Capacity building for clinical research in infectious diseases: scoping review of initiatives in low-and middle-income countries

Infectious diseases have a disproportionately high burden in low- and middle-income countries (LMICs). Lack of skilled human resources and capacity have hindered adequate research response to common infectious diseases in these settings. The need for clinical research particularly in LMICs is being increasingly recognised in recent times. However, not enough attention has been paid in developing clinical research capacity in these settings. Understanding context-specific training needs and targeted capacity building activities are needed to strengthen the clinical research response.  The aim of this scoping review was to identify existing research capacity building initiatives around infectious disease in LMICs. We searched nine electronic databases OvidSP, Embase, OvidSP, MEDLINE, OvidSP Global Health, Scopus, ProQuest ASSIA, EBSCOhost CINAHL, and WHO Global Index Medicus, for literature on research capacity building initiatives targeting health researchers in LMICs focused on infectious diseases and published in English between January 2009 and November 2021. Two reviewers independently screened each title/abstracts and full texts for inclusion into the study. Disagreements were resolved by consensus. We identified 23 publications that met our inclusion criteria. Key training themes included field epidemiology, laboratory training, operational research and implementation research. One initiative specifically focused on clinical research during outbreaks. Country ministry of health were involved in 47.83% (11/23) initiatives. External funders for these initiatives were all based in high-income countries with United States funding 56% (13/23) initiatives. Key challenges identified include sustainability of initiatives linked to a lack of continuous funding, time constraints and inadequate mentoring. Few initiatives, 9% (2/23), reported external quality evaluation measures. Our review describes research capacity strengthening initiatives related to infectious diseases in LMICs. There is an overall lack of literature on such initiatives with only 23 published reports identified in this review. Most initiatives identified are dependent on HIC funders and not specifically focused on developing clinical research capacity. Key lessons can be learned from these initiatives reporting their challenges and efforts to scale-up programs. This can help inform future efforts on similar targeted training programs on clinical research for infectious diseases in LMICs.