Background: academic publications about health help generate evidence for guidelines, policies, and knowledge in general, but their frequency and focus may be affected by factors such as armed conflict. The Syrian war displaced massive numbers of refugees worldwide, and spurred research interest about Syria.
Objectives: the objective of this scoping review was to analyze the possible impact of the Syrian war on features of the health literature about Syria.
Methods: we searched Embase, Global Health Library, MEDLINE, PsychINFO, PubMed, Scopus, and Web of Science for articles published after 1990. We used combinations of MeSH terms and keywords and did not apply language restrictions. We screened titles and abstracts, followed by full-text articles, in duplicate, using predefined inclusion criteria: article is about Syria or Syrians; related to health or health systems; involving human subjects. We collected data independently using a standardized form and covering publication characteristics, Syrian institutions, funding, public health or health system area, and target population of analysis. We analyzed data using STATA 15.1 statistical software, and applied analytical descriptive comparisons and trend analysis.
Results: we identified 21,919 publications; we included 1597 publications, 1003 (62.8%) of which were research papers. Trends showed a consistent increase in the number of publications over time, this was linear before 2011 and became exponential after 2011. Country of affiliation of first authors was mostly Syria (33.38%), followed by the USA (11.23%), Turkey (7.40%), the UK (6.40%), and Lebanon (5.58%). In terms of Institutions, Damascus University was the most common institution of affiliation of first (35.25%) and last authors (34.14%). Funding sources were minimally reported in only 18.4% of the publications. The proportion of publications with at least one Syrian author decreased significantly after 2011, where publications were mostly by non-Syrian authors. Yearly percentages show emerging literature in the areas of mental health, conflict and health and human rights, which were absent before the year 2011. Publications about communicable diseases, mental health and injuries increased significantly after the start of the conflict.
Conclusions: armed conflict can affect the type and frequency of health-related publications. It is important for research during armed conflict to reflect the health needs of patients and those mostly affected by conflict or displacement.