Study warns of dominance by richer countries but praises Nigerian efforts
Guidelines for the clinical management of monkeypox are shoddy and largely produced by richer countries, a study has warned.
The authors found only 14 guidelines with recommendations for treatment and care of monkeypox, and most are in high income or upper-middle income countries.
However, the paper found that the only current comprehensive clinical management guideline for monkeypox was produced by an African institution, the Nigerian Centre for Disease Control (NCDC).
The article was written by researchers based in South Africa and the United Kingdom. It appeared in BMJ Global Health on 16 August.
Of the 14 guidelines, only Nigeria’s was aimed at Africa. Generally, the authors warn, there is a dearth of up-to-date information for treatment of the disease.
“We found that most guidelines did not document the methodology used … with most [assessed] guidelines [being] of poor quality,” the authors say.
The current guidelines also pay little attention to vulnerable groups such as children, pregnant women, and people living with HIV. In addition, the authors say, none of the guidelines provide details on the timing, dosage, and duration of treatment.
The paper praised the NCDC for its supportive care recommendations, as well as its advice for management of acute symptoms and secondary complications. Monkeypox is endemic in Nigeria.
The authors warn that monkeypox is proving to be a challenge even in high-resource settings and that “urgent investments into research to identify optimal treatment and prophylaxis strategies are needed for the whole population, in any setting, to benefit patient care and outcomes.”
On 4 August a number of countries, including the Democratic Republic of Congo, Ghana, Nigeria and South Africa, urged international publishers to make research data and papers on monkeypox freely available. Two of the world’s largest academic publishers, Elsevier and Springer Nature, have agreed to do so.
Canadian funders issued a call in July for collaborative research with Africans into clinical and health system management of monkeypox.