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Standard of care for viral haemorrhagic fevers (VHFs): a systematic review of clinical management guidelines for high-priority VHFs

Rigby, Ishmeala, Michelen, Melina, Dagens, Andrew, Cheng, Vincent, Dahmash, Dania, Harriss, Eli, Webb, Eika, Cai, Erhui, Lipworth, Samuel, Oti, Alexandra, Balan, Valeria, Piotrowski, Helen, Nartowski, Robert, Rojek, Amanda, Groves, Helen, Hart, Peter, Cevik, Muge, Bosa, Henry Kyobe, Blumberg, Lucille, Fletcher, Tom, Horby, Peter W, Jacob, Shevin ORCID: and Sigfrid, Louise (2023) 'Standard of care for viral haemorrhagic fevers (VHFs): a systematic review of clinical management guidelines for high-priority VHFs'. Lancet Infectious Diseases, Vol 23, Issue 7, E240-E252.

VHF_Manuscript_19.07.2022 .pdf - Accepted Version
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The Sudan virus disease outbreak in Uganda in 2022 showed our vulnerability to viral haemorrhagic fevers (VHFs). Although there are regular outbreaks of VHFs with high morbidity and mortality, which disproportionally affect low-income settings, our understanding of how to treat them remains inadequate. In this systematic review, we aim to explore the availability, scope, standardisation, and quality of clinical management guidelines for VHFs. We identified 32 guidelines, 25 (78%) of which were low quality and did not have supporting evidence and eight (25%) of which had been produced or updated in the past 3 years. Guidance on supportive care and therapeutics had little detail and was sometimes contradictory. Guidelines based on uncertain evidence are a risk to patients, an ethical challenge for clinicians, and a challenge to implementing trials due to heterogeneous standards of care. We recommend a standard living guideline framework to improve the quality, scope, and applicability of guidelines. Furthermore, investments into trials should aim to identify optimal treatment strategies for VHFs and prioritise affordable and scalable interventions to improve outcomes globally.

Item Type: Article
Subjects: WC Communicable Diseases > Virus Diseases > General RNA Virus Infections > WC 501 RNA virus infections (General or not elsewhere classified)
WG Cardiovascular System > WG 120 Cardiovascular diseases
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 29 Jun 2023 14:08
Last Modified: 06 Aug 2023 03:12


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