The objective of this review is to identify sanitation failures that have contributed to the occurrence of diarrhoeal disease outbreaks among displaced populations living in camps. Three electronic databases (Medline, Embase, Global Health) and reference lists were searched for peer-reviewed literature using a systematic approach. Articles published since 1960 describing both diarrhoeal disease outbreaks and sanitation characteristics in camps hosting displaced populations were included. Evidence linking outbreaks to sanitation-related factors was synthesized and critically appraised. The search yielded 608 articles, of which 12 met inclusion criteria. They described cholera and shigellosis outbreaks occurring in 21 different camps between 1974 and 2009. Recurring contributing factors across outbreaks included a sudden population influx, inadequate provision or maintenance of latrines, sudden rains, and insufficient safe water quantities. Most studies were descriptive only or did not consider sanitation-related exposures in risk factor analyses. However, two case-control studies found that cases were significantly more likely than controls to share latrines with several households. Two other case-control studies identified an increased risk of infection from exposure to drinking contaminated river or shallow well water. Evidence from previous outbreak investigations illustrates how sanitation failures, particularly following population influxes, can contribute to the occurrence of diarrhoeal disease outbreaks in refugee camps. Further development and application of sanitation assessment tools and metrics would enable more robust evaluation of risks associated with specific sanitation-related exposures and the effectiveness of interventions. Recent guidelines address the identified risk factors but stakeholders should be aware of the impact of population dynamics.

Bechen, R., Boutin, J.P., Combes, D., Coue, J.C., Desfontaine, M., Lamarque, D., Milleliri, J.M., Merouze, F., Niel, L., Regis, R., Rey, J.L., Signoret, J. and Soares, J.L. (1996) ‘Cholera in Goma, July 1994’, Revue d’Epidemiologie et de Sante Publique 44(4): 358–63.

Bill & Melinda Gates Foundation (2010) Water, Sanitation & Hygiene Fact Sheet [pdf] <https://docs.gatesfoundation.org/documents/water-sanitation-hygiene-fact-sheet-2010.pdf> [accessed 20 October 2016].

Blanchet, K., Ramesh, A., Frison, S., Warren, E., Hossain, M., Smith, J., Knight, A., Post, N., Lewis, C., Woodward, A., Dahab, M., Ruby, A., Sistenich, V., Pantuliano, S. and Roberts, B. (2017) ‘Evidence on public health interventions in humanitarian crises’, Lancet 390(10109): 2287–96 <http://dx.doi.org/10.1016/S0140-6736(16)30768-1>.

Bradley, M., Shakespeare, R., Ruwende, A., Woolhouse, M.E.J., Mason, E. and Munatsi, A. (1996) ‘Epidemiological features of epidemic cholera (El Tor) in Zimbabwe’, Transactions of the Royal Society of Tropical Medicine and Hygiene 90(4): 378–82.

Brown, J., Jeandron, A., Cavill, S. and Cumming, O. (2012) Evidence Review and Research Priorities: Water, Sanitation, and Hygiene for Emergency Response, London: DFID.

Bruckner, C. and Checchi, F. (2011) ‘Detection of infectious disease outbreaks in twenty-two fragile states, 2000-2010: a systematic review.’, Conflict and Health 5(1): 13 <http://dx.doi.org/10.1186/1752-1505-5-13>.

Cairncross, S. and Valdmanis, V. (2006) ‘Water supply, sanitation and hygiene promotion’, in D.T. Jamison, J.G. Breman, A.R. Measham, G. Alleyne, M. Claeson, D.B. Evans, P. Jha, A. Mills, and P. Musgrove (eds), Disease Control Priorities in Developing Countries, pp. 771–92, Washington, DC: World Bank.

Campbell, F. and Howard, N. (2012) ‘The humanitarian system’, in N. Howard, E. Sondorp, and A.M. ter Veen (eds), Conflict and Health, pp. 46–56, Maidenhead: Open University Press.

Carneiro, I. and Howard, N. (2011) Introduction to Epidemiology, 2nd edn. Maidenhead: Open University Press.

Centers for Disease Control and Prevention (2009) ‘Cholera outbreak: southern Sudan, 2007’, Morbidity and Mortality Weekly Report 58(13): 337–41 <http://dx.doi.org/mm5813a3 [pii]>.

Checchi, F., Gayer, M., Freeman Grais, R. and Mills, E.J. (2007) Public Health in Crisis-affected Populations: A Practical Guide for Decision-Makers, Network Paper 61, London: Humanitarian Practice Network.

Critical Appraisal Skills Programme (2017) CASP (Case Control Study Checklist) [online] <http://www.casp-uk.net/casp-tools-checklists> [accessed 2 April 2017].

Cronin, A.A., Shrestha, D., Cornier, N., Abdalla, F., Ezard, N. and Aramburu, C. (2008) ‘A review of water and sanitation provision in refugee camps in association with selected health and nutrition indicators: the need for integrated service provision’, Journal of Water and Health 6(1): 1–13 <http://dx.doi.org/10.2166/wh.2007.019>.

Cronin, A.A., Shrestha, D., Spiegel, P., Gore, F. and Hering, H. (2009) ‘Quantifying the burden of disease associated with inadequate provision of water and sanitation in selected sub-Saharan refugee camps’, Journal of Water and Health 7(4): 557–68 <http://dx.doi.org/10.2166/wh.2009.089>.

von Elm, E., Altman, D.G., Egger, M., Pocock, S.J. and Gøtzsche, P.C. (2007) ‘The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies’, PLoS ONE 4(10): e296 <https://doi.org/10.1371/journal.pmed.0040296>.

Esrey, S.A., Potash, J.B., Roberts, L. and Shiff, C. (1991) ‘Effects of improved water supply and sanitation on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and trachoma’, Bulletin of the World Health Organization 69(5): 609–21 <http://dx.doi.org/10.2147/IJWH.S77807>.

Goma Epidemiology Group (1995) ‘Public health impact of Rwandan refugee crisis: what happened in Goma, Zaire, in July, 1994?’ Lancet 345(8946): 339–44 <http://dx.doi.org/10.1016/S0140-6736%2895%2990338-0>.

Hershey, C.L., Doocy, S., Anderson, J., Haskew, C., Spiegel, P. and Moss, W.J. (2011) ‘Incidence and risk factors for Malaria, pneumonia and diarrhea in children under 5 in UNHCR refugee camps: a retrospective study’, Conflict and Health 5(24): 1–11 <http://dx.doi.org/10.1186/1752-1505-5-24>.

Iijima, Y., Oundo, J., Taga, K., Saidi, S. and Honda, T. (1995) ‘Simultaneous outbreak due to Vibrio cholerae and Shigella dysenteriae in Kenya’, The Lancet 345(8941): 69–70 <http://dx.doi.org/10.1016/S0140-6736(95)91197-9>.

Kernéis, S., Guerin, P.J., von Seidlein, L., Legros, D. and Grais, R.F. (2009) ‘A look back at an ongoing problem: Shigella dysenteriae type 1 epidemics in refugee settings in Central Africa (1993-1995)’, PLoS ONE 4(2): 1–6 <http://dx.doi.org/10.1371/journal.pone.0004494>.

Khan, M.U. and Shahidullah, M.D. (1982) ‘Role of water and sanitation in the incidence of cholera in refugee camps’, Transactions of the Royal Society of Tropical Medicine and Hygiene 76(3): 373–7 <http://dx.doi.org/10.1016/0035-9203(82)90194-8>.

Khan, M.U. and Munshi, M.H. (1983) ‘Clinical illnesses and causes of death in a Burmese refugee camp in Bangladesh’, International Journal of Epidemiology 12(4): 460–4 <http://dx.doi.org/10.1093/ije/12.4.460>.

Lam, E., McCarthy, A. and Brennan, M. (2015) ‘Vaccine-preventable diseases in humanitarian emergencies among refugee and internally-displaced populations’, Human Vaccines and Immunotherapeutics 11(11): 2627–36 <http://dx.doi.org/10.1080/21645515.2015.1096457>.

Mahamud, A., Ahmed, J., Nyoka, R., Auko, E., Kahi, V. and Ndirangu, J. (2012) ‘Epidemic cholera in Kakuma refugee camp, Kenya, the importance of sanitation and soap’, Journal of Infection in Developing Countries 6(3): 234–41.

Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G. and Grp, P. (2009) ‘Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement’, PLoS Medicine 6(7): e1000097 <http://dx.doi.org/10.1371/journal.pmed1000097>.

Moren, A., Stefanaggi, S., Antona, D., Bitar, D., Gastellu Etchegorry, M., Tchatchioka, M., Lungu, G., Etchegorry, M.G., Tchatchioka, M. and Lungu, G. (1991) ‘Practical field epidemiology to investigate a cholera outbreak in a Mozambican refugee camp in Malawi, 1988’, Journal of Tropical Medicine and Hygiene 94(1): 1–7.

Mulemba, F. and Nabeth, P. (1994) ‘Environmental sanitation for the control of cholera in Lisungwi Refugee Camp, Malawi’, Waterlines 12(4): 9–11 <http://dx.doi.org/10.3362/0262-8104.1994.016>.

Mulholland, K. (1985) ‘Cholera in Sudan: an account of an epidemic in a refugee camp in eastern Sudan, May-June 1985’, Disasters 9(4): 247–58.

Piarroux, R. and Faucher, B. (2012) ‘Cholera epidemics in 2010: respective roles of environment, strain changes, and human-driven dissemination’, Clinical Microbiology and Infection 18(3): 231–8 <http://dx.doi.org/10.1111/j.1469-0691.2012.03763.x>.

Piarroux, R., Barrais, R., Faucher, B., Haus, R., Piarroux, M., Gaudart, J., Magloire, R. and Raoult, D. (2011) ‘Understanding the cholera epidemic, Haiti’, Emerging Infectious Diseases 17(7): 1161–7 <http://dx.doi.org/10.3201/eid1707.110059>.

ProMED-mail (no date) <https://www.promedmail.org/> [accessed 30 November 2018].

Ramesh, A., Blanchet, K., Ensink, J.H.J. and Roberts, B. (2015) ‘Evidence on the effectiveness of water, sanitation and hygiene (WASH) interventions on health outcomes in humanitarian crises: a systematic review’, PLoS ONE 10(9): 1–20 <http://dx.doi.org/10.1371/journal.pone.0124688>.

Rebaudet, S., Sudre, B., Faucher, B. and Piarroux, R. (2013) ‘Environmental determinants of cholera outbreaks in inland africa: a systematic review of main transmission foci and propagation routes’, Journal of Infectious Diseases 208(Suppl. 1): S46–54 <http://dx.doi.org/10.1093/infdis/jit195>.

Reingold, A. (1998) ‘Outbreak investigations: a perspective’, Emerging Infectious Diseases 4(1): 21–7.

Sack, D.A., Sack, R.B., Nair, G.B. and Siddique, A. (2004) ‘Cholera’, The Lancet 363(9404): 223–33 <http://dx.doi.org/10.1016/S0140-6736(03)15328-7>.

Schuller, M. and Levey, T. (2014) ‘Kabrit ki gen twòp mèt: understanding gaps in WASH services in Haiti’s IDP camps’, Disasters 38(S1): S1–24 <http://dx.doi.org/10.1111/disa.12053>.

Seukap Pena, E., Bwire, G., Dzotsi, E., Bonnet, M.C. and Hessel, L. (2016) ‘New momentum in prevention, control and elimination of cholera in Africa: priority actions identified by affected countries’, The Weekly Epidemiological Record 24(91): 305–16 <http://dx.doi.org/10.1016/j.actatropica.2012.04.013>.

Shultz, A., Omollo, J.O., Burke, H., Qassim, M., Ochieng, J.B., Weinberg, M., Feikin, D.R. and Breiman, R.F. (2009) ‘Cholera outbreak in Kenyan refugee camp: risk factors for illness and importance of sanitation’, American Journal of Tropical Medicine and Hygiene 80(4): 640–5 <http://dx.doi.org/80/4/640 [pii]>.

Swerdlow, D.L., Malenga, G., Begkoyian, G., Nyangulu, D., Toole, M., Waldman, R.J., Puhr, D.N.D. and Tauxe, R.V. (1997) ‘Epidemic cholera among refugees in Malawi, Africa: treatment and transmission’, Epidemiology and Infection 118(3): 207–14 <http://dx.doi.org/10.1017/S0950268896007352>.

The Sphere Project (2011) Humanitarian Charter and Minimum Standards in Humanitarian response, 3rd edn, Rugby: Practical Action Publishing.

Toole, M.J. and Waldman, R.J. (1997) ‘The public health aspects of complex emergencies and refugee situations’, Annual Review of Public Health 18(1): 283–312 <http://dx.doi.org/10.1146/annurev.publhealth.18.1.283>.

UNHCR (2018) Global Trends: Forced Displacement in 2017 [online] <http://www.unhcr.org/globaltrends2017/> [accessed 27 June 2018].

United Nations High Level Panel on Humanitarian Financing (2016) Too Important to Fail: Addressing the Humanitarian Financing Gap [online], Report to the Secretary-General, World Humanitarian Summit <https://reliefweb.int/report/world/high-level-panel-humanitarian-financing-report-secretary-general-too-important-fail> [accessed 19 January 2019].

USAID (2016) Sanitation: Water and Development Strategy Implementation Brief, Washington, DC: USAID.

Bechen, R., Boutin, J.P., Combes, D., Coue, J.C., Desfontaine, M., Lamarque, D., Milleliri, J.M., Merouze, F., Niel, L., Regis, R., Rey, J.L., Signoret, J. and Soares, J.L. (1996) ‘Cholera in Goma, July 1994’, Revue d’Epidemiologie et de Sante Publique 44(4): 358–63.

Bill & Melinda Gates Foundation (2010) Water, Sanitation & Hygiene Fact Sheet [pdf] <https://docs.gatesfoundation.org/documents/water-sanitation-hygiene-fact-sheet-2010.pdf> [accessed 20 October 2016].

Blanchet, K., Ramesh, A., Frison, S., Warren, E., Hossain, M., Smith, J., Knight, A., Post, N., Lewis, C., Woodward, A., Dahab, M., Ruby, A., Sistenich, V., Pantuliano, S. and Roberts, B. (2017) ‘Evidence on public health interventions in humanitarian crises’, Lancet 390(10109): 2287–96 <http://dx.doi.org/10.1016/S0140-6736(16)30768-1>.

Bradley, M., Shakespeare, R., Ruwende, A., Woolhouse, M.E.J., Mason, E. and Munatsi, A. (1996) ‘Epidemiological features of epidemic cholera (El Tor) in Zimbabwe’, Transactions of the Royal Society of Tropical Medicine and Hygiene 90(4): 378–82.

Brown, J., Jeandron, A., Cavill, S. and Cumming, O. (2012) Evidence Review and Research Priorities: Water, Sanitation, and Hygiene for Emergency Response, London: DFID.

Bruckner, C. and Checchi, F. (2011) ‘Detection of infectious disease outbreaks in twenty-two fragile states, 2000-2010: a systematic review.’, Conflict and Health 5(1): 13 <http://dx.doi.org/10.1186/1752-1505-5-13>.

Cairncross, S. and Valdmanis, V. (2006) ‘Water supply, sanitation and hygiene promotion’, in D.T. Jamison, J.G. Breman, A.R. Measham, G. Alleyne, M. Claeson, D.B. Evans, P. Jha, A. Mills, and P. Musgrove (eds), Disease Control Priorities in Developing Countries, pp. 771–92, Washington, DC: World Bank.

Campbell, F. and Howard, N. (2012) ‘The humanitarian system’, in N. Howard, E. Sondorp, and A.M. ter Veen (eds), Conflict and Health, pp. 46–56, Maidenhead: Open University Press.

Carneiro, I. and Howard, N. (2011) Introduction to Epidemiology, 2nd edn. Maidenhead: Open University Press.

Centers for Disease Control and Prevention (2009) ‘Cholera outbreak: southern Sudan, 2007’, Morbidity and Mortality Weekly Report 58(13): 337–41 <http://dx.doi.org/mm5813a3 [pii]>.

Checchi, F., Gayer, M., Freeman Grais, R. and Mills, E.J. (2007) Public Health in Crisis-affected Populations: A Practical Guide for Decision-Makers, Network Paper 61, London: Humanitarian Practice Network.

Critical Appraisal Skills Programme (2017) CASP (Case Control Study Checklist) [online] <http://www.casp-uk.net/casp-tools-checklists> [accessed 2 April 2017].

Cronin, A.A., Shrestha, D., Cornier, N., Abdalla, F., Ezard, N. and Aramburu, C. (2008) ‘A review of water and sanitation provision in refugee camps in association with selected health and nutrition indicators: the need for integrated service provision’, Journal of Water and Health 6(1): 1–13 <http://dx.doi.org/10.2166/wh.2007.019>.

Cronin, A.A., Shrestha, D., Spiegel, P., Gore, F. and Hering, H. (2009) ‘Quantifying the burden of disease associated with inadequate provision of water and sanitation in selected sub-Saharan refugee camps’, Journal of Water and Health 7(4): 557–68 <http://dx.doi.org/10.2166/wh.2009.089>.

von Elm, E., Altman, D.G., Egger, M., Pocock, S.J. and Gøtzsche, P.C. (2007) ‘The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies’, PLoS ONE 4(10): e296 <https://doi.org/10.1371/journal.pmed.0040296>.

Esrey, S.A., Potash, J.B., Roberts, L. and Shiff, C. (1991) ‘Effects of improved water supply and sanitation on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and trachoma’, Bulletin of the World Health Organization 69(5): 609–21 <http://dx.doi.org/10.2147/IJWH.S77807>.

Goma Epidemiology Group (1995) ‘Public health impact of Rwandan refugee crisis: what happened in Goma, Zaire, in July, 1994?’ Lancet 345(8946): 339–44 <http://dx.doi.org/10.1016/S0140-6736%2895%2990338-0>.

Hershey, C.L., Doocy, S., Anderson, J., Haskew, C., Spiegel, P. and Moss, W.J. (2011) ‘Incidence and risk factors for Malaria, pneumonia and diarrhea in children under 5 in UNHCR refugee camps: a retrospective study’, Conflict and Health 5(24): 1–11 <http://dx.doi.org/10.1186/1752-1505-5-24>.

Iijima, Y., Oundo, J., Taga, K., Saidi, S. and Honda, T. (1995) ‘Simultaneous outbreak due to Vibrio cholerae and Shigella dysenteriae in Kenya’, The Lancet 345(8941): 69–70 <http://dx.doi.org/10.1016/S0140-6736(95)91197-9>.

Kernéis, S., Guerin, P.J., von Seidlein, L., Legros, D. and Grais, R.F. (2009) ‘A look back at an ongoing problem: Shigella dysenteriae type 1 epidemics in refugee settings in Central Africa (1993-1995)’, PLoS ONE 4(2): 1–6 <http://dx.doi.org/10.1371/journal.pone.0004494>.

Khan, M.U. and Shahidullah, M.D. (1982) ‘Role of water and sanitation in the incidence of cholera in refugee camps’, Transactions of the Royal Society of Tropical Medicine and Hygiene 76(3): 373–7 <http://dx.doi.org/10.1016/0035-9203(82)90194-8>.

Khan, M.U. and Munshi, M.H. (1983) ‘Clinical illnesses and causes of death in a Burmese refugee camp in Bangladesh’, International Journal of Epidemiology 12(4): 460–4 <http://dx.doi.org/10.1093/ije/12.4.460>.

Lam, E., McCarthy, A. and Brennan, M. (2015) ‘Vaccine-preventable diseases in humanitarian emergencies among refugee and internally-displaced populations’, Human Vaccines and Immunotherapeutics 11(11): 2627–36 <http://dx.doi.org/10.1080/21645515.2015.1096457>.

Mahamud, A., Ahmed, J., Nyoka, R., Auko, E., Kahi, V. and Ndirangu, J. (2012) ‘Epidemic cholera in Kakuma refugee camp, Kenya, the importance of sanitation and soap’, Journal of Infection in Developing Countries 6(3): 234–41.

Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G. and Grp, P. (2009) ‘Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement’, PLoS Medicine 6(7): e1000097 <http://dx.doi.org/10.1371/journal.pmed1000097>.

Moren, A., Stefanaggi, S., Antona, D., Bitar, D., Gastellu Etchegorry, M., Tchatchioka, M., Lungu, G., Etchegorry, M.G., Tchatchioka, M. and Lungu, G. (1991) ‘Practical field epidemiology to investigate a cholera outbreak in a Mozambican refugee camp in Malawi, 1988’, Journal of Tropical Medicine and Hygiene 94(1): 1–7.

Mulemba, F. and Nabeth, P. (1994) ‘Environmental sanitation for the control of cholera in Lisungwi Refugee Camp, Malawi’, Waterlines 12(4): 9–11 <http://dx.doi.org/10.3362/0262-8104.1994.016>.

Mulholland, K. (1985) ‘Cholera in Sudan: an account of an epidemic in a refugee camp in eastern Sudan, May-June 1985’, Disasters 9(4): 247–58.

Piarroux, R. and Faucher, B. (2012) ‘Cholera epidemics in 2010: respective roles of environment, strain changes, and human-driven dissemination’, Clinical Microbiology and Infection 18(3): 231–8 <http://dx.doi.org/10.1111/j.1469-0691.2012.03763.x>.

Piarroux, R., Barrais, R., Faucher, B., Haus, R., Piarroux, M., Gaudart, J., Magloire, R. and Raoult, D. (2011) ‘Understanding the cholera epidemic, Haiti’, Emerging Infectious Diseases 17(7): 1161–7 <http://dx.doi.org/10.3201/eid1707.110059>.

ProMED-mail (no date) <https://www.promedmail.org/> [accessed 30 November 2018].

Ramesh, A., Blanchet, K., Ensink, J.H.J. and Roberts, B. (2015) ‘Evidence on the effectiveness of water, sanitation and hygiene (WASH) interventions on health outcomes in humanitarian crises: a systematic review’, PLoS ONE 10(9): 1–20 <http://dx.doi.org/10.1371/journal.pone.0124688>.

Rebaudet, S., Sudre, B., Faucher, B. and Piarroux, R. (2013) ‘Environmental determinants of cholera outbreaks in inland africa: a systematic review of main transmission foci and propagation routes’, Journal of Infectious Diseases 208(Suppl. 1): S46–54 <http://dx.doi.org/10.1093/infdis/jit195>.

Reingold, A. (1998) ‘Outbreak investigations: a perspective’, Emerging Infectious Diseases 4(1): 21–7.

Sack, D.A., Sack, R.B., Nair, G.B. and Siddique, A. (2004) ‘Cholera’, The Lancet 363(9404): 223–33 <http://dx.doi.org/10.1016/S0140-6736(03)15328-7>.

Schuller, M. and Levey, T. (2014) ‘Kabrit ki gen twòp mèt: understanding gaps in WASH services in Haiti’s IDP camps’, Disasters 38(S1): S1–24 <http://dx.doi.org/10.1111/disa.12053>.

Seukap Pena, E., Bwire, G., Dzotsi, E., Bonnet, M.C. and Hessel, L. (2016) ‘New momentum in prevention, control and elimination of cholera in Africa: priority actions identified by affected countries’, The Weekly Epidemiological Record 24(91): 305–16 <http://dx.doi.org/10.1016/j.actatropica.2012.04.013>.

Shultz, A., Omollo, J.O., Burke, H., Qassim, M., Ochieng, J.B., Weinberg, M., Feikin, D.R. and Breiman, R.F. (2009) ‘Cholera outbreak in Kenyan refugee camp: risk factors for illness and importance of sanitation’, American Journal of Tropical Medicine and Hygiene 80(4): 640–5 <http://dx.doi.org/80/4/640 [pii]>.

Swerdlow, D.L., Malenga, G., Begkoyian, G., Nyangulu, D., Toole, M., Waldman, R.J., Puhr, D.N.D. and Tauxe, R.V. (1997) ‘Epidemic cholera among refugees in Malawi, Africa: treatment and transmission’, Epidemiology and Infection 118(3): 207–14 <http://dx.doi.org/10.1017/S0950268896007352>.

The Sphere Project (2011) Humanitarian Charter and Minimum Standards in Humanitarian response, 3rd edn, Rugby: Practical Action Publishing.

Toole, M.J. and Waldman, R.J. (1997) ‘The public health aspects of complex emergencies and refugee situations’, Annual Review of Public Health 18(1): 283–312 <http://dx.doi.org/10.1146/annurev.publhealth.18.1.283>.

UNHCR (2018) Global Trends: Forced Displacement in 2017 [online] <http://www.unhcr.org/globaltrends2017/> [accessed 27 June 2018].

United Nations High Level Panel on Humanitarian Financing (2016) Too Important to Fail: Addressing the Humanitarian Financing Gap [online], Report to the Secretary-General, World Humanitarian Summit <https://reliefweb.int/report/world/high-level-panel-humanitarian-financing-report-secretary-general-too-important-fail> [accessed 19 January 2019].

USAID (2016) Sanitation: Water and Development Strategy Implementation Brief, Washington, DC: USAID.

Bechen, R., Boutin, J.P., Combes, D., Coue, J.C., Desfontaine, M., Lamarque, D., Milleliri, J.M., Merouze, F., Niel, L., Regis, R., Rey, J.L., Signoret, J. and Soares, J.L. (1996) ‘Cholera in Goma, July 1994’, Revue d’Epidemiologie et de Sante Publique 44(4): 358–63.

Bill & Melinda Gates Foundation (2010) Water, Sanitation & Hygiene Fact Sheet [pdf] <https://docs.gatesfoundation.org/documents/water-sanitation-hygiene-fact-sheet-2010.pdf> [accessed 20 October 2016].

Blanchet, K., Ramesh, A., Frison, S., Warren, E., Hossain, M., Smith, J., Knight, A., Post, N., Lewis, C., Woodward, A., Dahab, M., Ruby, A., Sistenich, V., Pantuliano, S. and Roberts, B. (2017) ‘Evidence on public health interventions in humanitarian crises’, Lancet 390(10109): 2287–96 <http://dx.doi.org/10.1016/S0140-6736(16)30768-1>.

Bradley, M., Shakespeare, R., Ruwende, A., Woolhouse, M.E.J., Mason, E. and Munatsi, A. (1996) ‘Epidemiological features of epidemic cholera (El Tor) in Zimbabwe’, Transactions of the Royal Society of Tropical Medicine and Hygiene 90(4): 378–82.

Brown, J., Jeandron, A., Cavill, S. and Cumming, O. (2012) Evidence Review and Research Priorities: Water, Sanitation, and Hygiene for Emergency Response, London: DFID.

Bruckner, C. and Checchi, F. (2011) ‘Detection of infectious disease outbreaks in twenty-two fragile states, 2000-2010: a systematic review.’, Conflict and Health 5(1): 13 <http://dx.doi.org/10.1186/1752-1505-5-13>.

Cairncross, S. and Valdmanis, V. (2006) ‘Water supply, sanitation and hygiene promotion’, in D.T. Jamison, J.G. Breman, A.R. Measham, G. Alleyne, M. Claeson, D.B. Evans, P. Jha, A. Mills, and P. Musgrove (eds), Disease Control Priorities in Developing Countries, pp. 771–92, Washington, DC: World Bank.

Campbell, F. and Howard, N. (2012) ‘The humanitarian system’, in N. Howard, E. Sondorp, and A.M. ter Veen (eds), Conflict and Health, pp. 46–56, Maidenhead: Open University Press.

Carneiro, I. and Howard, N. (2011) Introduction to Epidemiology, 2nd edn. Maidenhead: Open University Press.

Centers for Disease Control and Prevention (2009) ‘Cholera outbreak: southern Sudan, 2007’, Morbidity and Mortality Weekly Report 58(13): 337–41 <http://dx.doi.org/mm5813a3 [pii]>.

Checchi, F., Gayer, M., Freeman Grais, R. and Mills, E.J. (2007) Public Health in Crisis-affected Populations: A Practical Guide for Decision-Makers, Network Paper 61, London: Humanitarian Practice Network.

Critical Appraisal Skills Programme (2017) CASP (Case Control Study Checklist) [online] <http://www.casp-uk.net/casp-tools-checklists> [accessed 2 April 2017].

Cronin, A.A., Shrestha, D., Cornier, N., Abdalla, F., Ezard, N. and Aramburu, C. (2008) ‘A review of water and sanitation provision in refugee camps in association with selected health and nutrition indicators: the need for integrated service provision’, Journal of Water and Health 6(1): 1–13 <http://dx.doi.org/10.2166/wh.2007.019>.

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Lam, E., McCarthy, A. and Brennan, M. (2015) ‘Vaccine-preventable diseases in humanitarian emergencies among refugee and internally-displaced populations’, Human Vaccines and Immunotherapeutics 11(11): 2627–36 <http://dx.doi.org/10.1080/21645515.2015.1096457>.

Mahamud, A., Ahmed, J., Nyoka, R., Auko, E., Kahi, V. and Ndirangu, J. (2012) ‘Epidemic cholera in Kakuma refugee camp, Kenya, the importance of sanitation and soap’, Journal of Infection in Developing Countries 6(3): 234–41.

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Piarroux, R. and Faucher, B. (2012) ‘Cholera epidemics in 2010: respective roles of environment, strain changes, and human-driven dissemination’, Clinical Microbiology and Infection 18(3): 231–8 <http://dx.doi.org/10.1111/j.1469-0691.2012.03763.x>.

Piarroux, R., Barrais, R., Faucher, B., Haus, R., Piarroux, M., Gaudart, J., Magloire, R. and Raoult, D. (2011) ‘Understanding the cholera epidemic, Haiti’, Emerging Infectious Diseases 17(7): 1161–7 <http://dx.doi.org/10.3201/eid1707.110059>.

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Ramesh, A., Blanchet, K., Ensink, J.H.J. and Roberts, B. (2015) ‘Evidence on the effectiveness of water, sanitation and hygiene (WASH) interventions on health outcomes in humanitarian crises: a systematic review’, PLoS ONE 10(9): 1–20 <http://dx.doi.org/10.1371/journal.pone.0124688>.

Rebaudet, S., Sudre, B., Faucher, B. and Piarroux, R. (2013) ‘Environmental determinants of cholera outbreaks in inland africa: a systematic review of main transmission foci and propagation routes’, Journal of Infectious Diseases 208(Suppl. 1): S46–54 <http://dx.doi.org/10.1093/infdis/jit195>.

Reingold, A. (1998) ‘Outbreak investigations: a perspective’, Emerging Infectious Diseases 4(1): 21–7.

Sack, D.A., Sack, R.B., Nair, G.B. and Siddique, A. (2004) ‘Cholera’, The Lancet 363(9404): 223–33 <http://dx.doi.org/10.1016/S0140-6736(03)15328-7>.

Schuller, M. and Levey, T. (2014) ‘Kabrit ki gen twòp mèt: understanding gaps in WASH services in Haiti’s IDP camps’, Disasters 38(S1): S1–24 <http://dx.doi.org/10.1111/disa.12053>.

Seukap Pena, E., Bwire, G., Dzotsi, E., Bonnet, M.C. and Hessel, L. (2016) ‘New momentum in prevention, control and elimination of cholera in Africa: priority actions identified by affected countries’, The Weekly Epidemiological Record 24(91): 305–16 <http://dx.doi.org/10.1016/j.actatropica.2012.04.013>.

Shultz, A., Omollo, J.O., Burke, H., Qassim, M., Ochieng, J.B., Weinberg, M., Feikin, D.R. and Breiman, R.F. (2009) ‘Cholera outbreak in Kenyan refugee camp: risk factors for illness and importance of sanitation’, American Journal of Tropical Medicine and Hygiene 80(4): 640–5 <http://dx.doi.org/80/4/640 [pii]>.

Swerdlow, D.L., Malenga, G., Begkoyian, G., Nyangulu, D., Toole, M., Waldman, R.J., Puhr, D.N.D. and Tauxe, R.V. (1997) ‘Epidemic cholera among refugees in Malawi, Africa: treatment and transmission’, Epidemiology and Infection 118(3): 207–14 <http://dx.doi.org/10.1017/S0950268896007352>.

The Sphere Project (2011) Humanitarian Charter and Minimum Standards in Humanitarian response, 3rd edn, Rugby: Practical Action Publishing.

Toole, M.J. and Waldman, R.J. (1997) ‘The public health aspects of complex emergencies and refugee situations’, Annual Review of Public Health 18(1): 283–312 <http://dx.doi.org/10.1146/annurev.publhealth.18.1.283>.

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