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...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-08-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537021003126 |
| _version_ | 1818715973898731520 |
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| author | Amir Mohsenpour Kayvan Bozorgmehr Sven Rohleder Jan Stratil Diogo Costa |
| author_facet | Amir Mohsenpour Kayvan Bozorgmehr Sven Rohleder Jan Stratil Diogo Costa |
| author_sort | Amir Mohsenpour |
| collection | DOAJ |
| 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, WHOCovid19, 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. |
| first_indexed | 2024-12-17T19:11:53Z |
| format | Article |
| id | doaj.art-3ffd2972b87b47db92895017caee6f76 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-12-17T19:11:53Z |
| publishDate | 2021-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-3ffd2972b87b47db92895017caee6f762022-12-21T21:35:50ZengElsevierEClinicalMedicine2589-53702021-08-0138101032SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysisAmir Mohsenpour0Kayvan Bozorgmehr1Sven Rohleder2Jan Stratil3Diogo Costa4Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, P.O. Box: 10 01 31, 33501 Bielefeld, Germany; Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, Heidelberg University Hospital, Germany; Corresponding author at: Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, P.O. Box: 10 01 31, 33501 Bielefeld, Germany.Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, P.O. Box: 10 01 31, 33501 Bielefeld, Germany; Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, Heidelberg University Hospital, GermanyDepartment of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, P.O. Box: 10 01 31, 33501 Bielefeld, Germany; Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, Heidelberg University Hospital, GermanyInstitute for Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University Munich, GermanyDepartment of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, P.O. Box: 10 01 31, 33501 Bielefeld, GermanyBackground: 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, WHOCovid19, 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.http://www.sciencedirect.com/science/article/pii/S2589537021003126people experiencing homelessnesshomeless sheltersSARS-CoV-2COVID-19systematic reviewMeta-analysis |
| spellingShingle | Amir Mohsenpour Kayvan Bozorgmehr Sven Rohleder Jan Stratil Diogo Costa SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis EClinicalMedicine people experiencing homelessness homeless shelters SARS-CoV-2 COVID-19 systematic review 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 | people experiencing homelessness homeless shelters SARS-CoV-2 COVID-19 systematic review Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2589537021003126 |
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