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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Mask use in community settings in the context of COVID-19: A systematic review of ecological data
eClinicalMedicine, Volume 38, Article 101024, Year 2021
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Description
Background: The wearing of medical and non-medical masks by the general public in community settings is one intervention that is important for the reduction of SARS-CoV-2 transmission, and has been the subject of considerable research, policy, advocacy and debate. Several observational studies have used ecological (population-level) data to assess the effect of masks on transmission, hospitalization, and mortality at the region or community level. Methods: We undertook this systematic review to summarize the study designs, outcomes, and key quality indicators of using ecological data to evaluate the association between mask wearing and COVID-19 outcomes. We searched the World Health Organization (WHO) COVID-19 global literature database up to 5 March 2021 for studies reporting the impact of mask use in community settings on outcomes related to SARS-CoV-2 transmission using ecological data. Findings: Twenty one articles were identified that analysed ecological data to assess the protective effect of policies mandating community mask wearing. All studies reported SARS-CoV-2 benefits in terms of reductions in either the incidence, hospitalization, or mortality, or a combination of these outcomes. Few studies assessed compliance to mask wearing policies or controlled for the possible influence of other preventive measures such as hand hygiene and physical distancing, and information about compliance to these policies was lacking. Interpretation: Ecological studies have been cited as evidence to advocate for the adoption of universal masking policies. The studies summarized by this review suggest that community mask policies may reduce the population-level burden of SARS-CoV-2. Methodological limitations, in particular controlling for the actual practice of mask wearing and other preventive policies make it difficult to determine causality. There are several important limitations to consider for improving the validity of ecological data. © 2021 World Health Organization
Authors & Co-Authors
Ford, Nathan P.
Switzerland, Geneva
Organisation Mondiale de la Santé
Chou, Roger
United States, Portland
Oregon Health & Science University
Villeneuve, Paul J.
Canada, Ottawa
Carleton University
Baller, April
Switzerland, Geneva
Organisation Mondiale de la Santé
van Kerkhove, Maria D.
Switzerland, Geneva
Organisation Mondiale de la Santé
Allegranzi, Benedetta
Switzerland, Geneva
Organisation Mondiale de la Santé
Statistics
Citations: 22
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1016/j.eclinm.2021.101024
ISSN:
25895370
Research Areas
Covid
Health System And Policy
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Study Approach
Systematic review