Article type
Year
Abstract
Background: The West African outbreak of the Ebola virus disease in 2014 evolved rapidly, yielding the highest number of cases and deaths of outbreaks to date. We performed a rapid review of the evidence to inform recommendations issued by the World Health Organization on the use of personal protective equipment (PPE) by healthcare workers managing patients with known or suspected filovirus (Ebola and Marburg) disease.
Objectives: To determine the comparative benefits and harms of various PPE (e.g. double gloves, full face protection) components.
Methods: A rapid review (accelerated and/or modified systematic review methods) guided by a protocol was conducted over seven weeks. Bibliographic databases, grey literature sources, and supplemental sources were searched. Eligibility criteria initially included only comparative studies on Ebola and Marburg diseases reported in English or French, but criteria were expanded to studies on other, viral hemorrhagic fevers and to non-comparative designs because comparative studies were lacking. Titles and abstracts were reviewed by one person, and a second person verified potentially excluded records. Full-text articles were reviewed by two independent people. Meta-analysis of data was not done, but plots summarizing data were produced where appropriate. The domains of the Grading of Recommendations Assessment Development and Evaluation framework (GRADE) were used to inform judgments on the quality of the evidence.
Results: No comparative studies were located. Thirty non-comparative (eight related to Ebola) studies were included; 27 studies provided data on viral transmission, while nine studies reported on other adverse events, such as needle-stick injuries. The quality of the body of evidence for all outcomes was low. In general, studies reported information on PPE components and infection prevention and control protocols poorly.
Conclusions: Insufficient evidence exists to draw conclusions on the comparative effectiveness of various types of PPE. Additional research is urgently needed, and considerations exist for future research.
Objectives: To determine the comparative benefits and harms of various PPE (e.g. double gloves, full face protection) components.
Methods: A rapid review (accelerated and/or modified systematic review methods) guided by a protocol was conducted over seven weeks. Bibliographic databases, grey literature sources, and supplemental sources were searched. Eligibility criteria initially included only comparative studies on Ebola and Marburg diseases reported in English or French, but criteria were expanded to studies on other, viral hemorrhagic fevers and to non-comparative designs because comparative studies were lacking. Titles and abstracts were reviewed by one person, and a second person verified potentially excluded records. Full-text articles were reviewed by two independent people. Meta-analysis of data was not done, but plots summarizing data were produced where appropriate. The domains of the Grading of Recommendations Assessment Development and Evaluation framework (GRADE) were used to inform judgments on the quality of the evidence.
Results: No comparative studies were located. Thirty non-comparative (eight related to Ebola) studies were included; 27 studies provided data on viral transmission, while nine studies reported on other adverse events, such as needle-stick injuries. The quality of the body of evidence for all outcomes was low. In general, studies reported information on PPE components and infection prevention and control protocols poorly.
Conclusions: Insufficient evidence exists to draw conclusions on the comparative effectiveness of various types of PPE. Additional research is urgently needed, and considerations exist for future research.