Zoonotic Diseases in Refugee or Internally Displaced Person Camps: A Scoping Review Open Access

Abstract

Introduction: Emerging and re-emerging zoonotic diseases pose an increasing threat to public health and global health security. 61% of infectious and 75% of emerging diseases affecting humans are zoonotic in nature. With over 63 million people around the world today either forcibly displaced or refugees, the number of refugee or displaced person camps continues to grow. Population movement of humans and livestock, increased habitat overlap with wildlife, poor sanitation and hygiene conditions, and low vaccination rates in camp or conflict settings are known risk factors for communicable and likely zoonotic disease transmission. We conducted a scoping review to describe the extent and importance of zoonotic diseases in camp-like settings. Methods: We conducted a comprehensive literature search in 5 databases for articles that mentioned a case or suspected case of zoonotic disease specifically in displaced populations or people in camp or conflict settings. Articles were screened for relevance and key characteristics were extracted if included. We excluded mosquito-borne disease articles. Results: The literature search yielded 579 articles. Of the 70 articles that met inclusion criteria, 57% highlighted parasitic zoonoses, 34% highlighted bacterial zoonoses, 29% highlighted viral zoonoses, and 4% highlighted zoonotic injury. 27 different zoonoses and 1 condition were reported within these articles. 15 articles excluded, for not reporting any human zoonoses cases, identified either zoonoses positive animals or non-mosquito vectors in camp settings. Discussion: Zoonoses are present within camps and conflict settings. Given that 18% of zoonoses identified are notifiable under the International Health Regulations and 28.5% are considered bioterrorism agents, the nature and associated risk of the zoonoses seen within camp settings is significant and may be further intensified in these vulnerable populations and camp conditions. Further review of the current guidance documents revealed gaps for how to adequately address zoonotic disease risk in camp-like settings. Management of zoonoses within camps requires an interdisciplinary One Health approach to help mitigate and control zoonoses within camp settings.

Table of Contents

Chapter 1. Introduction 1 Chapter 2: Comprehensive Review of the Literature 5 Chapter 3. Manuscript 13 Title Page 13 Abstract 14 Keywords 14 Background 15 Main Text 17 Review Methodology 17 Results 19 Discussion 27 Future Recommendations 31 Conclusions 34 Figures 36 Declarations 37 Ethics approval and consent to participate 37 Consent for publication 37 Availability of data and material 37 Competing Interests 37 Funding 37 Author's Contributions 37 Acknowledgements 37 Author's Information 38 Chapter 4. Recommendations and Conclusions 39 References 44

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Agriculture, Animal Pathology
Keyword	Camp Zoonotic Disease Refugee Refugee Camp Internally Displaced Person Conflict IDP Zoonoses
Committee Chair / Thesis Advisor	Salyer, Stephanie, Centers for Disease Control and Prevention
Committee Members	Barton-Behravesh, Casey, Centers for Disease Control and Prevention Navarro Colorado, Carlos , Emory University
Partnering Agencies	CDC

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