Abstract
BackgroundOutbreaks of zoonotic diseases that transmit between animals and humans, against a backdrop of increasing levels of forced migration, present a major challenge to global public health. This review provides an overview of the currently available evidence of how displacement may affect zoonotic disease and pathogen transmission, with the aim to better understand how to protect health and resilience of displaced and host populations.MethodsA systematic review was conducted aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Between December 2019 - February 2020, PubMed, Web of Science, PLoS, ProQuest, Science Direct and JSTOR were searched for literature. Studies were included based on a focus on zoonotic disease risks in displacement and/or humanitarian emergencies, and relevance in terms of livestock dependency of the displaced populations. Evidence was synthesised in form of a table and thematic analysis.ResultsOf all records, 78 papers were selected for inclusion. Among the included studies, the majority were based on secondary data, including literature reviews (n=43) and case studies (n=5), while the majority of papers covered wide geographical areas such as the Global South (n=17) and Africa (n=20). The review shows significant gaps in the literature, which is specifically lacking primary data on zoonotic diseases in displacement. Risk factors for the transmission of zoonoses in displacement are based on generic infectious disease risks, which include the loss of health services, increased population density, changes in environment, reduced quality of living conditions and socio-economic factors. Regardless of the presence of these disease drivers during forced migration however, there is little evidence of large-scale zoonotic disease outbreaks linked directly to livestock in displacement.ConclusionDue to the lack of primary research, the complex interlinkages of factors affecting zoonotic pathogen transmission in displacement remain unclear. While the presence of animals may increase the burden of zoonotic pathogens, maintaining access to livestock may improve livelihoods, nutrition and mental health, with the potential to reduce people’s vulnerability to disease. Further primary interdisciplinary and multi-sectoral research is urgently required to address the evidence gaps identified in this review to support policy and program development.
Highlights
Outbreaks of zoonotic diseases that transmit between animals and humans, against a backdrop of increasing levels of forced migration, present a major challenge to global public health
In this literature review we provide an overview of the currently available evidence of 1) zoonotic diseases associated with displacement contexts, and 2) drivers during displacement affecting zoonotic pathogen transmission risks, followed by a discussion addressing 3) gaps in the literature, and 4) current risk mitigation measures, concluding with entry points for further research to increase understanding on how to protect health, livelihoods and resilience of displaced populations, host communities and livestock
No publication focused on the specific risk of zoonoses related to livestock movement during displacement
Summary
Outbreaks of zoonotic diseases that transmit between animals and humans, against a backdrop of increasing levels of forced migration, present a major challenge to global public health. This review provides an overview of the currently available evidence of how displacement may affect zoonotic disease and pathogen transmission, with the aim to better understand how to protect health and resilience of displaced and host populations. Research shows that most emerging infectious diseases in humans have animal origins, either originating in domestic animals or wildlife [1], while neglected and endemic zoonoses, continuously transmitted between livestock and humans, are a significant burden to public health and livelihoods [2]. Movement is associated with increased mixing of displaced and host populations’ and their livestock, and increased contact between domestic animals, wildlife and humans, which risks increased disease transmission between species. Health services and staff may be affected or become displaced themselves, hampering an organized response, exacerbating zoonotic disease outbreaks [6]
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