Quality of clinical evidence and political justifications of ivermectin mass distribution of COVID-19 kits in eight Latin American countries
Background Several countries in Latin America conducted mass distribution of COVID-19 kits intended to treat mild COVID-19, thereby preventing excess hospitalisations. Many of the kits contained ivermectin, an antiparasitic medicine that was not approved at the time for the treatment of COVID-19. Th...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-05-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/8/5/e010962.full |
| _version_ | 1811153976099340288 |
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| author | Veronika J Wirtz Dolores Mino-León José Antonio Requejo Domínguez |
| author_facet | Veronika J Wirtz Dolores Mino-León José Antonio Requejo Domínguez |
| author_sort | Veronika J Wirtz |
| collection | DOAJ |
| description | Background Several countries in Latin America conducted mass distribution of COVID-19 kits intended to treat mild COVID-19, thereby preventing excess hospitalisations. Many of the kits contained ivermectin, an antiparasitic medicine that was not approved at the time for the treatment of COVID-19. The study objective was to compare the timing of the publication of scientific evidence about the efficacy of ivermectin for COVID-19 with the timeline of distribution of COVID-19 kits in eight Latin American countries and to analyse whether evidence was used to justify ivermectin distribution.Methods We conducted a systematic review of randomised controlled trials (RCTs) published on the efficacy of ivermectin or ivermectin as adjuvant therapy on mortality from, or as prevention for, COVID-19. Each RCT was assessed using the Cochrane Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Information on the timing and justification of government decisions was collected through a systematic search of leading newspapers and government press releases.Results After removing the duplicates and abstracts without full text, 33 RCTs met our inclusion criteria. According to GRADE, the majority had a substantial risk of bias. Many government officials made claims that ivermectin was effective and safe in the prevention or treatment of COVID-19, despite the lack of published evidence.Conclusion All eight governments distributed COVID-19 kits to their populations despite the absence of high-quality evidence on the efficacy of ivermectin for prevention, hospitalisation and mortality in COVID-19 patients. Lessons learnt from this situation could be used to strengthen government institutions’ capacities to implement evidence-informed public health policies. |
| first_indexed | 2024-03-13T09:49:53Z |
| format | Article |
| id | doaj.art-ca6069131b494673b8cbd03aeae3ee62 |
| institution | Directory Open Access Journal |
| issn | 2059-7908 |
| language | English |
| last_indexed | 2024-03-13T09:49:53Z |
| publishDate | 2023-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj.art-ca6069131b494673b8cbd03aeae3ee622023-05-24T15:00:06ZengBMJ Publishing GroupBMJ Global Health2059-79082023-05-018510.1136/bmjgh-2022-010962Quality of clinical evidence and political justifications of ivermectin mass distribution of COVID-19 kits in eight Latin American countriesVeronika J Wirtz0Dolores Mino-León1José Antonio Requejo Domínguez2Department of Global Health, School of Public Health, Boston University, Boston, Massachusetts, USA5 Research Unit in Clinic Epidemiology, Specialties Hospital of the National Medical Centre SXXI, Mexican Institute of Social Security, Mexico City, MexicoDepartment of Global Health, Boston University School of Public Health, Boston, Massachusetts, USABackground Several countries in Latin America conducted mass distribution of COVID-19 kits intended to treat mild COVID-19, thereby preventing excess hospitalisations. Many of the kits contained ivermectin, an antiparasitic medicine that was not approved at the time for the treatment of COVID-19. The study objective was to compare the timing of the publication of scientific evidence about the efficacy of ivermectin for COVID-19 with the timeline of distribution of COVID-19 kits in eight Latin American countries and to analyse whether evidence was used to justify ivermectin distribution.Methods We conducted a systematic review of randomised controlled trials (RCTs) published on the efficacy of ivermectin or ivermectin as adjuvant therapy on mortality from, or as prevention for, COVID-19. Each RCT was assessed using the Cochrane Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Information on the timing and justification of government decisions was collected through a systematic search of leading newspapers and government press releases.Results After removing the duplicates and abstracts without full text, 33 RCTs met our inclusion criteria. According to GRADE, the majority had a substantial risk of bias. Many government officials made claims that ivermectin was effective and safe in the prevention or treatment of COVID-19, despite the lack of published evidence.Conclusion All eight governments distributed COVID-19 kits to their populations despite the absence of high-quality evidence on the efficacy of ivermectin for prevention, hospitalisation and mortality in COVID-19 patients. Lessons learnt from this situation could be used to strengthen government institutions’ capacities to implement evidence-informed public health policies.https://gh.bmj.com/content/8/5/e010962.full |
| spellingShingle | Veronika J Wirtz Dolores Mino-León José Antonio Requejo Domínguez Quality of clinical evidence and political justifications of ivermectin mass distribution of COVID-19 kits in eight Latin American countries BMJ Global Health |
| title | Quality of clinical evidence and political justifications of ivermectin mass distribution of COVID-19 kits in eight Latin American countries |
| title_full | Quality of clinical evidence and political justifications of ivermectin mass distribution of COVID-19 kits in eight Latin American countries |
| title_fullStr | Quality of clinical evidence and political justifications of ivermectin mass distribution of COVID-19 kits in eight Latin American countries |
| title_full_unstemmed | Quality of clinical evidence and political justifications of ivermectin mass distribution of COVID-19 kits in eight Latin American countries |
| title_short | Quality of clinical evidence and political justifications of ivermectin mass distribution of COVID-19 kits in eight Latin American countries |
| title_sort | quality of clinical evidence and political justifications of ivermectin mass distribution of covid 19 kits in eight latin american countries |
| url | https://gh.bmj.com/content/8/5/e010962.full |
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