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dc.contributor.authorWebb, Eika
dc.contributor.authorMichelen, Melina
dc.contributor.authorRigby, Ishmeala
dc.contributor.authorDagens, Andrew
dc.contributor.authorDahmash, Dania
dc.contributor.authorCheng, Vincent
dc.contributor.authorJoseph, Reena
dc.contributor.authorLipworth, Samuel
dc.contributor.authorHarriss, Eli
dc.contributor.authorCai, Erhui
dc.contributor.authorNartowski, Robert
dc.contributor.authorJanuraga, Pande Putu
dc.contributor.authorGedela, Keerti
dc.contributor.authorSukmaningrum, Evi
dc.contributor.authorCevik, Muge
dc.contributor.authorGroves, Helen
dc.contributor.authorHart, Peter
dc.contributor.authorFletcher, Tom
dc.contributor.authorBlumberg, Lucille
dc.contributor.authorHorby, Peter W
dc.contributor.authorJacob, Shevin T
dc.contributor.authorSigfrid, Louise
dc.date.accessioned2022-10-28T16:32:56Z
dc.date.available2022-10-28T16:32:56Z
dc.date.issued2022-12-01
dc.identifier.citationWebb , E , Michelen , M , Rigby , I , Dagens , A , Dahmash , D , Cheng , V , Joseph , R , Lipworth , S , Harriss , E , Cai , E , Nartowski , R , Januraga , P P , Gedela , K , Sukmaningrum , E , Cevik , M , Groves , H , Hart , P , Fletcher , T , Blumberg , L , Horby , P W , Jacob , S T & Sigfrid , L 2022 , ' An evaluation of global Chikungunya clinical management guidelines : a systematic review ' , EClinicalMedicine , vol. 54 , 101672 . https://doi.org/10.1016/j.eclinm.2022.101672en
dc.identifier.issn2589-5370
dc.identifier.otherPURE: 281911635
dc.identifier.otherPURE UUID: 9d63b752-b13e-4963-bb79-c1bd6fb8614f
dc.identifier.otherJisc: 666908
dc.identifier.otherPubMed: 36193172
dc.identifier.otherpii: S2589-5370(22)00402-3
dc.identifier.otherpmc: PMC9526181
dc.identifier.otherScopus: 85138813674
dc.identifier.urihttp://hdl.handle.net/10023/26270
dc.descriptionFunding: This work was supported by funding from the UK Foreign, Commonwealth and Development Office, Wellcome Trust [215091/Z/18/Z] and the Bill & Melinda Gates Foundation [OPP1209135]. Thanks to the ISARIC Global Support Centre for their invaluable logistical and administrative support on this project.en
dc.description.abstractBackground 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].
dc.format.extent15
dc.language.isoeng
dc.relation.ispartofEClinicalMedicineen
dc.rightsCopyright 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)en
dc.subjectAGREE IIen
dc.subjectEmerging infectionsen
dc.subjectChikungunyaen
dc.subjectSupportive careen
dc.subjectClinical management guidelinesen
dc.subjectRA Public aspects of medicineen
dc.subjectMCCen
dc.subject.lccRAen
dc.titleAn evaluation of global Chikungunya clinical management guidelines : a systematic reviewen
dc.typeJournal itemen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. Arctic Research Centreen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. Infection and Global Health Divisionen
dc.identifier.doihttps://doi.org/10.1016/j.eclinm.2022.101672
dc.description.statusPeer revieweden


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