St George's University of London Institute for Infection and Immunity, London, UK.
Barcelona Institute for Global Health, Barcelona, Catalunya, Spain.
BMJ Open. 2024 Jul 13;14(7):e083813. doi: 10.1136/bmjopen-2023-083813.
The Middle East and North African (MENA) region is characterised by high and complex migration flows, yet little is known about the health of migrant populations, their levels of underimmunisation and access to healthcare provision. Data are needed to support regional elimination and control targets for key diseases and the design and delivery of programmes to improve health outcomes in these groups. This protocol describes a suite of seven systematic reviews that aim to identify, appraise and synthesise the available evidence on the burden and health outcomes, policies and access (barriers and facilitators) related to these mobile populations in the region.
Seven systematic reviews will cover three questions to explore the: (1) burden and health outcomes, (2) policies and (3) healthcare barriers and facilitators for the following seven disease areas in migrants in the MENA region: tuberculosis, HIV and hepatitis B and C, malaria and neglected tropical diseases, diabetes, mental health, maternal and neonatal health, and vaccine-preventable diseases. We will search electronic databases for studies in any language (year 2000-2023), reference-check relevant publications and cross-check included studies with experts. We will search for grey literature by hand searching key databases and websites (including regional organisations and MoH websites) for country-specific guidelines and talking to our network of experts for local and regional reports and key datasets. We will assess the studies and policies for their quality using appropriate tools. We will meta-analyse the data by disease outcome if they are of sufficient volume and similarity. Where meta-analysis is not possible and where data are on policy or access, we will narratively synthesise the evidence using summary tables, figures and text.
We anticipate disseminating the findings through peer-reviewed publications, conferences and other formats relevant to all stakeholders. We are following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and protocols will be registered on International Prospective Register of Systematic Reviews.
中东和北非（MENA）地区的移民流动规模大且复杂，但人们对移民人口的健康状况、免疫不足程度以及获得医疗保健的情况知之甚少。需要数据来支持该地区针对主要疾病的消除和控制目标，并为这些群体设计和提供改善健康结果的方案。本方案描述了一套七项系统评价，旨在确定、评估和综合该地区流动人口的疾病负担和健康结果、政策以及与这些流动人口相关的医疗保健障碍和促进因素的现有证据。
七项系统评价将涵盖三个问题，以探索以下七个疾病领域的移民的负担和健康结果、政策和医疗保健障碍和促进因素：中东和北非地区的结核病、艾滋病毒和乙型肝炎和丙型肝炎、疟疾和被忽视的热带病、糖尿病、心理健康、孕产妇和新生儿健康以及疫苗可预防疾病。我们将用任何语言（2000 年至 2023 年）搜索电子数据库中的研究，参考相关出版物，并与专家核对已纳入的研究。我们将通过手动搜索关键数据库和网站（包括区域组织和卫生部网站）查找特定国家的指南，并与我们的专家网络联系以获取当地和区域报告和主要数据集，对手头的文献进行搜索。我们将使用适当的工具评估研究和政策的质量。如果数据量和相似性足够，我们将按疾病结果进行荟萃分析。在不可能进行荟萃分析且数据涉及政策或获取途径的情况下，我们将使用汇总表、图表和文字对证据进行叙述性综合。
我们预计将通过同行评议的出版物、会议和其他与所有利益相关者相关的格式传播研究结果。我们正在遵循系统评价和荟萃分析的首选报告项目的建议，并将在国际前瞻性系统评价注册中心注册方案。
