SynthesisInternational journal of epidemiology2017
Spillover effects on health outcomes in low- and middle-income countries: a systematic review.
Synthesis in International journal of epidemiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 39 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
39 citing papers in PubMed, 77 citations in OpenAlex.
- Spillover of Azithromycin Mass Drug Administration and Child Survival: A Secondary Analysis of a Cluster-Randomized Clinical Trial.JAMA network open · 2025Trial
- Extension of efficacy range for targeted malaria-elimination interventions due to spillover effects.Nature medicine · 2024Trial
- Measuring effects of ivermectin-treated cattle on potential malaria vectors in Vietnam: A cluster-randomized trial.PLoS neglected tropical diseases · 2024Trial
- Effect of Mass Azithromycin Distributions on Childhood Growth in Niger: A Cluster-Randomized Trial.JAMA network open · 2021Trial
- Effect of a maternal counselling intervention delivered by community health workers on child nutrition: secondary analysis of a cluster randomised controlled trial in India.BMC public health · 2021Trial
- Targeted Antibiotics for Trachoma: A Cluster-Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Trial
- Community-level spillover effects of an intervention to prevent intimate partner violence and HIV transmission in rural Ethiopia.BMJ global health · 2021Trial
- Trial
- Cause-specific mortality of children younger than 5 years in communities receiving biannual mass azithromycin treatment in Niger: verbal autopsy results from a cluster-randomised controlled trial.The Lancet. Global health · 2020Trial
- Biannual mass azithromycin distributions and malaria parasitemia in pre-school children in Niger: A cluster-randomized, placebo-controlled trial.PLoS medicine · 2019Trial
- Linear growth in preschool children treated with mass azithromycin distributions for trachoma: A cluster-randomized trial.PLoS neglected tropical diseases · 2019Trial
- A Randomized Controlled Trial to Measure Spillover Effects of a Combined Water, Sanitation, and Handwashing Intervention in Rural Bangladesh.American journal of epidemiology · 2018Trial
- A National Collaborative Project to Decrease Healthcare-Associated Infections in Intensive Care Units: Results from Stop Hospital Infection, in Portugal.Antibiotics (Basel, Switzerland) · 2026Article
- Institutional spillover effects of antimicrobial use on antimicrobial resistance andAntimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Measuring and valuing spillover effects in caregivers and families: A scoping review.PloS one · 2026Article
- 'You don't need schooling-just take the pills and don't stop.': Pathways between formal education and chronic HIV care in Malawi.SSM. Qualitative research in health · 2025Article
- Individualizing social determinants of health: is educational attainment a community resource?European journal of epidemiology · 2025Article
- Whose burden, whose benefit? Revisiting ethical trade-offs in the WHO guidelines on scaling up mass azithromycin administration.PLoS medicine · 2025Article
- Reconsidering indoor residual spraying coverage targets: A retrospective analysis of high-resolution programmatic malaria control data.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- Cost-effectiveness of community-based type 2 diabetes prevention and control in Indonesia: a health economics modelling study.BMJ public health · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
Abstract
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.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.