Interventions to Maintain HIV/AIDS, Tuberculosis, and Malaria Service Delivery During Public Health Emergencies in Low- and Middle-Income Countries: Protocol for a Systematic Review.

Interventions to Maintain HIV/AIDS, Tuberculosis, and Malaria Service Delivery During Public Health Emergencies in Low- and Middle-Income Countries: Protocol for a Systematic Review.

Publication date: Jan 15, 2025

Although existing disease preparedness and response frameworks provide guidance about strengthening emergency response capacity, little attention is paid to health service continuity during emergency responses. During the 2014 Ebola outbreak, there were 11,325 reported deaths due to the Ebola virus and yet disruption in access to care caused more than 10,000 additional deaths due to measles, HIV/AIDS, tuberculosis, and malaria. Low- and middle-income countries account for the largest disease burden due to HIV, tuberculosis, and malaria and yet previous responses to health emergencies showed that HIV, tuberculosis, and malaria service delivery can be significantly disrupted. To date, there has not been a systematic synthesis of interventions implemented to maintain the delivery of these services during emergencies. This study aimed to synthesize the interventions implemented to maintain HIV/AIDS, tuberculosis, and malaria services during public health emergencies in low- and middle-income countries. The systematic review was registered in the international register for prospective systematic reviews. It will include activities undertaken to improve human health either through preventing the occurrence of HIV, tuberculosis, or malaria, reducing the severity among patients, or promoting the restoration of functioning lost as a result of experiencing HIV, tuberculosis, or malaria during health emergencies. These will include policy-level (eg, development of guidelines), health facility-level (eg, service rescheduling), and community-level interventions (eg, community drug distribution). Service delivery will be in terms of improving access, availability, use, and coverage. We will report on any interventions to maintain services along the care cascade for HIV, tuberculosis, or malaria. Peer-reviewed study databases including MEDLINE, Web of Science, Embase, Cochrane, and Global Index Medicus will be searched. Reference lists from global reports on HIV/AIDS, tuberculosis, or malaria will also be searched. We will use the GRADE-CERQual (Grading of Recommendations Assessment, Development, and Evaluation-Confidence in Evidence from Reviews of Qualitative Research) approach to report on the quality of evidence in each paper. The information from the studies will be synthesized at the disease or condition level (HIV/AIDS, tuberculosis, and malaria), implementation level (policy, health facility, and community), and outcomes (improving access, availability, use, or coverage). We will use the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist to report findings and discuss implications for strengthening preparedness and response, as well as strengthening health systems in low- and middle-income countries. The initial search for published literature was conducted between January 2023 and March 2023 and yielded 8119 studies. At the time of publication, synthesis and interpretation of results were being concluded. Final results will be published in 2025. The findings will inform the development of national and global guidance to minimize disruption of services for patients with HIV/AIDS, tuberculosis, and malaria during public health emergencies. PROSPERO CRD42023408967; https://www. crd. york. ac. uk/prospero/display_record. php?RecordID=408967. PRR1-10. 2196/64316.

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Concepts Keywords
Crd42023408967 Acquired Immunodeficiency Syndrome
Php AIDS
Tuberculosis communities
Developing Countries
Emergencies
emergencies
emergency
health facilities
health services
HIV
HIV Infections
Humans
implement
implementation
Malaria
malaria
policies
Public Health
public health emergency
qualitative
qualitative reviews
service availability
systematic reviews
Tuberculosis
tuberculosis

Semantics

Type Source Name
disease MESH AIDS
disease MESH Tuberculosis
pathway KEGG Tuberculosis
disease MESH Malaria
pathway KEGG Malaria
disease MESH Emergencies
disease MESH access to care
disease MESH measles
pathway KEGG Measles
disease IDO facility
disease IDO quality
disease IDO country
disease MESH morbidity
disease MESH COVID 19 pandemic
disease MESH complications
disease MESH influenza
disease MESH poliomyelitis
disease MESH monkeypox
disease IDO process
disease IDO intervention
disease MESH viral load
disease MESH noncommunicable diseases
disease MESH hypertension
disease MESH virus infection
drug DRUGBANK Pentaerythritol tetranitrate
drug DRUGBANK Methacholine
pathway REACTOME Reproduction
disease MESH HIV Infections

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