story at a glance
- A team of researchers, primarily from the University of Oxford, looked at 14 clinical guidelines for monkeypox and found that most of them were “low quality”.
- The researchers said the guidelines lacked sufficient detail on the virus and conflicted treatment recommendations.
- The lack of standardization of these clinical guidelines could stifle global efforts to treat people with the disease.
According to the researchers, the lack of up-to-date clinical guidelines on monkeypox may affect the ability of health care workers to administer effective and safe treatment to infected people.
UK-based researchers looked at existing clinical guidelines for the disease and found that they often lack sufficient detail, are contradictory in their recommendations and fail to include the effects of the disease on different groups, including children. Huh.
The findings of the analysis were published earlier this week in the journal BMI Global Health.
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Monkeypox is a viral disease belonging to the same family as chickenpox that can appear as a rash made up of small and painful blisters. Symptoms of illness may also include fever, chills, fatigue, muscle aches, cough, neck pain and swollen lymph nodes.
The rare disease has hit an outbreak this summer, with the US Centers for Disease Control and Prevention confirming 14,115 cases of the virus nationwide as of Thursday.
According to the CDC, before the 2022 outbreak, the disease was reported primarily in people living in about a dozen Central and West African countries.
Now, the worldwide surge in cases has prompted the World Health Organization to declare the spike a public health emergency.
In their analysis, the researchers combed through six major research databases with relevant information on monkeypox published up to October last year and other “grey literature” such as policy documents, newspapers and reports in multiple languages published up to this May. They found a total of 14 relevant clinical guidelines, most of which were of “low quality” and covered only a range of topics.
According to the findings of the analysis, only five out of 14 clinical guidelines provided any guidance on how to care for children infected with the virus and only three gave any advice on treating pregnant women or people living with HIV. .
The researchers said monkeypox treatment guidance was mostly limited to advice on antiviral medication and was not consistent. Seven of the guidelines reviewed recommended that cidofovir be given to patients with monkeypox, and only four of those seven noted that the drug should be given only to treat severe infections.
Only four clinical guidelines recommended tecovirimat and one recommended giving the sick brincidofovir.
Currently, WHO recommends that health care professionals use tecovirimat to treat monkeypox patients instead of cidofovir.
Consistent with the findings, none of the clinical guidelines reviewed had details on optimal dosage, timing or length of treatment and only one had any recommendations on supportive care and treatment complications.
Each of the 14 guidelines encouraged vaccination as exposure prophylaxis but not all of them had updated information about the new generation of vaccines.
The guidelines are important tools for clinicians and are particularly important for emerging infectious diseases, which health care workers may be less familiar with, according to Louise Siegfried, who works at the Institute for Epidemiology, the Isrik Global Support Center at the University of Oxford. and is one of the leading researchers in analysis.
Siegfried noted that some of his colleagues in London who treated monkeypox patients in the early days of the UK outbreak this spring were struggling to learn how to diagnose and treat patients because of limited guidelines .
“The main objective of clinical national guidelines is to benefit patient care,” Siegfried told Changing America. “It is also to standardize care. To ensure that all patients in all settings have access to evidence-based care and that physicians have access to evidence-based treatment.”
Siegfried said standardization of clinical guidelines also serves an important purpose when it comes to developing vaccines for diseases such as monkeypox. Without them, clinical research for treatments may be undermined and randomized control trials may be hindered.
“As rare diseases are emerging … we’ve also seen that physicians from different sites will use different treatments when we are trying to implement faster ones,” Siegfried said.
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Published on August 19, 2022
(This story has not been edited by seemayo staff and is published from a rss feed)