Elodie Besnier
Which public health interventions are effective in reducing morbidity, mortality and health inequalities from infectious diseases amongst children in low- and middle-income countries (LMICs): An umbrella review
Besnier, Elodie; Thomson, Katie; Stonkute, Donata; Mohammad, Talal; Akhter, Nasima; Todd, Adam; Rom Jensen, Magnus; Kilvik, Astrid; Bambra, Clare
Authors
Katie Thomson
Donata Stonkute
Talal Mohammad
Dr Nasima Akhter nasima.akhter@durham.ac.uk
Assistant Professor
Adam Todd
Magnus Rom Jensen
Astrid Kilvik
Clare Bambra
Abstract
Despite significant progress in the last few decades, infectious diseases remain a major threat to child health in low- and middle-income countries (LMICs)—particularly amongst more disadvantaged groups. It is imperative to understand the best available evidence concerning which public health interventions reduce morbidity, mortality and health inequalities in children aged under five years. To address this gap, we carried out an umbrella review (a systematic reviews of reviews) to identify evidence on the effects of public health interventions (promotion, protection, prevention) on morbidity, mortality and/or health inequalities due to infectious diseases amongst children in LMICs. Ten databases were searched for records published between 2014–2021 alongside a manual search of gray literature. Articles were quality-assessed using the Assessment of Multiple Systematic Reviews tool (AMSTAR 2). A narrative synthesis was conducted. We identified 60 systematic reviews synthesizing 453 individual primary studies. A majority of the reviews reported on preventive interventions (n = 48), with a minority on promotion (n = 17) and almost no reviews covering health protection interventions (n = 2). Effective interventions for improving child health across the whole population, as well as the most disadvantaged included communication, education and social mobilization for specific preventive services or tools, such as immunization or bed nets. For all other interventions, the effects were either unclear, unknown or detrimental, either at the overall population level or regarding health inequalities. We found few reviews reporting health inequalities information and the quality of the evidence base was generally low. Our umbrella review identified some prevention interventions that might be useful in reducing under five mortality from infectious diseases in LMICs, particularly amongst the most disadvantaged groups.
Citation
Besnier, E., Thomson, K., Stonkute, D., Mohammad, T., Akhter, N., Todd, A., …Bambra, C. (2021). Which public health interventions are effective in reducing morbidity, mortality and health inequalities from infectious diseases amongst children in low- and middle-income countries (LMICs): An umbrella review. PLoS ONE, 16(6), Article e0251905. https://doi.org/10.1371/journal.pone.0251905
Journal Article Type | Article |
---|---|
Acceptance Date | May 4, 2021 |
Online Publication Date | Jun 10, 2021 |
Publication Date | 2021 |
Deposit Date | Oct 28, 2021 |
Publicly Available Date | Oct 28, 2021 |
Journal | PLoS ONE |
Publisher | Public Library of Science |
Peer Reviewed | Peer Reviewed |
Volume | 16 |
Issue | 6 |
Article Number | e0251905 |
DOI | https://doi.org/10.1371/journal.pone.0251905 |
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Publisher Licence URL
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Copyright Statement
© 2021 Besnier et al. This is an open<br />
access article distributed under the terms of the<br />
Creative Commons Attribution License, which<br />
permits unrestricted use, distribution, and<br />
reproduction in any medium, provided the original<br />
author and source are credited.
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