Trainings for Infectious Disease Outbreaks and Other Emergencies in Low and Middle Income Country Trainings for Infectious Disease Outbreaks and Other Emergencies in Low and Middle Income Country Settings: a Systematic Literature Review

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Original Article

Executive Summary

Background As part of the Global Health Security Agenda, the U.S. Centers for Disease Control and Prevention awarded a grant to the Center for Humanitarian Health at the Johns Hopkins Bloomberg School of Public Health to, among other things, conduct a systematic review of literature on trainings on infectious disease outbreak (and other emergencies) response, including implementation, evaluation, curriculum and recommendations.

Methods The literature review searched three databases—Scopus, EmBase, and PubMed—using four “concepts” (each concept combining controlled vocabulary and key words): “rapid response”, “preparedness”, “training” and “infectious disease.” The publication date range was from January 1, 2000 to February 1, 2018. Articles included peer-reviewed journals and gray literature sources focusing on training implementation, training evaluation, training curriculum, and training recommendations. A total of 10,555 articles were included for title and abstract review; 225 articles were selected for fulltext review, and 160 articles were selected for full-text data extraction and analysis.

Results Most of the 160 publications came from and/or were focused on high-income or upper-middle income countries. These articles differed in significant respects—in training content, format, and evaluation methodologies to name only a few—from the much smaller number of publications that focused on lower-middle and low-income countries. While infectious diseases with pandemic potential threaten all countries, our review found that high income and upper-middle income countries tended to focus training efforts more on complex emergencies, bioterrorism, and mass casualty incidents than on infectious disease outbreaks. In lower-middle and low income countries, on the other hand, infectious disease was the predominant focus of training implementation. As content focus differed, so too did training formats and methods, with more extensive and complex simulations and interactive exercises being used in locations with more resources.


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