的标准化定义和疫苗广泛使用之前的1960年代和1970年代识别为CRS的婴儿队列的研究。我们对不同收入水平的国家/地区的每例CRS病例损失了未贴现的残疾调整生命年（DALY）进行了估算。对于高收入国家，如果采用最佳治疗，估计数约为19至39；对于低收入和中低收入国家，如果采用最低限度治疗，则每例CRS病例损失的DALY约为29至39，根据2010年全球总体疾病残障权重的权重和上限基于1990年针对特定年龄和特定治疗的全球疾病残障权重的权重。政策制定者和分析人员在评估管理风疹的机会时应感谢CRS造成的严重残疾负担。

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