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

‘Involve those, who are managing these outbreaks’– Identifying barriers and facilitators to the implementation of clinical management guidelines for High-Consequence Infectious Diseases in Uganda

“…Many of our results were reminiscent of previous findings, highlighting the limited awareness of existing guidelines by HCP [26], limited access to treatments and equipment [1], as well as limitations of availability, inclusivity, and applicability of HCID CMGs across global LMIC contexts [1][2][3][4][5][6].…”

“…For example, a recent survey of 76 clinicians from 27 countries conducted during the COVID-19 pandemic identified issues in the implementation of COVID-19 CMGs, including limited access to treatments and equipment and lack of guidance for at-risk populations and resource-constrained settings [1]. These findings are supported by a series of systematic evidence reviews of existing CMGs, for viral haemorrhagic fevers (VHFs), chikungunya, mpox and severe acute respiratory syndrome (SARS), which found similar issues regarding availability, inclusivity, quality, and applicability of CMGs [2][3][4][5][6], particularly in Low-and Middle-Income Countries (LMICs).…”

“…As such, the study assessed when and why guidelines were mobilised or foregone; how CMGs may be communicated to patients and the public to bolster confidence and trust and how far guidelines accommodate different aspects and priorities of care. This case study was conducted as part of the 'Evaluation of Clinical Management Guidelines for High Consequence Infectious Diseases' (ESHCID), which comprised two other case studies and a series of reviews exploring availability, inclusivity, scope and quality of CMGs for HCIDs [2][3][4][5][6]. This qualitative in-depth case study examined the barriers and facilitators of CMG development and implementation within the Ugandan context.…”

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Prior research highlighting the complexity of clinical management guidelines (CMG) implementation, has suggested that limited access to treatments and equipment [1] and substantial issues regarding availability, inclusivity, quality, and applicability [2][3][4][5][6] hinder the implementation of CMGs in Low-and Middle-Income Countries (LMICs). This in-depth case study of Uganda -coincidentally occurring during the 2022 Sudan Virus Disease outbreak -aimed to explore contextual and supplementary factors which hinder or facilitate CMG development and implementation.

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Ebola-Virus- und Marburg-Viruserkrankung

“…In den Leitlinien zur supportiven Therapie bei hämorrhagischen Fiebern werden für die Marburg-Viruserkrankunggenau wie für die Ebola-Viruserkrankungfolgende Maßnahmen empfohlen: eine rationale Flüssigkeitstherapie, wenn nötig Sauerstoffgabe und Gabe von Blutprodukten, eine symptomatische Therapie von Schmerzen und Fieber, eine antibiotische Therapie sowiewenn möglich -Monitoring der Herz-Kreislauf-Funktion und des Bewusstseins und außerdem eine Katecholamin-bzw. eine Nierenersatztherapie[19]. Es gibt keine zugelassenen prophylaktischen oder therapeutischen Pharmaka gegen die Marburg-Viruserkrankung.…”