Vector-borne diseases and the Syrian conflict: A systematic review of literature from Syria and neighbouring, refugee-hosting countries.

Abstract

<h4>Objectives</h4>Syria's conflict has forced more than half its populations from their homes, decimated its health system and water and sanitation infrastructure, leading to an increase in communicable diseases, particularly vector-borne diseases (VBDs.) This systematic review explores the epidemiological burden and geographical distribution of VBDs in Syria and neighbouring, refugee-hosting countries following the onset of the Syrian uprisings.<h4>Methods</h4>Four databases were searched using appropriate MeSH terms. Included studies reported on data collected between March 2011 and May 2024 on VBD-affected populations in Syria, Turkey, Jordan, Lebanon or Iraq. Data were extracted, study quality assessed, and findings synthesized in narrative form.<h4>Results</h4>33 studies were included; all but one reported on leishmaniasis, the exception reported on malaria. 16 were from Turkey, nine from Lebanon, five from Syria and three from Jordan. Data showed an increase over time in the numbers of reported leishmaniasis cases and geographical spread as well as barriers to healthcare access for Syrian refugees.<h4>Conclusions</h4>In this systematic review, Leishmania was the primary VBD described in this context. Studies from country-specific health ministries mostly reported data whereas smaller studies added more granular information including around healthcare access. Additional studies are needed to identify vector reservoir populations and to investigate the burden of other VBDs in this region.