Feasibility, acceptability, and effectiveness of non-pharmaceutical interventions against infectious diseases among crisis-affected populations: a scoping review.

IF 4.8 1区 医学 Q1 INFECTIOUS DISEASES Infectious Diseases of Poverty Pub Date : 2022-01-28 DOI:10.1186/s40249-022-00935-7
Jonathan A Polonsky, Sangeeta Bhatia, Keith Fraser, Arran Hamlet, Janetta Skarp, Isaac J Stopard, Stéphane Hugonnet, Laurent Kaiser, Christian Lengeler, Karl Blanchet, Paul Spiegel
{"title":"Feasibility, acceptability, and effectiveness of non-pharmaceutical interventions against infectious diseases among crisis-affected populations: a scoping review.","authors":"Jonathan A Polonsky,&nbsp;Sangeeta Bhatia,&nbsp;Keith Fraser,&nbsp;Arran Hamlet,&nbsp;Janetta Skarp,&nbsp;Isaac J Stopard,&nbsp;Stéphane Hugonnet,&nbsp;Laurent Kaiser,&nbsp;Christian Lengeler,&nbsp;Karl Blanchet,&nbsp;Paul Spiegel","doi":"10.1186/s40249-022-00935-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Non-pharmaceutical interventions (NPIs) are a crucial suite of measures to prevent and control infectious disease outbreaks. Despite being particularly important for crisis-affected populations and those living in informal settlements, who typically reside in overcrowded and resource limited settings with inadequate access to healthcare, guidance on NPI implementation rarely takes the specific needs of such populations into account. We therefore conducted a systematic scoping review of the published evidence to describe the landscape of research and identify evidence gaps concerning the acceptability, feasibility, and effectiveness of NPIs among crisis-affected populations and informal settlements.</p><p><strong>Methods: </strong>We systematically reviewed peer-reviewed articles published between 1970 and 2020 to collate available evidence on the feasibility, acceptability, and effectiveness of NPIs in crisis-affected populations and informal settlements. We performed quality assessments of each study using a standardised questionnaire. We analysed the data to produce descriptive summaries according to a number of categories: date of publication; geographical region of intervention; typology of crisis, shelter, modes of transmission, NPI, research design; study design; and study quality.</p><p><strong>Results: </strong>Our review included 158 studies published in 85 peer-reviewed articles. Most research used low quality study designs. The acceptability, feasibility, and effectiveness of NPIs was highly context dependent. In general, simple and cost-effective interventions such as community-level environmental cleaning and provision of water, sanitation and hygiene services, and distribution of items for personal protection such as insecticide-treated nets, were both highly feasible and acceptable. Logistical, financial, and human resource constraints affected both the implementation and sustainability of measures. Community engagement emerged as a strong factor contributing to the effectiveness of NPIs. Conversely, measures that involve potential restriction on personal liberty such as case isolation and patient care and burial restrictions were found to be less acceptable, despite apparent effectiveness.</p><p><strong>Conclusions: </strong>Overall, the evidence base was variable, with substantial knowledge gaps which varied between settings and pathogens. Based on the current landscape, robust evidence-based guidance is not possible, and a research agenda is urgently required that focusses on these specific vulnerable populations. Although implementation of NPIs presents unique practical challenges in these settings, it is critical that such an agenda is put in place, and that the lessons learned from historical and present experiences are documented to build a firm evidence base.</p>","PeriodicalId":13587,"journal":{"name":"Infectious Diseases of Poverty","volume":null,"pages":null},"PeriodicalIF":4.8000,"publicationDate":"2022-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8796190/pdf/","citationCount":"9","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infectious Diseases of Poverty","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40249-022-00935-7","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 9

Abstract

Background: Non-pharmaceutical interventions (NPIs) are a crucial suite of measures to prevent and control infectious disease outbreaks. Despite being particularly important for crisis-affected populations and those living in informal settlements, who typically reside in overcrowded and resource limited settings with inadequate access to healthcare, guidance on NPI implementation rarely takes the specific needs of such populations into account. We therefore conducted a systematic scoping review of the published evidence to describe the landscape of research and identify evidence gaps concerning the acceptability, feasibility, and effectiveness of NPIs among crisis-affected populations and informal settlements.

Methods: We systematically reviewed peer-reviewed articles published between 1970 and 2020 to collate available evidence on the feasibility, acceptability, and effectiveness of NPIs in crisis-affected populations and informal settlements. We performed quality assessments of each study using a standardised questionnaire. We analysed the data to produce descriptive summaries according to a number of categories: date of publication; geographical region of intervention; typology of crisis, shelter, modes of transmission, NPI, research design; study design; and study quality.

Results: Our review included 158 studies published in 85 peer-reviewed articles. Most research used low quality study designs. The acceptability, feasibility, and effectiveness of NPIs was highly context dependent. In general, simple and cost-effective interventions such as community-level environmental cleaning and provision of water, sanitation and hygiene services, and distribution of items for personal protection such as insecticide-treated nets, were both highly feasible and acceptable. Logistical, financial, and human resource constraints affected both the implementation and sustainability of measures. Community engagement emerged as a strong factor contributing to the effectiveness of NPIs. Conversely, measures that involve potential restriction on personal liberty such as case isolation and patient care and burial restrictions were found to be less acceptable, despite apparent effectiveness.

Conclusions: Overall, the evidence base was variable, with substantial knowledge gaps which varied between settings and pathogens. Based on the current landscape, robust evidence-based guidance is not possible, and a research agenda is urgently required that focusses on these specific vulnerable populations. Although implementation of NPIs presents unique practical challenges in these settings, it is critical that such an agenda is put in place, and that the lessons learned from historical and present experiences are documented to build a firm evidence base.

Abstract Image

Abstract Image

Abstract Image

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
在受危机影响的人群中防治传染病的非药物干预措施的可行性、可接受性和有效性:范围审查。
背景:非药物干预措施(NPIs)是预防和控制传染病暴发的一套关键措施。尽管对受危机影响的人口和生活在非正规住区的人特别重要,因为这些人通常居住在拥挤和资源有限的环境中,无法获得充分的医疗保健,但关于实施新方案的指导很少考虑到这些人口的具体需求。因此,我们对已发表的证据进行了系统的范围审查,以描述研究前景,并确定有关危机影响人群和非正式定居点的npi的可接受性、可行性和有效性的证据差距。方法:我们系统地回顾了1970年至2020年间发表的同行评议文章,以整理有关npi在受危机影响人群和非正式定居点中的可行性、可接受性和有效性的现有证据。我们使用标准化问卷对每项研究进行质量评估。我们对数据进行了分析,并根据以下几个类别生成了描述性摘要:出版日期;干预的地理区域;危机类型、庇护所、传播方式、新产品导入、研究设计;研究设计;还有学习质量。结果:我们的综述包括了发表在85篇同行评议文章中的158项研究。大多数研究采用了低质量的研究设计。npi的可接受性、可行性和有效性高度依赖于上下文。一般来说,简单和具有成本效益的干预措施,如社区一级的环境清洁和提供水、环境卫生和个人卫生服务,以及分发驱虫蚊帐等个人防护用品,都是高度可行和可接受的。后勤、财政和人力资源方面的限制影响了各项措施的执行和可持续性。社区参与成为促进国家倡议机构有效性的一个重要因素。相反,可能限制人身自由的措施,如病例隔离和病人护理以及埋葬限制,虽然效果明显,但被认为不太可接受。结论:总体而言,证据基础是可变的,在环境和病原体之间存在着巨大的知识差距。根据目前的情况,不可能有强有力的基于证据的指导,迫切需要一个研究议程,重点关注这些特定的弱势群体。虽然在这些情况下实施国家自主行动方案提出了独特的实际挑战,但至关重要的是,必须制定这样一个议程,并记录从历史和当前经验中吸取的教训,以建立坚实的证据基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Infectious Diseases of Poverty
Infectious Diseases of Poverty Medicine-Public Health, Environmental and Occupational Health
CiteScore
16.70
自引率
1.20%
发文量
368
审稿时长
13 weeks
期刊介绍: Infectious Diseases of Poverty is a peer-reviewed, open access journal that focuses on essential public health questions related to infectious diseases of poverty. It covers a wide range of topics and methods, including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies, and their application. The journal also explores the impact of transdisciplinary or multisectoral approaches on health systems, ecohealth, environmental management, and innovative technologies. It aims to provide a platform for the exchange of research and ideas that can contribute to the improvement of public health in resource-limited settings. In summary, Infectious Diseases of Poverty aims to address the urgent challenges posed by infectious diseases in impoverished populations. By publishing high-quality research in various areas, the journal seeks to advance our understanding of these diseases and contribute to the development of effective strategies for prevention, diagnosis, and treatment.
期刊最新文献
Spatio-temporal dynamics of malaria in Rwanda between 2012 and 2022: a demography-specific analysis Global patterns of syphilis, gonococcal infection, typhoid fever, paratyphoid fever, diphtheria, pertussis, tetanus, and leprosy from 1990 to 2021: findings from the Global Burden of Disease Study 2021 The abundance of snail hosts mediates the effects of antagonist interactions between trematodes on the transmission of human schistosomes MODELS: a six-step framework for developing an infectious disease model Mutations and intron polymorphisms in voltage-gated sodium channel genes of different geographic populations of Culex pipiens pallens/Culex pipiens quinquefasciatus in China
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1