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Meta-Analysis
. 2022 Feb;20(2):279-290.
doi: 10.1080/14787210.2021.1949985. Epub 2021 Aug 4.

Associations of infection control measures and norovirus outbreak outcomes in healthcare settings: a systematic review and meta-analysis

Carly Adams  1 , Shenita R Peterson  2 , Aron J Hall  3 , Umesh Parashar  3 , Benjamin A Lopman  1
Affiliations
Meta-Analysis

Associations of infection control measures and norovirus outbreak outcomes in healthcare settings: a systematic review and meta-analysis

Carly Adams et al. Expert Rev Anti Infect Ther. 2022 Feb.

Abstract

Background: Although most norovirus outbreaks in high-income countries occur in healthcare facilities, information on associations between control measures and outbreak outcomes in these settings is lacking.

Methods: We conducted a systematic review/meta-analysis to assess associations between norovirus outbreak control measures and outcomes in hospitals and long-term care facilities (LTCFs), globally. Using regression analyses stratified by setting (hospital/LTCF), we compared durations, attack rates, and case counts for outbreaks in which control measures were reportedly implemented to those in which they were not.

Results: We identified 102 papers describing 162 norovirus outbreaks. Control measures were reportedly implemented in 118 (73%) outbreaks and were associated with 0.6 (95% CI: 0.3-1.1) times smaller patient case counts and 0.7 (95% CI: 0.4, 1.0) times shorter durations in hospitals but 1.5 (95% CI: 1.1-2.2), 1.5 (95% CI: 1.0-2.1) and 1.6 (95% CI: 1.0-2.6) times larger overall, resident and staff case counts, respectively, and 1.4 (95% CI: 1.0-2.0) times longer durations in LTCFs.

Conclusions: Reported implementation of control measures was associated with smaller/shorter outbreaks in hospitals but larger/longer outbreaks in LTCFs. Control measures were likely implemented in response to larger/longer outbreaks in LTCFs, rather than causing them. Prospective observational or intervention studies are needed to determine effectiveness.

Keywords: Control measures; gastrointestinal infection; healthcare; hospitals; infection control; long-term care facilities; meta-analysis; norovirus; outbreaks; systematic review.

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Conflict of interest statement

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Dr. Lopman reports grants and personal fees from Takeda Pharmaceuticals and personal fees from the World Health Organization, outside the submitted work.

Figures

Figure 1.
Figure 1.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart of review process.
See this image and copyright information in PMC

References

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