An evaluation of global Chikungunya clinical management guidelines: A systematic review
Summary: Background: Chikungunya virus (CHIKV) has expanded its geographical reach in recent decades and is an emerging global health threat. CHIKV can cause significant morbidity and lead to chronic, debilitating arthritis/arthralgia in up to 40% of infected individuals. Prevention, early identifi...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537022004023 |
| _version_ | 1811257819038482432 |
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| author | Eika Webb Melina Michelen Ishmeala Rigby Andrew Dagens Dania Dahmash Vincent Cheng Reena Joseph Samuel Lipworth Eli Harriss Erhui Cai Robert Nartowski Pande Putu Januraga Keerti Gedela Evi Sukmaningrum Muge Cevik Helen Groves Peter Hart Tom Fletcher Lucille Blumberg Peter W. Horby Shevin T. Jacob Louise Sigfrid |
| author_facet | Eika Webb Melina Michelen Ishmeala Rigby Andrew Dagens Dania Dahmash Vincent Cheng Reena Joseph Samuel Lipworth Eli Harriss Erhui Cai Robert Nartowski Pande Putu Januraga Keerti Gedela Evi Sukmaningrum Muge Cevik Helen Groves Peter Hart Tom Fletcher Lucille Blumberg Peter W. Horby Shevin T. Jacob Louise Sigfrid |
| author_sort | Eika Webb |
| collection | DOAJ |
| description | Summary: Background: Chikungunya virus (CHIKV) has expanded its geographical reach in recent decades and is an emerging global health threat. CHIKV can cause significant morbidity and lead to chronic, debilitating arthritis/arthralgia in up to 40% of infected individuals. Prevention, early identification, and clinical management are key for improving outcomes. The aim of this review is to evaluate the quality, availability, inclusivity, and scope of evidence-based clinical management guidelines (CMG) for CHIKV globally. Methods: We conducted a systematic review. Six databases were searched from Jan 1, 1989, to 14 Oct 2021 and grey literature until Sept 16, 2021, for CHIKV guidelines providing supportive care and treatment recommendations. Quality was assessed using the appraisal of Guidelines for Research and Evaluation tool. Findings are presented in a narrative synthesis. PROSPERO registration: CRD42020167361. Findings: 28 CMGs were included; 54% (15/28) were produced more than 5 years ago, and most were of low-quality (median score 2 out of 7 (range 1–7)). There were variations in the CMGs’ guidance on the management of different at-risk populations, long-term sequelae, and the prevention of disease transmission. While 54% (15/28) of CMGs recommended hospitalisation for severe cases, only 39% (11/28) provided guidance for severe disease management. Further, 46% (13/28) advocated for steroids in the chronic phase, but 18% (5/28) advised against its use. Interpretation: There was a lack of high-quality CMGs that provided supportive care and treatment guidance, which may impact patient care and outcomes. It is essential that existing guidelines are updated and adapted to provide detailed evidence-based treatment guidelines for different at-risk populations. This study also highlights a need for more research into the management of the acute and chronic phases of CHIKV infection to inform evidence-based care. Funding: The UK Foreign, Commonwealth and Development Office, Wellcome Trust [215091/Z/18/Z] and the Bill & Melinda Gates Foundation [OPP1209135]. |
| first_indexed | 2024-04-12T18:03:28Z |
| format | Article |
| id | doaj.art-9b3d5b6c3c0f4464a9faa05dd483c295 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-04-12T18:03:28Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-9b3d5b6c3c0f4464a9faa05dd483c2952022-12-22T03:22:04ZengElsevierEClinicalMedicine2589-53702022-12-0154101672An evaluation of global Chikungunya clinical management guidelines: A systematic reviewEika Webb0Melina Michelen1Ishmeala Rigby2Andrew Dagens3Dania Dahmash4Vincent Cheng5Reena Joseph6Samuel Lipworth7Eli Harriss8Erhui Cai9Robert Nartowski10Pande Putu Januraga11Keerti Gedela12Evi Sukmaningrum13Muge Cevik14Helen Groves15Peter Hart16Tom Fletcher17Lucille Blumberg18Peter W. Horby19Shevin T. Jacob20Louise Sigfrid21Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool, UKInternational Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UKInternational Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UKInternational Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UKInternational Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UKBristol Medical School, University of Bristol, Bristol, UKImperial College London, London, UKOxford University Hospitals NHS Foundation Trust, Oxford, UK; Nuffield Department of Medicine, University of Oxford, Oxford, UKBodleian Health Care Libraries, University of Oxford, Oxford, UKInternational Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UKInternational Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UKUdayana University, Bali, IndonesiaImperial College London, London, UKAtma Jaya Catholic University of Indonesia, Jakarta, Indonesia; HIV AIDS Research Centre-HPSI, AJCU, Jakarta, IndonesiaDepartment of Global Health and Infection Research, School of Medicine, University of St Andrews, Fife, Scotland, UKWellcome Trust, Euston Rd, London, UKWellcome Trust, Euston Rd, London, UKLiverpool School of Tropical Medicine, Pembroke Pl, Liverpool, UKNational Institute for Communicable Diseases, Johannesburg, South AfricaInternational Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UKLiverpool School of Tropical Medicine, Pembroke Pl, Liverpool, UKInternational Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK; Corresponding author.Summary: Background: Chikungunya virus (CHIKV) has expanded its geographical reach in recent decades and is an emerging global health threat. CHIKV can cause significant morbidity and lead to chronic, debilitating arthritis/arthralgia in up to 40% of infected individuals. Prevention, early identification, and clinical management are key for improving outcomes. The aim of this review is to evaluate the quality, availability, inclusivity, and scope of evidence-based clinical management guidelines (CMG) for CHIKV globally. Methods: We conducted a systematic review. Six databases were searched from Jan 1, 1989, to 14 Oct 2021 and grey literature until Sept 16, 2021, for CHIKV guidelines providing supportive care and treatment recommendations. Quality was assessed using the appraisal of Guidelines for Research and Evaluation tool. Findings are presented in a narrative synthesis. PROSPERO registration: CRD42020167361. Findings: 28 CMGs were included; 54% (15/28) were produced more than 5 years ago, and most were of low-quality (median score 2 out of 7 (range 1–7)). There were variations in the CMGs’ guidance on the management of different at-risk populations, long-term sequelae, and the prevention of disease transmission. While 54% (15/28) of CMGs recommended hospitalisation for severe cases, only 39% (11/28) provided guidance for severe disease management. Further, 46% (13/28) advocated for steroids in the chronic phase, but 18% (5/28) advised against its use. Interpretation: There was a lack of high-quality CMGs that provided supportive care and treatment guidance, which may impact patient care and outcomes. It is essential that existing guidelines are updated and adapted to provide detailed evidence-based treatment guidelines for different at-risk populations. This study also highlights a need for more research into the management of the acute and chronic phases of CHIKV infection to inform evidence-based care. Funding: The UK Foreign, Commonwealth and Development Office, Wellcome Trust [215091/Z/18/Z] and the Bill & Melinda Gates Foundation [OPP1209135].http://www.sciencedirect.com/science/article/pii/S2589537022004023Clinical management guidelinesAGREE IISupportive careChikungunyaEmerging infections |
| spellingShingle | Eika Webb Melina Michelen Ishmeala Rigby Andrew Dagens Dania Dahmash Vincent Cheng Reena Joseph Samuel Lipworth Eli Harriss Erhui Cai Robert Nartowski Pande Putu Januraga Keerti Gedela Evi Sukmaningrum Muge Cevik Helen Groves Peter Hart Tom Fletcher Lucille Blumberg Peter W. Horby Shevin T. Jacob Louise Sigfrid An evaluation of global Chikungunya clinical management guidelines: A systematic review EClinicalMedicine Clinical management guidelines AGREE II Supportive care Chikungunya Emerging infections |
| title | An evaluation of global Chikungunya clinical management guidelines: A systematic review |
| title_full | An evaluation of global Chikungunya clinical management guidelines: A systematic review |
| title_fullStr | An evaluation of global Chikungunya clinical management guidelines: A systematic review |
| title_full_unstemmed | An evaluation of global Chikungunya clinical management guidelines: A systematic review |
| title_short | An evaluation of global Chikungunya clinical management guidelines: A systematic review |
| title_sort | evaluation of global chikungunya clinical management guidelines a systematic review |
| topic | Clinical management guidelines AGREE II Supportive care Chikungunya Emerging infections |
| url | http://www.sciencedirect.com/science/article/pii/S2589537022004023 |
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