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2015 ; 10
(9
): e0138303
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The Effectiveness of Interventions for Non-Communicable Diseases in Humanitarian
Crises: A Systematic Review
#MMPMID26406317
Ruby A
; Knight A
; Perel P
; Blanchet K
; Roberts B
PLoS One
2015[]; 10
(9
): e0138303
PMID26406317
show ga
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.
|*Warfare
[MESH]
|Arthritis/*epidemiology/prevention & control
[MESH]
|Diabetes Mellitus/*epidemiology/prevention & control
[MESH]
|Heart Failure/*epidemiology/prevention & control
[MESH]
|Humans
[MESH]
|Hypertension/*epidemiology/prevention & control
[MESH]
|Randomized Controlled Trials as Topic
[MESH]
|Renal Insufficiency, Chronic/*epidemiology/prevention & control
[MESH]