University of Montreal Public Health Research Institute (IRSPUM), Montreal, Quebec, Canada.
French Institute For Research on sustainable Development (IRD), IRD-Paris Descartes University (CEPED), Paris Sorbonne Cités University, Erl Inserm Sagesud, Paris, France.
Infect Dis Poverty. 2018 Sep 3;7(1):95. doi: 10.1186/s40249-018-0478-4.
The emergence and re-emergence of vector-borne and other infectious diseases of poverty pose a threat to the health of populations living in urban and low-income settings. A detailed understanding of intervention strategies, including effectiveness of past outbreak containment, is necessary to improve future practices. The objective was to determine what is known about the effectiveness of containment measures for emerging and re-emerging vector-borne and other infectious diseases of poverty in urban settings and identify research gaps and implications for public health practice.
We conducted a scoping review and systematically searched peer-reviewed and grey literature published between 2000 and 2016. Different data extraction tools were used for data coding and extraction, and data on implementation process and transferability were extracted from all studies. A quality assessment was conducted for each included study. We screened 205 full-text articles and reports for a total of 31 articles included in the review. The quality of the studies was generally low to moderate. The largest body of evidence concerned control activities for Ebola virus and dengue fever. The majority of interventions (87%) relied on multiple types of measures, which were grouped into four categories: 1) healthcare provision; 2) epidemiological investigation and/or surveillance; 3) environmental or sanitary interventions; and 4) community-based interventions. The quality of the majority of studies (90%) was poor or moderate, and one-third of the studies did not provide a clear description of the outcomes and of the procedures and/or tools used for the intervention.
Our results highlight the difficulty of establishing causation when assessing the effect of containment measures. Studies that extend beyond solely reporting on effectiveness and take into account the complexity of real-world settings are urgently needed. We recommend the allocation of research efforts to the evaluation of the implementation processes of interventions as well as their comprehensive and systematic description using validated checklists.
虫媒传染病和其他贫困相关传染病的出现和再现对城市和低收入地区人群的健康构成威胁。为了改善未来的实践,必须深入了解干预策略,包括过去控制疫情的有效性。本研究的目的是确定在城市环境中,针对新发和再现的虫媒传染病和其他贫困相关传染病的控制措施的有效性,以及识别研究差距和对公共卫生实践的影响。
我们进行了范围界定审查,并系统地检索了 2000 年至 2016 年期间发表的同行评议和灰色文献。不同的数据提取工具用于数据编码和提取,从所有研究中提取实施过程和可转移性的数据。对每一项纳入的研究进行了质量评估。我们筛选了 205 篇全文文章和报告,共有 31 篇文章纳入综述。研究的质量普遍较低到中等。最大的证据来自埃博拉病毒和登革热的控制活动。大多数干预措施(87%)依赖于多种类型的措施,这些措施分为四类:1)医疗保健提供;2)流行病学调查和/或监测;3)环境或卫生干预;和 4)以社区为基础的干预。大多数研究(90%)的质量较差或中等,三分之一的研究没有清楚地描述结果以及干预措施所使用的程序和/或工具。
我们的结果强调了在评估控制措施效果时确定因果关系的困难。迫切需要开展超越单纯报告有效性的研究,并考虑到现实环境的复杂性。我们建议将研究工作集中在评估干预措施的实施过程上,并使用经过验证的清单对其进行全面和系统的描述。