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Dermatological Diseases and Infestations · Journal article
Infectious Microbes & Diseases · August 5, 2026
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This systematic review synthesizes evidence on infectious disease epidemiology and antimicrobial resistance patterns among displaced populations across 61 heterogeneous studies from 2015–2026. The review documents markedly elevated AMR prevalence in conflict-affected settings (MRSA to 94.4%, ESBL-producing Enterobacterales >80%, carbapenem-resistant A. baumannii >70%), transborder organism dissemination, and migration-linked neglected tropical disease clusters, but lacks meta-analytic pooling and quantified risk estimates; findings are descriptive rather than comparative.
Systematic review with narrative synthesis. Studies reporting infectious disease epidemiology or antimicrobial susceptibility data in refugees, asylum seekers, and internally displaced persons during humanitarian emergencies.. Compared with: Comparisons made between conflict-affected and non-conflict countries for surveillance site density; baseline resistance levels referenced but not quantified in source.. 28 countries; specific regions mentioned include Turkey (Syrian refugees), Ukraine, Syria, Balkan route, Europe..
MRSA rates as high as 94.4% in conflict zones, markedly higher than baseline resistance levels Extended-spectrum beta-lactamase–producing and multidrug-resistant Enterobacterales prevalence over 80% in displaced populations Carbapenem-resistant Acinetobacter baumannii rates exceeding 70% in conflict-affected regions
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Clinicians and public health professionals should be alert to markedly elevated AMR prevalence in displaced populations and migration-linked disease clusters (leishmaniasis, diphtheria, scabies), and advocate for standardized screening protocols and expanded surveillance capacity in conflict-affected regions. The substantial underestimation of true resistance burden due to surveillance gaps in conflict zones suggests current data likely understate clinical risk.
Systematic review with narrative synthesis across 61 heterogeneous studies showing severe AMR prevalence in displaced populations, but without meta-analysis, pooled estimates, or quantified comparative risk—descriptive findings that document patterns rather than test hypotheses with rigorous synthesis.
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Clinicians and public health professionals should be alert to markedly elevated AMR prevalence in displaced populations and migration-linked disease clusters (leishmaniasis, diphtheria, scabies), and advocate for standardized screening protocols and expanded surveillance capacity in conflict-affected regions. The substantial underestimation of true resistance burden due to surveillance gaps in conflict zones suggests current data likely understate clinical risk.
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Humanitarian emergencies and forced displacement create conditions that accelerate infectious disease transmission and antimicrobial resistance (AMR). This systematic review synthesizes evidence on infectious disease epidemiology and AMR patterns among displaced populations. PubMed/MEDLINE and Scopus were searched for studies published from January 2015 through March 2026 reporting laboratory-confirmed infections or antimicrobial susceptibility data among refugees, asylum seekers and internally displaced persons. A total of 61 studies from 28 countries were included and narrative synthesis was performed due to substantial heterogeneity. The AMR burden in conflict zones was severe, with rates of methicillin-resistant Staphylococcus aureus (as high as 94.4%), extended-spectrum beta-lactamase–producing and multidrug-resistant Enterobacterales (over 80%) and carbapenem-resistant Acinetobacter baumannii (exceeding 70%) markedly higher than baseline resistance levels. Transborder dissemination of highly drug-resistant organisms via medical evacuations from Ukraine and Syrian refugee movements was documented, and clones that simultaneously carry multidrug-resistance and virulence factors are prevalent. Neglected tropical diseases followed migration routes: Syrian refugees accounted for 93.8% of cutaneous leishmaniasis cases in Turkish border provinces and the 2022 European diphtheria outbreak was linked to migration via the Balkan route. Scabies was among the most frequently reported skin conditions in displacement settings. Critically, conflict-affected countries had significantly fewer AMR surveillance sites than non-conflict countries (0.16 vs. 0.76 per million population; P <0.001), suggesting substantial underestimation of the true resistance burden. These findings support the urgent need for standardized screening protocols, the integration of neglected tropical disease screening into primary care, and investment in surveillance capacity in conflict-affected regions.
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