Spillover effects on health outcomes in low- and middle-income countries: a systematic review.


Background:Many interventions delivered to improve health may benefit not only direct recipients but also people in close physical or social proximity. Our objective was to review all published literature about the spillover effects of interventions on health outcomes in low-middle income countries and to identify methods used in estimating these effects. Methods:We searched 19 electronic databases for articles published before 2014 and hand-searched titles from 2010 to 2013 in five relevant journals. We adapted the Cochrane Collaboration's quality grading tool for spillover estimation and rated the quality of evidence. Results:A total of 54 studies met inclusion criteria. We found a wide range of terminology used to describe spillovers, a lack of standardization among spillover methods and poor reporting of spillovers in many studies. We identified three primary mechanisms of spillovers: reduced disease transmission, social proximity and substitution of resources within households. We found the strongest evidence for spillovers through reduced disease transmission, particularly vaccines and mass drug administration. In general, the proportion of a population receiving an intervention was associated with improved health. Most studies were of moderate or low quality. We found evidence of publication bias for certain spillover estimates but not for total or direct effects. To facilitate improved reporting and standardization in future studies, we developed a reporting checklist adapted from the CONSORT framework specific to reporting spillover effects. Conclusions:We found the strongest evidence for spillovers from vaccines and mass drug administration to control infectious disease. There was little high quality evidence of spillovers for other interventions.


Int J Epidemiol


Benjamin-Chung J,Abedin J,Berger D,Clark A,Jimenez V,Konagaya E,Tran D,Arnold BF,Hubbard AE,Luby SP,Miguel E,Colford JM Jr




Has Abstract


2017-08-01 00:00:00














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    journal_title:International journal of epidemiology

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    authors: Trinquart L,Johns DM,Galea S

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  • Lessons from a decade of suicide surveillance in India: who, why and how?

    abstract:Background:This paper investigates trends in suicide rate, the reasons for and means of suicide and the occupation of deceased, to prioritize suicide prevention activities in India and to highlight the limitations to data quality for surveillance. Methods:Data available in the public domain from the National Crimes Re...

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    authors: Gauffin K,Vinnerljung B,Hjern A

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    authors: de Vogel S,Meyer K,Fredriksen Å,Ulvik A,Ueland PM,Nygård O,Vollset SE,Tell GS,Tretli S,Bjørge T

    更新日期:2013-02-01 00:00:00

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    abstract:BACKGROUND:Previous studies have shown socioeconomic inequalities in the metabolic syndrome and coronary heart disease (CHD), but it is not known whether educational disparities in the metabolic syndrome explain educational inequalities in CHD. We investigated this question in a prospective study of middle-aged men and...

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    authors: Silventoinen K,Pankow J,Jousilahti P,Hu G,Tuomilehto J

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    pub_type: 杂志文章


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    更新日期:2001-08-01 00:00:00

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    pub_type: 杂志文章


    authors: Luoto R,Auvinen A,Pukkala E,Hakama M

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    pub_type: 杂志文章


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