Neglected tropical diseases in conflict-related humanitarian emergency settings: a systematic review of the literature
Clinical Snapshot
PICO Framework
| P — Population | Populations affected by neglected tropical diseases in conflict-related humanitarian emergency settings |
| I — Intervention | NTD control, elimination, or eradication programmes and interventions |
| C — Comparator | Not applicable (descriptive systematic review) |
| O — Outcomes | Programme challenges, implementation strategies, evidence gaps, and effectiveness of NTD interventions in conflict settings |
Bottom Line
This systematic review identifies critical barriers to neglected tropical disease control in conflict settings, including healthcare access limitations, infrastructure damage, population displacement, and poor data quality. With only 26 studies included, the evidence base appears limited, highlighting significant research gaps in this important area. The authors recommend multisectoral collaboration, community engagement, and decentralised approaches as key strategies. While the findings provide valuable insights for humanitarian health programming, the small evidence base and lack of quantitative synthesis limit the strength of recommendations. The review underscores the urgent need for more robust research in conflict-affected populations to achieve WHO's 2030 NTD elimination targets. For Australian practitioners involved in humanitarian health responses, this review emphasises the importance of collaborative, community-centred approaches when implementing NTD interventions in complex emergency settings.
Key Findings
Effect Size: Not applicable - qualitative synthesis
Primary Outcome: Common challenges for NTD programmes in conflict settings: healthcare access, infrastructure, population movement, and data quality
Nnt Or Sensitivity: Not applicable - descriptive review identifying barriers and facilitators
Confidence Interval: Not provided
Clinical Application
Recommendations for multisectoral collaboration and community participation appear feasible but require coordinated implementation Relevant for Australian humanitarian aid programmes, DFAT health initiatives, and Australian medical teams deployed in conflict zones. Aligns with Australia's commitment to global health security and NTD elimination goals Healthcare workers, public health practitioners, and humanitarian organisations working in conflict-affected regions
Abstract
Neglected tropical diseases (NTDs) are a group of 21 conditions affecting an estimated 1 billion people worldwide, causing significant mortality and morbidity. WHO has targeted their control, elimination or eradication by 2030, while highlighting that conflict and humanitarian emergencies are risks to achieving this. A systematic review of peer-reviewed literature was undertaken, using terms related to conflict-related humanitarian emergencies (CRHE), based on the Armed Conflict Location & Event Data Project codebook terms for defining emergencies and terms including all WHO-defined NTDs. After a two-stage screening process, 26 papers were included. Common challenges for NTD programmes in CRHE were healthcare access, infrastructure, population movement and data quality. Multisectoral collaboration between actors in conflict-settings was offered as a learning for NTD programmes, along with community participation and decentralisation. Evidence gaps were identified in the knowledge base for certain NTDs and in high-quality evidence for interventions in CRHE. Collaboration is a key area for focused improvement for NTD programmes in CRHE. This should be across sectors and extend to research and analysis approaches, to ensure the most effective interventions are identified and implemented and that NTD road map targets can be achieved.
References
- 1.Bestwick, C., Badia-Rius, X., Lopes, S., Kelly-Hope, L. A., & Harding-Esch, E. M. (2026). Neglected tropical diseases in conflict-related humanitarian emergency settings: a systematic review of the literature. International Health. https://doi.org/10.1093/inthealth/ihaf148
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