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SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis
BACKGROUND: People experiencing homelessness (PEH) may be at risk for COVID19. We synthesised evidence on SARS-Cov-2 infection, transmission, outcomes of disease, effects of non-pharmaceutical interventions (NPI), and the effectiveness of strategies for infection prevention and control (IPC). METHOD...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298932/ https://www.ncbi.nlm.nih.gov/pubmed/34316550 http://dx.doi.org/10.1016/j.eclinm.2021.101032 |
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author | Mohsenpour, Amir Bozorgmehr, Kayvan Rohleder, Sven Stratil, Jan Costa, Diogo |
author_facet | Mohsenpour, Amir Bozorgmehr, Kayvan Rohleder, Sven Stratil, Jan Costa, Diogo |
author_sort | Mohsenpour, Amir |
collection | PubMed |
description | BACKGROUND: People experiencing homelessness (PEH) may be at risk for COVID19. We synthesised evidence on SARS-Cov-2 infection, transmission, outcomes of disease, effects of non-pharmaceutical interventions (NPI), and the effectiveness of strategies for infection prevention and control (IPC). METHODS: Systematic review of articles, indexed in electronic databases (EMBASE, WHO—Covid19, Web of Science), institutional websites and the Norwegian Institute of Public Health's live map of COVID-19 evidence, and published from December 1st, 2019, to March 3rd, 2021. Empirical papers of any study design addressing Covid-19 and health(-related) outcomes in PEH or shelters’ staff were included. (PROSPERO-2020-CRD42020187033) FINDINGS: Of 536 publications, 37 studies were included (two modelling, 31 observational, four qualitative studies). Random-effect meta-analysis yields a baseline SARS-Cov-2 prevalence of 2•32% (95% Confidence-Interval, 95%CI=1•30–3•34) in PEH and 1•55% (95%CI=0•79–2•31) in staff. In outbreaks, the pooled prevalence increases to 31•59% (95%CI=20•48–42•71) in PEH and 14•80% (95%CI=10•73–18•87) in staff. Main IPC strategies were universal rapid testing, expansion of non-congregate housing, and in-shelter measures (bed spacing, limited staff rotation, reduction in number of residents). INTERPRETATION: 32% of PEH and 15% staff are infected during outbreaks of SARS-Cov-2 in homeless shelters. Most studies were conducted in the USA. No studies were found quantifying health-related outcomes of NPI. Overview and evaluation of IPC strategies for PEH, a better understanding of disease transmission, and reliable data on PEH within Covid-19 notification systems are needed. Qualitative studies may serve to voice PEH and shelter staff experiences, and guide future evaluations and IPC strategies. FUNDING: None. |
format | Online Article Text |
id | pubmed-8298932 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-82989322021-07-23 SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis Mohsenpour, Amir Bozorgmehr, Kayvan Rohleder, Sven Stratil, Jan Costa, Diogo EClinicalMedicine Research Paper BACKGROUND: People experiencing homelessness (PEH) may be at risk for COVID19. We synthesised evidence on SARS-Cov-2 infection, transmission, outcomes of disease, effects of non-pharmaceutical interventions (NPI), and the effectiveness of strategies for infection prevention and control (IPC). METHODS: Systematic review of articles, indexed in electronic databases (EMBASE, WHO—Covid19, Web of Science), institutional websites and the Norwegian Institute of Public Health's live map of COVID-19 evidence, and published from December 1st, 2019, to March 3rd, 2021. Empirical papers of any study design addressing Covid-19 and health(-related) outcomes in PEH or shelters’ staff were included. (PROSPERO-2020-CRD42020187033) FINDINGS: Of 536 publications, 37 studies were included (two modelling, 31 observational, four qualitative studies). Random-effect meta-analysis yields a baseline SARS-Cov-2 prevalence of 2•32% (95% Confidence-Interval, 95%CI=1•30–3•34) in PEH and 1•55% (95%CI=0•79–2•31) in staff. In outbreaks, the pooled prevalence increases to 31•59% (95%CI=20•48–42•71) in PEH and 14•80% (95%CI=10•73–18•87) in staff. Main IPC strategies were universal rapid testing, expansion of non-congregate housing, and in-shelter measures (bed spacing, limited staff rotation, reduction in number of residents). INTERPRETATION: 32% of PEH and 15% staff are infected during outbreaks of SARS-Cov-2 in homeless shelters. Most studies were conducted in the USA. No studies were found quantifying health-related outcomes of NPI. Overview and evaluation of IPC strategies for PEH, a better understanding of disease transmission, and reliable data on PEH within Covid-19 notification systems are needed. Qualitative studies may serve to voice PEH and shelter staff experiences, and guide future evaluations and IPC strategies. FUNDING: None. Elsevier 2021-07-23 /pmc/articles/PMC8298932/ /pubmed/34316550 http://dx.doi.org/10.1016/j.eclinm.2021.101032 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Research Paper Mohsenpour, Amir Bozorgmehr, Kayvan Rohleder, Sven Stratil, Jan Costa, Diogo SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis |
title | SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis |
title_full | SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis |
title_fullStr | SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis |
title_full_unstemmed | SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis |
title_short | SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis |
title_sort | sars-cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: systematic review and meta-analysis |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298932/ https://www.ncbi.nlm.nih.gov/pubmed/34316550 http://dx.doi.org/10.1016/j.eclinm.2021.101032 |
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