The socioeconomic burden of antibiotic resistance in conflict-affected settings and refugee hosting countries: a systematic scoping review

Conflict and Health

Elsa Kobeissi¹  Marilyne Menassa¹  Ghassan Abu-Sittah²  Marwan Hajjar³  Ismail Soboh³  Shadi Saleh⁴  Krystel Moussally⁵  Ernestina Repetto⁶ 

[1] Conflict Medicine Program, Global Health Institute, American University of Beirut, Beirut, Lebanon;Conflict Medicine Program, Global Health Institute, American University of Beirut, Beirut, Lebanon;Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, 1107-2020, Beirut, Lebanon;Division of Plastic Surgery, Department of Surgery, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, 1107-2020, Beirut, Lebanon;Global Health Institute, American University of Beirut, Beirut, Lebanon;Lebanon Branch Office, Médecins Sans Frontières, Beirut, Lebanon;Medical Department, Operational Center Brussels, Médecins Sans Frontières, Brussels, Belgium;

关键词: Antibiotic resistance;    Multi-drug resistance;    Conflict-affected;    Refugee;    Socioeconomic;    Cost of illness;   

DOI  :  10.1186/s13031-021-00357-6

来源: Springer

【 摘 要 】

BackgroundAntibiotic resistance (ABR) is a major global threat. Armed and protracted conflicts act as multipliers of infection and ABR, thus leading to increased healthcare and societal costs. We aimed to understand and describe the socioeconomic burden of ABR in conflict-affected settings and refugee hosting countries by conducting a systematic scoping review.MethodsA systematic search of PubMed, Medline (Ovid), Embase, Web of Science, SCOPUS and Open Grey databases was conducted to identify all relevant human studies published between January 1990 and August 2019. An updated search was also conducted in April 2020 using Medline/Ovid. Independent screenings of titles/abstracts followed by full texts were performed using pre-defined criteria. The Newcastle-Ottawa Scale was used to assess study quality. Data extraction and analysis were based on the PICOS framework and following the PRISMA-ScR guideline.ResultsThe search yielded 8 studies (7 publications), most of which were single-country, mono-center and retrospective studies. The studies were conducted in Lebanon (n = 3), Iraq (n = 2), Jordan (n = 1), Palestine (n = 1) and Yemen (n = 1). Most of the studies did not have a primary aim to assess the socioeconomic impact of ABR and were small studies with limited statistical power that could not demonstrate significant associations. The included studies lacked sufficient information for the accurate evaluation of the cost incurred by antibiotic resistant infections in conflict-affected countries.ConclusionThis review highlights the scarcity of research on the socioeconomic burden of ABR on general populations in conflict-affected settings and on refugees and migrants in host countries, and lists recommendations for consideration in future studies. Further studies are needed to understand the cost of ABR in these settings to develop and implement adaptable policies.

【 授权许可】

CC BY