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Table 1 Summary of included studies

From: Containment measures for emerging and re-emerging vector-borne and other infectious diseases of poverty in urban settings: a scoping review

Authors, Date Disease (country) Types of intervention Types of measures Outcome measures Effectiveness/rapidity Main limitations
Section I - Case studies
 Santa-Olalla et al. 2013 [19] Cholera (Haiti) Alert & response (A&R) system; identification and assessment of cholera alerts and hotspots; organization of a rapid response with partners to provide immediate support based on needs identified in the field (e.g., supplies, training, social mobilization, water, and sanitation) Healthcare provision; epidemiological investigation and/or surveillance; community-based measures Not mentioned Positive (A&R system showed how the rapid detection of cholera alerts was a key element in identifying outbreaks and in directing and coordinating urgent response) No clear outcome to evaluate the effectiveness of the A&R system
 Gazin and Louissaint 2011 [20] Cholera (Haiti) Awareness campaign; oral rehydration points; cholera treatment centres; water purification Healthcare provision; community-based measures; environmental and sanitary interventions Fatality rate Positive (mortality rate < 1% in treatment centres; strategy and coordination qualified as ‘efficient’) Few outcome measures; basic evaluation of effectiveness
 Guévart et al. 2005 [21] Cholera (Cameroon) Case management; preventive antibiotic treatment of all patient contacts; enhanced surveillance system Healthcare provision; epidemiological investigation and/or surveillance Incidence of notified cases from special units Positive (no new cases after the implementation of containment measures) The role of large-scale treatment of antibiotic prophylaxis in ending the cholera outbreak could not be ascertained
 Bin Yunus et al. 2001 [22] Dengue (Bangladesh) Development of national guidelines for clinical management; training of doctors; reorientation of specialists; entomological mapping; documentation of cases; operational studies for testing case definitions; collection of sero-evidence; community-based measures (community empowerment for prevention and control) Healthcare provision; epidemiological investigation and/or surveillance; community-based measures No clear outcome Positive (successful operationalization of action plans) No clear objective
 Maciel-de-Freitas et al. 2014 [23] Dengue (Brazil) Standard chemical and environmental vector control measures Environmental and physical interventions House index a; number of cases (no information whether laboratory validated); mean incidence Negative (only slight decrease in vector density; no significant change in seasonal dynamics of dengue) No clear objective; some highly-productive cryptic containers were not inspected by vector control professionals
 Khan and Abbas 2014 [24] Dengue (Pakistan) Creation of a provincial cabinet committee; data collection; training of professionals; awareness campaigns; improvement of health infrastructure; appointment of public health officers Healthcare provision; epidemiological investigation and/or surveillance Numbers of reported clinical cases Positive (252 reported cases of dengue in 2012 in Lahore with no deaths) Limited outcome measures
 Nyenswah et al. 2015 [25] Ebola virus disease (Liberia) Active case-finding; contact tracing; effective triage within the healthcare system; rapid isolation of symptomatic contacts; home-based and community quarantine; decentralized management of outbreak activities Epidemiological investigation and/or surveillance; healthcare provision; environmental and sanitary interventions No outcome measures Positive (more complete contact tracing, more prompt isolation of symptomatic patients in the second and third generations of transmission, increased survival, and reduced transmission in the community) Methodology unspecified
 Althaus et al. 2015 [26] Ebola virus disease (Nigeria) Surveillance and contact tracing; case management; screening of all arrivals/departures in and out of the country by land, air, and sea; social mobilization; use of technology for innovative applications in the EOCs Healthcare provision; Epidemiological investigation and/or surveillance Fitting a transmission model to Nigeria outbreaks Positive Methodology and outcomes measures not specified
 Webster-Kerr et al. 2011 [27] Malaria (Jamaica) Early detection and prompt treatment of cases; vector control; public education; community-based surveillance; intersectoral collaboration Healthcare provision; epidemiological investigation and/or surveillance; community-based measures; environmental and sanitary interventions Number of laboratory confirmed cases Positive (only one of 358 cases who had a post-treatment smear on day 7 had a persistent asexual parasitaemia, while none of the 149 persons who had a follow-up smear on day 28 was positive) No individual assessment of measures’ efficacy; data were observational rather than experimental
 Brostrom et al. 2011 [28] Multi-drug resistant TB (Micronesia) Case identification; contact investigation; creation of an action plan; construction of MDR-TB isolation units; training of community health workers; enhanced access to national and international subject-matter experts Healthcare provision; epidemiological investigation and/or surveillance TB-related mortality rates Positive (in the 12 months following implementation of these programmatic improvements, TB mortality in Chuuk dropped from 11% of all TB cases to less than 1%) Limited outcome measures
Section II - Descriptive studies
 Shen and Niu 2012 [29] A/H1N1 influenza (China) Screening at borders; isolation; quarantine; large-scale reactive vaccination campaign Healthcare provision; epidemiological investigation and/or surveillance; environmental and sanitary interventions Incidence of laboratory confirmed H1N1 influenza; mortality rates Positive (epidemic curve showed that control measures of containment and vaccination reduced H1N1 morbidity/mortality) Laboratory confirmed cases analyzed represented a small subset of cases of pandemic H1N1 influenza during the period, as only laboratory-confirmed cases were analyzed
 Guévart et al. 2007 [30] Cholera (Cameroon) Follow-up of notifications; bacteriological monitoring; antibiotic distribution; large-scale targeted antibiotic prophylaxis Healthcare provision; epidemiological investigation and/or surveillance Proportion of contacts among new cases; development of resistant strains Uncertain (antibiotic prophylaxis limited inter-human transmission of cholera but no impact on the epidemic was shown) New cases of cholera were not always the consequence of contact with a case, instead resulted from environmental exposure (e.g., contaminated water), such that it was difficult to measure the impact of a preventive strategy at the population level
 Peng et al. 2012 [31] Dengue (China) Vector surveillance; human surveillance; chemical and environmental vector control measures; community-based measures (prevention, public awareness) Epidemiological investigation and/or surveillance; community-based measures; environmental and sanitary interventions Breteau index b; number of dengue cases Positive (drop of the Breteau index, no more dengue cases reported since September 14, 2010) No clear objective; only suspected dengue cases were sent for laboratory confirmation
 Maciel-de-Freitas et al. 2014 [32] Dengue (Brazil) Intensification of standard chemical and environmental vector control measures Environmental and physical interventions Infestation levels, number of eggs in ovitraps Negative (infestation levels only slightly reduced) Reasons for low efficacy remain unclear due to several uncontrolled variables
 Seidahmed et al. 2012 [33] Dengue (Sudan) Health education; house inspection campaign by community volunteers; house inspection by health workers; space spraying; larviciding Healthcare provision; community-based measures; environmental and sanitary interventions Entomological indices; dengue incidence of laboratory confirmed cases Both positive and negative, depending on types of measures No individual assessment of control measure
 WHO Ebola Response Team 2016 [34] Ebola virus disease (Guinea, Liberia, and Sierra Leone) Case-finding; contact tracing; cases isolation; specially designed Ebola treatment centres; supportive clinical care; safe burials Healthcare provision; epidemiological investigation and/or surveillance Does not apply (purely descriptive study) Positive Did not explicitly evaluate the impact of the interventions
 Abramowitz et al. 2015 [35] Ebola virus disease (Liberia) Community-based measures (prevention; training; surveillance; response and treatment; post-outbreak measures) Community-based measures Does not apply (qualitative study) Negative (interventions regarded as necessary, but less desirable than a well-supported health-systems based response; community health messaging failed to provide the needed practical information and training) Large number of participants in focus groups; questions were posed as hypothetical rather than concerning local experiences and actions
 Okware et al. 2015 [36] Ebola virus disease (Uganda) Appointment of a national task force; community mobilization; community-based case search, isolation, and public education; improvement of health infrastructures; early detection and action Healthcare provision; Epidemiological investigation and/or surveillance; community-based measures; environmental and sanitary interventions Numbers of laboratory confirmed cases; case fatality rate; delays in early detection Negative in urban settings Limited outcome measures; methodology not mentioned; did not explicitly evaluate the impact of the interventions
 Iroezindu et al. 2015 [37] Lassa fever (Nigeria) Contact tracing; risk assessment; decontamination of the environment; establishment of a phone-based alert management system; provision of post-exposure prophylaxis for exposed individuals Healthcare provision; epidemiological investigation and/or surveillance; environmental and sanitary interventions Number of secondary cases Positive (no secondary case of LF occurred)  
 Ajayi et al. 2013 [38] Lassa fever (Nigeria) Coordination; active surveillance and community mobilization; suspect and contact evaluation; case management Healthcare provision; epidemiological investigation and/or surveillance; community-based measures Case fatality rate; timing of outbreak detection Positive Basic evaluation of effectiveness
 Pang et al. 2003 [39] Severe acute respiratory syndrome (China) Set up of fever clinics; training health care workers; closure of all public entertainment sites; construction of designated SARS hospitals with air extraction fans on windows or walls; quarantine of close contacts; self-quarantine Healthcare provision; environmental and sanitary interventions Attack rate; number of case; time lag between illness onset and hospitalization Positive (multiple control measures implemented in Beijing likely led to the rapid resolution of the SARS outbreak) Could not determine which intervention(s) was the most effective because of the simultaneous and overlapping implementation of multiple control measures; SARS attack rates might have been falsely elevated due to the unavailability of laboratory testing; the 5 districts selected to evaluate contact tracing and quarantine might not have been representative of all of Beijing.
 Liang et al. 2005 [40] Severe acute respiratory syndrome (China) Infection source control; timely hospital admission and safe transfer of all identified cases; classified isolation of all contacts and suspect cases; centralized treatment and personal protection equipment Healthcare provision; environmental and sanitary interventions Interval between disease onset and hospital admission Positive (notable shortening of the interval between disease onset and notification) Limited information on control measures; only measured the aggregated effect of multiple intervention measures
Section III - Analytic studies
 Sévère et al. 2016 [41] Cholera (Haiti) Reactive vaccination campaign Healthcare provision Rates of culture-confirmed cholera, severe dehydration at admission Positive (only 18 of the 52 357 vaccine recipients (0.034%) had culture-confirmed cholera compared with 370 of the 17 643 unvaccinated (2.09%); no case of cholera had been documented in a vaccine recipient since September 2013). Study not designed as a case-control study; impact of natural immunity to cholera not taken into account; heterogeneity of risk for cholera within the catchment area; impact of migration; passive surveillance for acute diarrhea cases; probable that asymptomatic or mild cases did not present to the treatment centres; migration of population in and out of the slum may also impact the estimated herd immunity; impact of interventions may be difficult to differentiate.
 Ordóñez González et al. 2011 [42] Dengue (Mexico) Chemical vector control measures Environmental and sanitary interventions Mosquito mortality rates (15 min and 24 h after exposure) Positive (mosquito mortality rates of 78.8% to 96.6% after 15 min of exposure and 98.8% to 100% 24 h after exposure. No mortalities were observed in the controls) Small sample size (4 houses with 3 cages in each)
Section IV – Model-based
 Tang et al. 2012 [43] A/H1N1 influenza (China) Contact tracing; campus quarantine Epidemiological investigation and/or surveillance; environmental and sanitary interventions Peak time of the epidemic; magnitude of outbreak (number of infectious individuals) Positive (reduction of A/H1N1 transmission from the campuses into the wider community; delay in timing of peak of infection) Generalization of findings is limited because of unique features of the social network and academic activities in Chinese campuses
 Pinho et al. 2010 [44] Dengue (Brazil) Adult vector control mechanisms Environmental and sanitary interventions Number of cases (no information whether laboratory validated) Negative (reduction in total number of cases; resurgence of the epidemic process (R(t) > 1) as a consequence of susceptible humans) Limited information on control measures
 Merler et al. 2015 [45] Ebola virus disease (Liberia) Deployment of protection kits to households; Ebola treatment units; safe burials Healthcare provision; environmental and sanitary interventions Number of projected cases and deaths Positive (Ebola treatment units may have contributed to halving the number of cases and deaths; deployment of protection kits to about 50% of households may have contributed to further reduce incidence from 30 new cases daily to 10; safer burial practices may have contributed an additional 50% reduction compared to no intervention) Data availability is limited (some estimates were obtained from previous outbreaks); quantitative assessment of effectiveness and coverage of protection kits was not possible
 Althaus et al. 2015 [26] Ebola virus disease (Nigeria) Case isolation; contact tracing; surveillance Epidemiological investigation and/or surveillance; environmental and sanitary interventions Change in net reproduction number after implementation of control interventions; risk of outbreak from a single undetected case Positive (reduction of net reproduction number Rt below unity 15 days (95% CI: 11–21 days) after the arrival of the index case) Fitting of a deterministic model to a small outbreak (20 cases); assumption that EVD cases are equally infectious throughout their infectious period; did not examine the separate contributions of transmission in healthcare settings and in the community; did not distinguish between different types of interventions; treated the two transmission clusters as a single outbreak
 Kucharski et al. 2015 [46] Ebola virus disease (Sierra Leona) Introduction of treatment beds in Ebola holding centres Healthcare provision Number of cases averted Positive (56 600 (95% credible interval: 48300–84 500) Ebola cases were averted in Sierra Leone as a direct result of additional treatment beds) Lack of quality data on timing and role of different interventions
 Ferrari et al. 2014 [47] Meningitis (Nigeria) Case management; strengthening of surveillance; mass vaccination campaigns Healthcare provision; epidemiological investigation and/or surveillance Reduction in confirmed meningitis cases Positive (overall impact of vaccination campaigns ranged from 4 to 12%; vaccination reduced cases by as much as 50% when campaigns were conducted early in the epidemic) Possible underestimation of campaign impact; provides an estimate of the vaccination campaign impact although rudimentary in its characterization of meningitis epidemiology
 Yip et al. 2008 [48] Severe acute respiratory syndrome (China) Information dissemination to the public; quarantine; closure of most public facilities, schools and universities; site surveillance at airport Epidemiological investigation and/or surveillance; Environmental and sanitary interventions Daily numbers of confirmed SARS patients Positive (drop in number of daily infections) Only measured the aggregated effect of multiple intervention measures; only showed that number of cases started to decline at time of interventions; the study could not determine what measure was the most important factor leading to the reduction
  1. EVD Ebola virus disease, LF Lassa fever, SARS Severe acute respiratory syndrome, TB Tuberculosis, MDR-TB Multi-drug resistant TB
  2. a The House index refers to the number of positive houses per total of inspected houses [23]
  3. b The Breteau index refers to the number of breeding sites per total of inspected houses [23]