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

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.

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.

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.

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.

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