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Vulnerability assessment tools for infectious threats and antimicrobial resistance: a scoping review protocol
  1. Maren Jeleff1,
  2. Lisa Lehner1,
  3. Tamara Giles-Vernick2,
  4. Michel L.A. Dückers3,
  5. A. David Napier4,
  6. Elena Jirovsky1,
  7. Ruth Kutalek1
  1. 1Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
  2. 2Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
  3. 3NIVEL, Netherlands Institute for Health Services Research, Utrecht, Netherlands
  4. 4Department of Anthropology, Centre for Applied Global Citizenship, University College London, London, UK
  1. Correspondence to Ms Maren Jeleff; maren.jeleff-entscheff{at}


Introduction This protocol will guide and explain the working process of a systematic scoping review on vulnerability assessment tools in the field of infectious disease outbreaks and antimicrobial resistance (AMR) crises. The scoping review will appraise existing tools or methodologies to identify local level vulnerabilities in the context of infectious disease outbreaks and AMR. Due to this focus on infectious threats and AMR, the review also considers articles using a ‘One Health’ approach to assess the vulnerability of individuals, groups and practices in human–animal–environment interactions. Given the broad nature of vulnerability, we aim to allocate studies discerning the process of identifying vulnerable or at-risk groups during a crisis, instead of studies taking vulnerability only as a starting point. Because considerable research has been conducted on vulnerability, disasters and climate change, we will also assemble tools developed from these fields. To our knowledge, this is the first planned systematic scoping review of vulnerability assessment tools for disease outbreaks and AMR, taking into account practices at the human–animal–environment interface that can lead to increased risk of exposure of individuals to infections, pathogen spillovers or epidemics.

Methods and analysis To develop the protocol, we used the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist (PRISMA-P 2015) in compliance with the PRISMA Extension for Scoping Reviews Explanation and Elaboration. With the assistance of an experienced research librarian, we developed the search strategy, which targeted the following databases: Medline, Global Health database, Web of Science and Embase. A second strategy was developed for Epistemonikos, African Journals Online and Global Index Medicus because these databases do not provide the infrastructure for an advanced search. We consider studies published between 1978 and 2019 and include articles, book chapters, websites and grey literature from selected non-governmental organisations and non-profit organisations working in the health field. We contact them directly regarding whether they are working with or have developed a vulnerability assessment tool. To address the dynamic nature of our investigation, we develop a flow diagram which we continually update to reflect the selection process. Two reviewers (MJ and LL) independently screen the literature and resolve conflicts through discussion rounds. Data extraction will be conducted by four researchers (MJ, LL, EJ and RK) through inductive and deductive coding. Extracted data will be systematically compared and divergences highlighted.

Ethics and dissemination Ethical approval is not required because this study does not involve collection of primary data. The purpose of this review is to disseminate a catalogue of vulnerability assessment tools and a brief summary of key results and recommendations for SoNAR-Global partners in Bangladesh, Ukraine and Uganda. The catalogue will be made publicly available. On the basis of our results, SoNAR-Global partners will pilot one of these tools.

  • Vulnerable groups
  • vulnerability assessment
  • infectious disease outbreaks
  • one health
  • medical anthropology

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors MJ and RK conceptualised the research, MJ wrote the protocol, LL helped in writing and editing the protocol, TG-V, MLAD, ADN, EJ and RK reviewed and edited the protocol.

  • Funding The scoping review is part of the SoNAR-Global project which has received funding from the European Union’s Horizon 2020 research and innovation program (Grant Agreement Number: 825671). The funders did not play a role in decision to publish or developing the protocol.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.