Approach to identifying research gaps on vector-borne and other infectious diseases of poverty in urban settings:scoping review protocol from the VERDAS consortium and reflections on the project’s implementation

Background:This paper presents the overall approach undertaken by the“VEctor boRne DiseAses Scoping reviews”(VERDAS)consortium in response to a call issued by the Vectors,Environment and Society unit of the Special Programme for Research and Training in Tropical Diseases hosted by the World Health Organization.The aim of the project was to undertake a broad knowledge synthesis and identify knowledge gaps regarding the control and prevention of vector-borne diseases in urban settings.Methods:The consortium consists of 14 researchers,13 research assistants,and one research coordinator from seven different institutions in Canada,Colombia,Brazil,France,Spain,and Burkina Faso.A six-step protocol was developed for the scoping reviews undertaken by the consortium,based on the framework developed by Arksey and O’Malley and improved by Levac et al.In the first step,six topics were identified through an international eDelphi consultation.In the next four steps,the scoping reviews were conducted.The sixth step was the VERDAS workshop held in Colombia in March 2017.Discussion:In this article,we discuss several methodological issues encountered and share our reflections on this work.We believe this protocol provides a strong example of an exhaustive and rigorous process for performing broad knowledge synthesis for any given topic and should be considered for future research initiatives and donor agendas in multiple fields to highlight research needs scientifically.

A scoping review on the field validation and implementation of rapid diagnostic tests for vector-borne and other infectious diseases of poverty in urban areas

Background:Health personnel face challenges in diagnosing vector-borne and other diseases of poverty in urban settings.There is a need to know what rapid diagnostic technologies are available,have been properly assessed,and are being implemented to improve control of these diseases in the urban context.This paper characterizes evidence on the field validation and implementation in urban areas of rapid diagnostics for vector-borne diseases and other diseases of poverty.Main body:A scoping review was conducted.Peer-reviewed and grey literature were searched using terms describing the targeted infectious diseases,diagnostics evaluations,rapid tests,and urban setting.The review was limited to studies published between 2000 and 2016 in English,Spanish,French,and Portuguese.Inclusion and exclusion criteria were refined post hoc to identify relevant literature regardless of study design and geography.A total of 179 documents of the 7806 initially screened were included in the analysis.Malaria(n=100)and tuberculosis(n=47)accounted for the majority of studies that reported diagnostics performance,impact,and implementation outcomes.Fewer studies,assessing mainly performance,were identified for visceral leishmaniasis(n=9),filariasis and leptospirosis(each n=5),enteric fever and schistosomiasis(each n=3),dengue and leprosy(each n=2),and Chagas disease,human African trypanosomiasis,and cholera(each n=1).Reported sensitivity of rapid tests was variable depending on several factors.Overall,specificities were high(>80%),except for schistosomiasis and cholera.Impact and implementation outcomes,mainly acceptability and cost,followed by adoption,feasibility,and sustainability of rapid tests are being evaluated in the field.Challenges to implementing rapid tests range from cultural to technical and administrative issues.Conclusions:Rapid diagnostic tests for vector-borne and other diseases of poverty are being used in the urban context with demonstrated impact on case detection.However,most evidence comes from malaria rapid diagnostics,with variable results.While rapid tests for tuberculosis and visceral leishmaniasis require further implementation studies,more evidence on performance of current tests or development of new alternatives is needed for dengue,Chagas disease,filariasis,leptospirosis,enteric fever,human African trypanosomiasis,schistosomiasis and cholera.

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.