Interventions for vector-borne diseases focused on housing and hygiene in urban areas:a scoping review

Background:Over half the world’s human populations are currently at risk from vector-borne diseases(VBDs),and the heaviest burden is borne by the world’s poorest people,communities,and countries.The aim of this study was to conduct a review on VBD interventions relevant to housing and hygiene(including sanitation and waste management)in urban areas.Main body:We conducted a scoping review,which involved systematically searching peer-reviewed and grey literature published between 2000 and 2016 using five scientific databases and one database for grey literature.Different data extraction tools were used for data coding and extraction.We assessed the quality of each study using the Mixed Methods Appraisal Tool and extracted descriptive characteristics and data about implementation process and transferability from all studies using the Template for Intervention Description and Replication and ASTAIRE(a tool for analyzing the transferability of health promotion interventions)tools.We reviewed 44 studies.Overall,the studies were judged to be of high risk for bias.Our results suggest multifaceted interventions,particularly community-based interventions,have the potential to achieve wider and more sustained effects than do standard vertical single-component programs.The evaluations of multifaceted interventions tend to include integrated evaluations,using not only entomological indicators but also acceptability and sustainability indicators.Conclusions:This review highlighted the important need for higher quality research in VBDs and improved and standardized reporting of interventions.Significant research gaps were found regarding qualitative research and implementation research,and results highlighted the need for more interventions focus on sanitation and hygiene practices.

Containment measures for emerging and re-emerging vector-borne and other infectious diseases of poverty in urban settings:a scoping review

Background: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.Main body: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.Conclusions: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.

Communities and service providers address access to perinatal care in postconflict Northern Uganda:socialising evidence for participatory action

Objectives Describe participatory codesign of interventions to improve access to perinatal care services in Northern Uganda.Study design Mixed-methods participatory research to codesign increased access to perinatal care.Fuzzy cognitive mapping,focus groups and a household survey identified and documented the extent of obstructions to access.Deliberative dialogue focused stakeholder discussions of this evidence to address the obstacles to access.Most significant change stories explored the participant experience of this process.Setting Three parishes in Nwoya district in the Gulu region,Northern Uganda.Participants Purposively sampled groups of women,men,female youth,male youth,community health workers,traditional midwives and service providers.Each of seven stakeholder categories included 5-8 participants in each of three parishes.Results Stakeholders identified several obstructions to accessing perinatal care:lack of savings in preparation for childbirth in facility costs,lack of male support and poor service provider attitudes.They suggested joining saving groups,practising saving money and income generation to address the short-term financial shortfall.They recommended increasing spousal awareness of perinatal care and they proposed improving service provider attitudes.Participants described their own improved care-seeking behaviour and patient-provider relationships as short-term gains of the codesign.Conclusion Participatory service improvement is feasible and acceptable in postconflict settings like Northern Uganda.Engaging communities in identifying perinatal service delivery issues and reflecting on local evidence about these issues generate workable community-led solutions and increases trust between community members and service providers.