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The Effectiveness of Interventions for Non-Communicable Diseases in Humanitarian Crises: A Systematic Review
BACKGROUND: Non-communicable diseases (NCDs) are of increasing concern in low- and middle-income countries (LMICs) affected humanitarian crises. Humanitarian agencies and governments are increasingly challenged with how to effectively tackle NCDs. Reviewing the evidence of interventions for NCDs in...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583445/ https://www.ncbi.nlm.nih.gov/pubmed/26406317 http://dx.doi.org/10.1371/journal.pone.0138303 |
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author | Ruby, Alexander Knight, Abigail Perel, Pablo Blanchet, Karl Roberts, Bayard |
author_facet | Ruby, Alexander Knight, Abigail Perel, Pablo Blanchet, Karl Roberts, Bayard |
author_sort | Ruby, Alexander |
collection | PubMed |
description | BACKGROUND: Non-communicable diseases (NCDs) are of increasing concern in low- and middle-income countries (LMICs) affected humanitarian crises. Humanitarian agencies and governments are increasingly challenged with how to effectively tackle NCDs. Reviewing the evidence of interventions for NCDs in humanitarian crises can help guide future policies and research by identifying effective interventions and evidence gaps. The aim of this paper is to systematically review evidence on the effectiveness of interventions targeting NCDs during humanitarian crises in LMICs. METHODS: A systematic review methodology was followed using PRISMA standards. Studies were selected on NCD interventions with civilian populations affected by humanitarian crises in low- and middle-income countries. Five bibliographic databases and a range of grey literature sources were searched. Descriptive analysis was applied and a quality assessment conducted using the Newcastle-Ottawa Quality Assessment Scale for observational studies and the Cochrane Risk of Bias Tool for experimental studies. RESULTS: The search yielded 4919 references of which 8 studies met inclusion criteria. Seven of the 8 studies were observational, and one study was a non-blinded randomised-controlled trial. Diseases examined included hypertension, heart failure, diabetes mellitus, chronic kidney disease, thalassaemia, and arthritis. Study settings included locations in the Middle East, Eastern Europe, and South Asia. Interventions featuring disease-management protocols and/or cohort monitoring demonstrated the strongest evidence of effectiveness. No studies examined intervention costs. The quality of studies was limited, with a reliance on observational study designs, limited use of control groups, biases associated with missing data and inadequate patient-follow-up, and confounding was poorly addressed. CONCLUSIONS: The review highlights the extremely limited quantity and quality of evidence on this topic. Interventions that incorporate standardisation and facilitate patient follow-up appear beneficial. However, substantially more research is needed, including data on costs. |
format | Online Article Text |
id | pubmed-4583445 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-45834452015-10-02 The Effectiveness of Interventions for Non-Communicable Diseases in Humanitarian Crises: A Systematic Review Ruby, Alexander Knight, Abigail Perel, Pablo Blanchet, Karl Roberts, Bayard PLoS One Research Article BACKGROUND: Non-communicable diseases (NCDs) are of increasing concern in low- and middle-income countries (LMICs) affected humanitarian crises. Humanitarian agencies and governments are increasingly challenged with how to effectively tackle NCDs. Reviewing the evidence of interventions for NCDs in humanitarian crises can help guide future policies and research by identifying effective interventions and evidence gaps. The aim of this paper is to systematically review evidence on the effectiveness of interventions targeting NCDs during humanitarian crises in LMICs. METHODS: A systematic review methodology was followed using PRISMA standards. Studies were selected on NCD interventions with civilian populations affected by humanitarian crises in low- and middle-income countries. Five bibliographic databases and a range of grey literature sources were searched. Descriptive analysis was applied and a quality assessment conducted using the Newcastle-Ottawa Quality Assessment Scale for observational studies and the Cochrane Risk of Bias Tool for experimental studies. RESULTS: The search yielded 4919 references of which 8 studies met inclusion criteria. Seven of the 8 studies were observational, and one study was a non-blinded randomised-controlled trial. Diseases examined included hypertension, heart failure, diabetes mellitus, chronic kidney disease, thalassaemia, and arthritis. Study settings included locations in the Middle East, Eastern Europe, and South Asia. Interventions featuring disease-management protocols and/or cohort monitoring demonstrated the strongest evidence of effectiveness. No studies examined intervention costs. The quality of studies was limited, with a reliance on observational study designs, limited use of control groups, biases associated with missing data and inadequate patient-follow-up, and confounding was poorly addressed. CONCLUSIONS: The review highlights the extremely limited quantity and quality of evidence on this topic. Interventions that incorporate standardisation and facilitate patient follow-up appear beneficial. However, substantially more research is needed, including data on costs. Public Library of Science 2015-09-25 /pmc/articles/PMC4583445/ /pubmed/26406317 http://dx.doi.org/10.1371/journal.pone.0138303 Text en © 2015 Ruby et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Ruby, Alexander Knight, Abigail Perel, Pablo Blanchet, Karl Roberts, Bayard The Effectiveness of Interventions for Non-Communicable Diseases in Humanitarian Crises: A Systematic Review |
title | The Effectiveness of Interventions for Non-Communicable Diseases in Humanitarian Crises: A Systematic Review |
title_full | The Effectiveness of Interventions for Non-Communicable Diseases in Humanitarian Crises: A Systematic Review |
title_fullStr | The Effectiveness of Interventions for Non-Communicable Diseases in Humanitarian Crises: A Systematic Review |
title_full_unstemmed | The Effectiveness of Interventions for Non-Communicable Diseases in Humanitarian Crises: A Systematic Review |
title_short | The Effectiveness of Interventions for Non-Communicable Diseases in Humanitarian Crises: A Systematic Review |
title_sort | effectiveness of interventions for non-communicable diseases in humanitarian crises: a systematic review |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583445/ https://www.ncbi.nlm.nih.gov/pubmed/26406317 http://dx.doi.org/10.1371/journal.pone.0138303 |
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