Abstract
BackgroundThe 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.Main bodyWe 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.ConclusionsOur 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.
Highlights
Introduction of treatment beds inEbola holding centresFerrari et al 2014 [47] Meningitis (Nigeria)Case management; strengthening of surveillance; mass vaccination campaignsYip et al 2008 [48]Severe acute respiratory Information syndrome (China) dissemination to the public; quarantine; closure of most public facilities, schools and universities; site surveillance at airportEpidemiological investigation and/or surveillance; Environmental and sanitary interventionsNumber of cases avertedReduction in confirmed meningitis casesDaily numbers of confirmed SARS patientsPositive (56 600 (95% credible interval: 48300–84 500) Ebola cases were averted in Sierra Leone as a direct result of additional treatment beds)Positive
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
Description of the Delphi process used to select the six topics of the scoping reviews This study is part of a larger series of six scoping reviews conducted by the “VEctor boRne DiseAses Scoping reviews” (VERDAS) consortium following a call from the Vectors, Environment and Society unit of the Special Programme for Research and Training in Tropical Diseases (TDR) hosted by the World Health Organization (WHO)
Summary
Introduction of treatment beds inEbola holding centresFerrari et al 2014 [47] Meningitis (Nigeria)Case management; strengthening of surveillance; mass vaccination campaignsYip et al 2008 [48]Severe acute respiratory Information syndrome (China) dissemination to the public; quarantine; closure of most public facilities, schools and universities; site surveillance at airportEpidemiological investigation and/or surveillance; Environmental and sanitary interventionsNumber of cases avertedReduction in confirmed meningitis casesDaily numbers of confirmed SARS patientsPositive (56 600 (95% credible interval: 48300–84 500) Ebola cases were averted in Sierra Leone as a direct result of additional treatment beds)Positive (overall impact of vaccination campaigns ranged from 4 to 12%; vaccination reduced cases by as much as 50% when campaigns were conducted early in the epidemic). Almost a year and a half after the declaration of the Zika virus outbreak as a Public Health Emergency of International Concern, public health practitioners and policy-makers remain indecisive about Zika control measures [1] This raises concerns about the ability of current systems to deal with the unpredictable nature of emerging pathogens, with 84 countries having confirmed local transmission of the disease since 2015 [2]. As the Zika pandemic will certainly not be the last emerging infectious disease to challenge global health systems, it is necessary to understand the common knowledge gaps in outbreak response across previous epidemics to improve the containment of future outbreaks This is important considering the emergence of new challenges for cities, including demographic and environmental changes. New megacities act as perfect incubators for the introduction of diseases, with the accelerated and often uncontrolled urbanization resulting in amplified circulation of pathogens due to high population densities and mobility, weak infrastructure and waste management services, and poor housing [5]
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