<i>Plasmodium vivax</i> malaria across South America: management guidelines and their quality assessment

Rodríguez, José Alejandro Iza; Rodríguez, Shirley Natali Iza; Olivera, Mario Javier

doi:10.1590/0037-8682-0179-2020

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Sumário

Short Communication • Rev. Soc. Bras. Med. Trop. 53 • 2020 • https://doi.org/10.1590/0037-8682-0179-2020 copy

Plasmodium vivax malaria across South America: management guidelines and their quality assessment

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

INTRODUCTION:

Plasmodium vivax malaria represents a major public health problem. This study presents the quality assessment of clinical practice guidelines for the management of P. vivax malaria.

METHODS:

A systematic review was conducted in PubMed, SciELO, and Google Scholar. Additionally, five guidelines were assessed with the AGREE (Appraisal of Guidelines Research and Evaluation) II protocol.

RESULTS

The general performance on the domains of stakeholder involvement, development rigor, and editorial independence was low.

CONCLUSIONS:

Most guidelines lack a solid research methodology, which implies ambiguous accuracy. Much needs to be done in the area of therapeutics and quality of policies.

Keywords:
Plasmodium vivax; Antimalarials; Clinical practice guidelines; AGREE

		Colombia	Venezuela	Brazil	Peru	Ecuador*	Guyana
Uncomplicated	1st line	CQ	CQ	CQ	CQ	CQ	CQ
		d1: 10 mg/kg;	d1: 10 mg/kg;	d1: 10 mg/kg;	d1: 10 mg/kg;	d1: 10 mg/kg;	d1: 10 mg/kg;
		d2: 7.5 mg/kg;	d2: 10 mg/kg;	d2: 7.5 mg/kg;	d2: 10 mg/kg;	d2: 7.5 mg/kg;	d2: 7.5 mg/kg;
		d3: 7.5 mg/kg.	d3: 5 mg/kg.	d3: 7.5 mg/kg.	d3: 5 mg/kg.	d3: 7.5 mg/kg.	d3: 7.5 mg/kg
		PQ	PQ	PQ	PQ	PQ	PQ
		0.25 mg/kg/d for 14 d	0.25 mg/kg/d for 14 d	0.5 mg/kg/d for 7 d	0.5 mg/kg/d for 7 d	0.5 mg/kg/d for 14 d	0.25 mg/kg/d for 14 d
	2nd line/relapse	CQ	CQ	AL	-	CQ	AL
		d1: 10 mg/kg;	d1: 10 mg/kg;	80-480 mg/12 h		d1: 10 mg/kg;	80-480 mg/12 h
		d2: 7.5 mg/kg;	d2: 10 mg/kg;	for 3 d		d2: 7.5 mg/kg;	for 3 d
		d3: 7.5 mg/kg.	d3: 5 mg/kg.	PQ		d3: 7.5 mg/kg.	PQ
		PQ	PQ	0.5 mg/kg/d for		PQ	0.5 mg/kg/d for
		0.25 mg/kg/d for 14 d	0.25 mg/kg/d for 14 d	14 d		0.5 mg/kg/d for 14 d	14 d
Severe	1st line	AS	AS	AS	AS	AS	AS
		2.4 mg/kg at 012, and 24 h, then daily for 7 d.,	2.4 mg/kg at 012, and 24 h,, then daily for 7 d,	2.4 mg/kg at 012, and 24 h, then daily for 7 d.,	2.4 mg/kg at 012, and 24 h, then daily for 7 d. ,	2.4 mg/kg at 012, and 24 h, then daily for 7 d.,	2.4 mg/kg at 012, and 24 h, then daily for 7 d.,
					Cdm
					10 mg/kg/12 h for 7 d
	2nd line	Quinine	AR IM	Cdm	Quinine bolus	AR IM	AR IM
		bolus 20 mg/kg; then 10 mg/kg/8 h for 7 d.	bolus 3.2 mg/kg; then 1.6 mg/kg/d for 5 d.	10 mg/kg/8 h for 7 d.	20 mg/kg; then 10 mg/kg/8 h for 48 h	bolus 3.2 mk/kg; then 1.6 mg/kg/d for 5 d.	bolus 3.2 mg/kg; then 1.6 mg/kg/d for 5 d.
		Cdm			Cdm
		10 mg/kg/8 h for 5 d.			10 mg/kg/12 h

Guidelines	Scope/purpose	Stakeholder	Rigor of	Clarity of	Applicability	Editorial
	(%)	involvement (%)	development (%)	presentation (%)	(%)	independence (%)
Comprehensive clinical practice guideline for medical care of patients with malaria (Colombia, 2010) ⁶6. Instituto Nacional de Salud. Guía para la atención clínica integral del paciente con malaria. Bogotá; 2010.	83	33	55	97	79	16
Treatment guideline in malaria cases (Venezuela, 2017) ¹³13. Ministerio del poder popular para la salud. Programa Nacional de Eliminación de Malaria: Pautas de tratamiento en casos de malaria. Caracas; 2017.	86	41	38	94	79	16
Guideline for the treatment of malaria in Brazil (Brazil, 2019) ⁷7. Ministério da Saúde. Guia de tratamento da malária no Brasil. Brasilia; 2019.	83	41	29	97	81	14
Technical standard for health care of malaria in Peru (Peru, 2015) ¹⁴14. Ministerio de Salud. Norma técnica de salud para la atención de la malaria y malaria grave en el Perú. Lima; 2015.	88	47	27	73	68	14
Malaria Treatment Guideline for health facilities in Guyana (Guyana, 2015) ¹⁵15. Ministry of Public Health. Malaria treatment guideline for health facilities in Guyana. Georgetown; 2015.	58	27	29	78	70	14
Median (95% confidence interval)	79.6	37.8	35.6	87.8	75.4	14.8
	(77.2-82.1)	(36.2-39.3)	(33.3-37.9)	(85.5-90.1)	(74.3-76.6)	(14.5-15.1)

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[1] Corresponding author: Dr. Mario Javier Olivera. e-mail: moliverajr@gmail.com