Table 3 Summary results of scoping review of the feasibility, acceptability, and effectiveness of non-pharmaceutical interventions, and their overall appropriateness for targeted application within crisis-affected settings
Level of intervention | NPI | No. studies | Measure of NPI | Summary recommendation* | |||||
|---|---|---|---|---|---|---|---|---|---|
Feasibility | Acceptability | Effectiveness | Camp or camp-like | Hosted | Resident | Informal housing | |||
Environmental | Vector control | 16 | – IRS feasible in many contexts – Barriers mostly concern logistic and infrastructure constraints | – Very weak evidence base; needs strengthening before conclusions can be made | – IRS is (cost)-effective against malaria in camp or camp-like settings – Insecticide (IRS, larvicide or fogging) can reduce exposure to a range of mosquito species | +++ |  +  | ++ | +++ |
Cleaning, disinfection, & waste management | 5 | – Weak evidence base – Disinfection of water containers was feasible in an IDP camp – Logistic constraints are main concerns for these interventions | – Weak evidence base – High acceptability of household disinfection kits – Chlorine use has low acceptability in many settings | – Weak evidence base – Inadequate WASH interventions associated with increased cholera risk in one refugee camp | ++ |  +  | ++ | ++ | |
Improving air ventilation | 0 | – No evidence found | – No evidence found | – No evidence found | − | − | − | − | |
Community | Risk communication & community engagement (RCCE) | 32 | – Highly feasible for a variety of diseases – Population-targeted messaging important | – Weak evidence base – Acceptability higher when members of the affected community involved in message formulation and delivery, in local language | – Generally, highly effective for interventions against a range of transmission types | +++ | +++ | +++ | +++ |
Water, Sanitation & Hygiene (WASH) | 21 | – Establishment often feasible, but financial constraints, sustainable maintenance, & implementation were challenges – Trust between stakeholders identified as key determinant of successful implementation | – Weak evidence base – Overcrowding and distance caused unacceptability of communal latrines in IDP camp – Community engagement can enhance acceptability | – WASH interventions effective at improving conditions and behaviour and reducing incidence in water-borne diseases in multiple settings | +++ |  +  |  +  | +++ | |
Physical distancing | Patient care/burial practices | 2 | – No evidence found | – Weak evidence base – Low acceptability reported during EVD outbreak in conflict-affected setting | – No evidence found | +++ | +++ | +++ | +++ |
Closures and restrictions on gatherings | 0 | – No evidence found | – No evidence found | – No evidence found | − | − | − | − | |
Maintaining minimum distances between indivduals | 0 | – No evidence found | – No evidence found | – No evidence found | − | − | − | − | |
Shielding vulnerable groups | 0 | – No evidence found | – No evidence found | – No evidence found | − | − | − | − | |
Travel | Entry/exit screening and isolation or quarantine | 2 | – No evidence found | – No evidence found | – Weak evidence base – Effective for TB and helminth infection detection in one refugee camp | +++ |  +  |  +  | ++ |
Closing land borders | 0 | – No evidence found | – No evidence found | – No evidence found | − | − | − | − | |
Restricting entry/exit | 0 | – No evidence found | – No evidence found | – No evidence found | − | − | − | − | |
Stay-at-home order | 0 | – No evidence found | – No evidence found | – No evidence found | − | − | − | − | |
Suspending or restricting movement | 0 | – No evidence found | – No evidence found | – No evidence found | − | − | − | − | |
Surveillance and response | Active case detection (ACD) | 31 | – Feasible for some diseases (HIV, TB, diarrhoeal disease) in various African refugee camps – Some difficulties reported in conflict-affected areas due to security | – Acceptable for some diseases (HIV, TB) in various African refugee camps – Highly acceptable in informal settlements – RCCE strongly linked to level of acceptability | – Highly effective for a variety of diseases (HIV, TB, malaria, cholera) in camp or camp-like settings | +++ | ++ | ++ | +++ |
Contact tracing | 5 | – Weak evidence base – Feasible for influenza outbreak in post-disaster temporary shelters in USA | – No evidence found | – Effective for TB control among different populations affected by different crises | +++ | ++ | ++ | +++ | |
Case isolation | 4 | – Very weak evidence base; needs strengthening before conclusions can be made | – Weak evidence base – Low acceptability for EVD among crisis-affected resident populations in Central Africa | – Weak evidence base – Effective for influenza outbreak in post-disaster temporary shelters in Japan when used in combination with other NPIs | ++ | +++ | +++ | ++ | |
Quarantine | 2 | – Very weak evidence base; needs strengthening before conclusions can be made | – No evidence found | – Very weak evidence base; needs strengthening before conclusions can be made | ++ | +++ | +++ | ++ | |
Individual | Vector protection | 19 | – ITN and mosquito repellent highly feasible | – ITN and mosquito repellent highly acceptable – User costs are only barrier reported | – ITNs highly effective in reducing malaria risk in various settings | +++ | +++ | +++ | +++ |
Hand hygiene | 9 | – Generally feasible – Dependent on ensuring adequate WASH service provision | – Generally acceptable, but cultural differences in eating habits can impact this | – Weak evidence base – Effective in several settings against a variety of diseases – Differences between age groups observed in one setting | +++ | ++ | ++ | +++ | |
Water purification | 5 | – Very weak evidence base; needs strengthening before conclusions can be made | – No evidence found | – Highly effective at reducing the diarrhoea among refugees in various settings in Africa | +++ | +++ | +++ | +++ | |
Condom distribution | 3 | – Very weak evidence base; needs strengthening before conclusions can be made | – No evidence found | – Weak evidence base – Mixed results reported among refugees in Africa | +++ | ++ | ++ | +++ | |
Face masks | 2 | – Very weak evidence base; needs strengthening before conclusions can be made | – Very weak evidence base; needs strengthening before conclusions can be made | – No evidence found | ++ | ++ | ++ | ++ | |