Institutional Review Board Preparedness for Disaster Research: a Practical Approach

A scoping review of ethics review processes during public health emergencies in Africa

BACKGROUND

The COVID-19 pandemic forced governments, multilateral public health organisations and research institutions to undertake research quickly to inform their responses to the pandemic. Most COVID-19-related studies required swift approval, creating ethical and practical challenges for regulatory authorities and researchers. In this paper, we examine the landscape of ethics review processes in Africa during public health emergencies (PHEs).

METHODS

We searched four electronic databases (Web of Science, PUBMED, MEDLINE Complete, and CINAHL) to identify articles describing ethics review processes during public health emergencies and/or pandemics. We selected and reviewed those articles that were focused on Africa. We charted the data from the retrieved articles including the authors and year of publication, title, country and disease(s) reference, broad areas of (ethical) consideration, paper type, and approach.

RESULTS

Of an initial 4536 records retrieved, we screened the titles and abstracts of 1491 articles, and identified 72 articles for full review. Nine articles were selected for inclusion. Of these nine articles, five referenced West African countries including Liberia, Guinea and Sierra Leone, and experiences linked to the Ebola virus disease. Two articles focused on South Africa and Kenya, while the other two articles discussed more general experiences and pitfalls of ethics review during PHEs in Africa more broadly. We found no articles published on ethics review processes in Africa before the 2014 Ebola outbreak, and only a few before the COVID-19 outbreak. Although guidelines on protocol review and approval processes for PHEs were more frequently discussed after the 2014 Ebola outbreak, these did not focus on Africa specifically.

CONCLUSIONS

There is a gap in the literature about ethics review processes and preparedness within Africa during PHEs. This paper underscores the importance of these processes to inform practices that facilitate timely, context-relevant research that adequately recognises and reinforces human dignity within the quest to advance scientific knowledge about diseases. This is important to improve fast responses to PHEs, reduce mortality and morbidity, and enhance the quality of care before, during, and after pandemics.

Impact of natural disasters on student enrollment in higher education programs: A systematic review

This study aims to evaluate how natural disasters affect student enrollment in higher education programs, considering both immediate and long-term consequences. The PRISMA guidelines were adhered to in conducting this review. Multiple databases, such as Web of Science and Scopus, including those with articles from January 2000 to February 2023, were thoroughly searched. Articles focusing on how natural disasters affect students' enrollment in higher education programs met the inclusion requirements. A total of 22 studies were deemed eligible for inclusion and detailed analysis. The findings suggest that natural disasters have a negative influence on higher education enrollment, with the most severe effects being felt by disadvantaged populations. This study reveals that natural disasters impact various aspects of the enrollment process, such as application, acceptance, registration, attendance, retention, and graduation, in higher education due to infrastructural and psychological impacts. Key variables linking natural disasters to enrollment changes include damage to institutional infrastructure, economic and psychological strain, resource limitations, loss of social support networks, and disruptions to academic programs. Enhancing resilience involves adopting online learning, providing financial support, flexible enrollment policies, mental health services, disaster preparedness training, resilient infrastructure development, and collaborative institutional programs. The study highlights the need for comprehensive, context-specific disaster management strategies that address both immediate and long-term educational needs. It identifies potential solutions, including online learning platforms, financial aid, flexible enrollment policies, mental health support, disaster preparedness training, infrastructure resilience, and collaborative programs with other institutions. Context-specific programs are essential to support impacted students by rebuilding educational infrastructure and providing financial and emotional support, thereby ensuring their continued access to higher education. This study offers valuable insights for disaster management, educational policy, and future research on this critical issue.

Considering Risks to Researchers and Staff in Low-Resource Settings during Public Health Crises: A Proposed Conceptual Model

Human subjects research protections have historically focused on mitigating risk of harm and promoting benefits for research participants. In many low-resource settings (LRS), complex and often severe challenges in daily living, poverty, geopolitical uprisings, sociopolitical, economic, and climate crises increase the burdens of even minimal risk research. While there has been important work to explore the scope of ethical responsibilities of researchers and research teams to respond to these wider challenges and hidden burdens in global health research, less attention has been given to the ethical dilemmas and risk experienced by frontline researcher staff as they perform research-related activities in LRS. Risks such as job insecurity, moral distress, infection, or physical harm can be exacerbated during public health crises, as recently highlighted by the COVID-19 pandemic. We highlight the layers of risk research staff face in LRS and present a conceptual model to characterize drivers of this risk, with particular attention to public health crises. A framework by which funders, institutions, principal investigators, and/or research team leaders can systematically consider these additional layers of risk to researchers and frontline staff is an important and needed addition to routine research proposals and protocol review.

Returning Individual Tap Water Testing Results to Research Study Participants after a Wildfire Disaster

After the devastating wildfire that destroyed most of the town of Paradise, California in 2018, volatile organic compounds were found in water distribution pipes. Approximately 11 months after the fire, we collected tap water samples from 136 homes that were still standing and tested for over 100 chemicals. Each participant received a customized report showing the laboratory findings from their sample. Our goal was to communicate individual water results and chemical information rapidly in a way that was understandable, scientifically accurate, and useful to participants. On the basis of this process, we developed a framework to illustrate considerations and priorities that draw from best practices of previous environmental results return research and crisis communication, while also addressing challenges specific to the disaster context. We also conducted a follow-up survey on participants’ perceptions of the results return process. In general, participants found the results return communications to be understandable, and they felt less worried about their drinking water quality after receiving the information. Over one-third of the participants reported taking some kind of action around their water usage habits after receiving their results. Communication with participants is a critical element of environmental disaster research, and it is important to have a strategy to communicate results that achieves the goals of timeliness, clarity, and scientific accuracy, ultimately empowering people toward actions that can reduce exposure.