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Availability, scope and quality of monkeypox clinical management guidelines globally: a systematic review.
Webb, Eika; Rigby, Ishmeala; Michelen, Melina; Dagens, Andrew; Cheng, Vincent; Rojek, Amanda M; Dahmash, Dania; Khader, Susan; Gedela, Keerti; Norton, Alice; Cevik, Muge; Cai, Erhui; Harriss, Eli; Lipworth, Samuel; Nartowski, Robert; Groves, Helen; Hart, Peter; Blumberg, Lucille; Fletcher, Tom; Jacob, Shevin T; Sigfrid, Louise; Horby, Peter W.
Afiliação
  • Webb E; Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK.
  • Rigby I; ISARIC Global Support Centre, Pandemic Sciences Institute, University of Oxford, Oxford, Oxfordshire, UK.
  • Michelen M; ISARIC Global Support Centre, Pandemic Sciences Institute, University of Oxford, Oxford, Oxfordshire, UK.
  • Dagens A; ISARIC Global Support Centre, Pandemic Sciences Institute, University of Oxford, Oxford, Oxfordshire, UK.
  • Cheng V; Bristol Medical School, Unversity of Bristol, Bristol, UK.
  • Rojek AM; ISARIC Global Support Centre, Pandemic Sciences Institute, University of Oxford, Oxford, Oxfordshire, UK.
  • Dahmash D; Royal Melbourne Hospital, Melbourne, Victoria, Australia.
  • Khader S; ISARIC Global Support Centre, Pandemic Sciences Institute, University of Oxford, Oxford, Oxfordshire, UK.
  • Gedela K; GloPID-R, University of Oxford, Oxford, Oxfordshire, UK.
  • Norton A; Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
  • Cevik M; GloPID-R, University of Oxford, Oxford, Oxfordshire, UK.
  • Cai E; Divison of Infection and Global Health Research, School of Medicine, University of St. Andrews, St Andrews, UK.
  • Harriss E; ISARIC Global Support Centre, Pandemic Sciences Institute, University of Oxford, Oxford, Oxfordshire, UK.
  • Lipworth S; Bodleian Health Care Libraries, University of Oxford, Oxford, UK.
  • Nartowski R; Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Groves H; Nuffield Department of Medicine, University of Oxford, Oxford, UK.
  • Hart P; ISARIC Global Support Centre, Pandemic Sciences Institute, University of Oxford, Oxford, Oxfordshire, UK.
  • Blumberg L; Wellcome Trust, London, London, UK.
  • Fletcher T; Wellcome Trust, London, London, UK.
  • Jacob ST; National Institute for Communicable Diseases, Johannesburg, South Africa.
  • Sigfrid L; Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK.
  • Horby PW; Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK.
BMJ Glob Health ; 7(8)2022 08.
Article em En | MEDLINE | ID: mdl-35973747
BACKGROUND: Monkeypox (MPX) is an important human Orthopoxvirus infection. There has been an increase in MPX cases and outbreaks in endemic and non-endemic regions in recent decades. We appraised the availability, scope, quality and inclusivity of clinical management guidelines for MPX globally. METHODS: For this systematic review, we searched six databases from inception until 14 October 2021, augmented by a grey literature search until 17 May 2022. MPX guidelines providing treatment and supportive care recommendations were included, with no exclusions for language. Two reviewers assessed the guidelines. Quality was assessed using the Appraisal of Guidelines for Research and Evaluation II tool. RESULTS: Of 2026 records screened, 14 guidelines were included. Overall, most guidelines were of low-quality with a median score of 2 out of 7 (range: 1-7), lacked detail and covered a narrow range of topics. Most guidelines focused on adults, five (36%) provided some advice for children, three (21%) for pregnant women and three (21%) for people living with HIV. Treatment guidance was mostly limited to advice on antivirals; seven guidelines advised cidofovir (four specified for severe MPX only); 29% (4/14) tecovirimat, and 7% (1/14) brincidofovir. Only one guideline provided recommendations on supportive care and treatment of complications. All guidelines recommended vaccination as post-exposure prophylaxis (PEP). Three guidelines advised on vaccinia immune globulin as PEP for severe cases in people with immunosuppression. CONCLUSION: Our results highlight a lack of evidence-based clinical management guidelines for MPX globally. There is a clear and urgent need for research into treatment and prophylaxis including for different risk populations. The current outbreak provides an opportunity to accelerate this research through coordinated high-quality studies. New evidence should be incorporated into globally accessible guidelines, to benefit patient and epidemic outcomes. A 'living guideline' framework is recommended. PROSPERO REGISTRATION NUMBER: CRD42020167361.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Mpox Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Mpox Idioma: En Ano de publicação: 2022 Tipo de documento: Article