Infectious disease research in forcibly displaced populations: A systematic review in low- and middle-income host countries

IF 2.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Migration and Health Pub Date : 2025-01-01 DOI:10.1016/j.jmh.2025.100341

Neila Gross , Maia C. Tarnas , Rashmina J. Sayeeda , Carly Ching , David Flynn , Muhammad H Zaman

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Abstract

Background

Infectious disease research is essential for disease prevention and management within refugee camps and informal settlements. The objective of this study is to identify the characteristics of existing infectious disease research in these settings and to assess stated research challenges, ethical considerations, and studied interventions within these studies.

Methods

This is a systematic review of forty primary studies focused on infectious disease research conducted among displaced populations. Included studies are published in English between 1995 and 2023. Three databases were searched, PubMed, Embase, and Web of Science, and this review was registered with PROSPERO (CRD42023461567). The risk of bias of the studies was assessed using the Mixed Methods Appraisal Tool.

Results

85 % of studies (n = 34) researched an intervention for infectious disease prevention or control and 70 % of studies (n = 28) were randomized controlled trials. 75 % of studies were located in Bangladesh (n = 15) or Pakistan (n = 15). 40 % of studies focused on diarrheal diseases (n = 16) and 28 % on malaria (n = 11). Common identified research challenges included population mobility, limited external validity, and low recruitment. No studies included the community in the initial study conception or investigated the research impact on the community. Community involvement was often through community health workers (45 %). Of the 18 studies that studied a resource-based intervention, 20 % explicitly noted that the intervention was unsustainable.

Discussion

While guidelines for conducting research in displaced settings exist, there are gaps in their utilization. We identified a disconnect between where displaced individuals reside and where research is conducted, as well as a prioritization of particular infectious diseases. Researchers identified numerous challenges in conducting research in these settings, though the community was rarely involved in the research. Context-specific considerations and community involvement are vital in research with displaced communities.

Funding

Wellcome Trust (Contract Number C-010,656).

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被迫流离失所人口的传染病研究：在低收入和中等收入东道国的系统审查

背景：传染病研究对难民营和非正式住区内的疾病预防和管理至关重要。本研究的目的是确定这些环境中现有传染病研究的特征，并评估这些研究中所述的研究挑战、伦理考虑和研究干预措施。方法系统回顾了在流离失所人群中进行的传染病研究的40项主要研究。纳入的研究在1995年至2023年间以英文发表。检索PubMed、Embase和Web of Science三个数据库，并在PROSPERO注册（CRD42023461567）。使用混合方法评估工具评估研究的偏倚风险。结果85% （n = 34）的研究为传染病预防或控制的干预措施，70% （n = 28）的研究为随机对照试验。75%的研究位于孟加拉国（n = 15）或巴基斯坦（n = 15）。40%的研究侧重于腹泻病（n = 16）， 28%侧重于疟疾（n = 11）。常见的研究挑战包括人口流动、有限的外部有效性和低招募率。没有研究将社区纳入最初的研究概念或调查研究对社区的影响。社区参与往往是通过社区卫生工作者进行的（45%）。在研究基于资源的干预措施的18项研究中，20%明确指出干预措施是不可持续的。讨论虽然存在在流离失所环境中进行研究的指导方针，但在使用方面存在差距。我们发现流离失所者的居住地与开展研究的地点之间存在脱节，并确定了特定传染病的优先次序。研究人员确定了在这些环境中进行研究的许多挑战，尽管社区很少参与研究。具体情况的考虑和社区参与对流离失所社区的研究至关重要。资助威康信托（合同编号C-010,656）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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