From the Guidelines
Systematic reviews are urgently needed in several neglected tropical disease (NTD) areas, particularly in treatment effectiveness for leishmaniasis, Chagas disease, and schistosomiasis, as well as vector control strategies, diagnostic accuracy, and implementation science for mass drug administration programs. These reviews should evaluate both established medications like praziquantel and newer therapeutic options, comparing their efficacy, optimal dosing regimens, and side effect profiles 1. Vector control strategies for diseases transmitted by insects require comprehensive assessment, especially comparing cost-effectiveness of different approaches in resource-limited settings. Diagnostic accuracy studies need systematic evaluation to determine which tests perform best in field conditions with limited infrastructure. Implementation science reviews are needed to identify successful strategies for mass drug administration programs, addressing challenges like medication adherence and healthcare worker training.
Some key areas that require systematic reviews include:
- Treatment effectiveness for leishmaniasis, Chagas disease, and schistosomiasis
- Vector control strategies for diseases transmitted by insects
- Diagnostic accuracy studies for NTDs
- Implementation science for mass drug administration programs
- Disease burden in vulnerable populations
- Co-infection management approaches
- Impact of climate change on NTD transmission patterns
According to a recent study on Chagas disease, there is a need to further study the epidemiology and predictors of reactivation due to most of the evidence relying on primary small case series and small cohorts 1. Another study highlights the importance of addressing co-infection in NTDs, as current surveillance systems often focus on single diseases at a time, despite the fact that multiple infections cluster together in the same community and in the same individuals 1. A study on onchocerciasis elimination in Africa also emphasizes the need for systematic reviews to inform national programs working on the elimination of onchocerciasis in Africa 1.
Overall, systematic reviews in these areas would help optimize limited resources and improve evidence-based approaches to diseases that affect over a billion people worldwide but receive disproportionately little research attention.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Areas Requiring Systematic Reviews in Neglected Tropical Diseases (NTDs)
The following areas in NTDs require systematic reviews:
- Policy and executive barriers in preventing and eradicating NTDs, including drawbacks of programs for disease management policies, environmental challenges, executive challenges, and research field challenges 2
- Emerging resistance of NTDs, such as antimicrobial resistance (AMR) and drug resistance, to identify the frequency of drug resistance for major NTDs and treatment drugs 3
- Comprehensive approaches to control and eliminate NTDs, including coordinated community-based programs, vector control, local training, education, and environmental change 4
- Prevention and control of NTDs, including randomized trials, systematic reviews, and meta-analyses, to identify areas where evidence is lacking 5
- Research prioritization, including identifying gaps in research and increasing prioritization of systematic reviews on NTDs, particularly diagnostic test accuracy reviews 6
Specific Diseases Requiring Systematic Reviews
Some specific NTDs that require systematic reviews include:
- Cysticercosis, dracunculiasis, echinococcosis, foodborne trematodes, and human African trypanosomiasis, which had no RCTs found 5
- Diseases with lower representation in the Cochrane Database of Systematic Reviews (CDSR) than their disability-adjusted life year (DALY) metrics, such as cysticercosis, human African trypanosomiasis, ascariasis, lymphatic filariasis, and hookworm 6
- Diseases with a need for diagnostic test accuracy reviews, such as only three of the 18 NTDs having reviews/protocols of diagnostic test accuracy 6