Health inequalities in infectious diseases: a systematic overview of reviews

Objectives The aim of this systematic overview of reviews was to synthesise available evidence on inequalities in infectious disease based on three dimensions of inequalities; inclusion health groups, protected characteristics and socioeconomic inequalities.Methods We searched MEDLINE, Embase, Web o...

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Main Authors: Ben Barr, Oyinlola Oyebode, Seun Stephen Anjorin, Noel McCarthy, Iman Ghosh, Abimbola Ayorinde, Iram Zahair, Ifra Ali, Olajumoke Olarewaju, Megha Singh, Edward Meehan, Suzanne Rotheram
Format: Article
Language:English
Published: BMJ Publishing Group 2023-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/4/e067429.full
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author Ben Barr
Oyinlola Oyebode
Seun Stephen Anjorin
Noel McCarthy
Iman Ghosh
Abimbola Ayorinde
Iram Zahair
Ifra Ali
Olajumoke Olarewaju
Megha Singh
Edward Meehan
Suzanne Rotheram
author_facet Ben Barr
Oyinlola Oyebode
Seun Stephen Anjorin
Noel McCarthy
Iman Ghosh
Abimbola Ayorinde
Iram Zahair
Ifra Ali
Olajumoke Olarewaju
Megha Singh
Edward Meehan
Suzanne Rotheram
author_sort Ben Barr
collection DOAJ
description Objectives The aim of this systematic overview of reviews was to synthesise available evidence on inequalities in infectious disease based on three dimensions of inequalities; inclusion health groups, protected characteristics and socioeconomic inequalities.Methods We searched MEDLINE, Embase, Web of Science and OpenGrey databases in November 2021. We included reviews published from the year 2000 which examined inequalities in the incidence, prevalence or consequences of infectious diseases based on the dimensions of interest. Our search focused on tuberculosis, HIV, sexually transmitted infections, hepatitis C, vaccination and antimicrobial resistance. However, we also included eligible reviews of any other infectious diseases. We appraised the quality of reviews using the Assessment of Multiple Systematic Reviews V.2 (AMSTAR2) checklist. We conducted a narrative data synthesis.Results We included 108 reviews in our synthesis covering all the dimensions of inequalities for most of the infectious disease topics of interest, however the quality and volume of review evidence and consistency of their findings varied. The existing literature reviews provide strong evidence that people in inclusion health groups and lower socioeconomic status are consistently at higher risk of infectious diseases, antimicrobial resistance and incomplete/delayed vaccination. In the protected characteristics dimension, ethnicity, and sexual orientation are important factors contributing to inequalities across the various infectious disease topics included in this overview of reviews.Conclusion We identified many reviews that provide evidence of various types of health inequalities in different infectious diseases, vaccination, and antimicrobial resistance. We also highlight areas where reviews may be lacking. The commonalities in the associations and their directions suggest it might be worth targeting interventions for some high risk-groups that may have benefits across multiple infectious disease outcomes rather than operating purely in infectious disease siloes.
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spelling doaj-art-3aef348d45fc485782e33acea35ad2242025-08-20T02:49:47ZengBMJ Publishing GroupBMJ Open2044-60552023-04-0113410.1136/bmjopen-2022-067429Health inequalities in infectious diseases: a systematic overview of reviewsBen Barr0Oyinlola Oyebode1Seun Stephen Anjorin2Noel McCarthy3Iman Ghosh4Abimbola Ayorinde5Iram Zahair6Ifra Ali7Olajumoke Olarewaju8Megha Singh9Edward Meehan10Suzanne Rotheram11Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UKWolfson Institute of Population Health, Queen Mary University of London, London, London, UKWarwick Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, University of Warwick, Coventry, West Midlands, UKPopulation Health Medicine, Public Health & Primary Care, Trinity College Dublin, Dublin, IrelandWarwick Medical School, University of Warwick, Coventry, UKWarwick Medical School, University of Warwick, Coventry, UKInstitute of Population Health, University of Liverpool, Liverpool, UKDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UKDepartment of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USAInstitute of Applied Health Research, University of Birmingham, Birmingham, UKSchool of Public Health and Prevention Medicine, Monash University, Clayton, Victoria, AustraliaInstitute of Population Health, University of Liverpool, Liverpool, UKObjectives The aim of this systematic overview of reviews was to synthesise available evidence on inequalities in infectious disease based on three dimensions of inequalities; inclusion health groups, protected characteristics and socioeconomic inequalities.Methods We searched MEDLINE, Embase, Web of Science and OpenGrey databases in November 2021. We included reviews published from the year 2000 which examined inequalities in the incidence, prevalence or consequences of infectious diseases based on the dimensions of interest. Our search focused on tuberculosis, HIV, sexually transmitted infections, hepatitis C, vaccination and antimicrobial resistance. However, we also included eligible reviews of any other infectious diseases. We appraised the quality of reviews using the Assessment of Multiple Systematic Reviews V.2 (AMSTAR2) checklist. We conducted a narrative data synthesis.Results We included 108 reviews in our synthesis covering all the dimensions of inequalities for most of the infectious disease topics of interest, however the quality and volume of review evidence and consistency of their findings varied. The existing literature reviews provide strong evidence that people in inclusion health groups and lower socioeconomic status are consistently at higher risk of infectious diseases, antimicrobial resistance and incomplete/delayed vaccination. In the protected characteristics dimension, ethnicity, and sexual orientation are important factors contributing to inequalities across the various infectious disease topics included in this overview of reviews.Conclusion We identified many reviews that provide evidence of various types of health inequalities in different infectious diseases, vaccination, and antimicrobial resistance. We also highlight areas where reviews may be lacking. The commonalities in the associations and their directions suggest it might be worth targeting interventions for some high risk-groups that may have benefits across multiple infectious disease outcomes rather than operating purely in infectious disease siloes.https://bmjopen.bmj.com/content/13/4/e067429.full
spellingShingle Ben Barr
Oyinlola Oyebode
Seun Stephen Anjorin
Noel McCarthy
Iman Ghosh
Abimbola Ayorinde
Iram Zahair
Ifra Ali
Olajumoke Olarewaju
Megha Singh
Edward Meehan
Suzanne Rotheram
Health inequalities in infectious diseases: a systematic overview of reviews
BMJ Open
title Health inequalities in infectious diseases: a systematic overview of reviews
title_full Health inequalities in infectious diseases: a systematic overview of reviews
title_fullStr Health inequalities in infectious diseases: a systematic overview of reviews
title_full_unstemmed Health inequalities in infectious diseases: a systematic overview of reviews
title_short Health inequalities in infectious diseases: a systematic overview of reviews
title_sort health inequalities in infectious diseases a systematic overview of reviews
url https://bmjopen.bmj.com/content/13/4/e067429.full
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