From the Guidelines
Systematic reviews are urgently needed in several areas of tropical medicine, including neglected tropical diseases, vector-borne diseases, and antimicrobial resistance, to improve evidence-based practice and patient outcomes.
Priority Areas for Systematic Reviews
The following areas in tropical medicine require systematic reviews:
- Neglected tropical diseases like leishmaniasis, Chagas disease, and schistosomiasis, where treatment protocols and prevention strategies require updated analysis 1
- Vector-borne diseases such as dengue, malaria, and Zika, which need systematic evaluation of emerging therapeutics, insecticide resistance patterns, and vaccine efficacy 1, 2
- Antimicrobial resistance in tropical infections, particularly regarding alternative treatment regimens for drug-resistant tuberculosis, typhoid fever, and bacterial dysentery
- Tropical snakebite management, which would benefit from systematic assessment of antivenom efficacy and supportive care protocols
- Climate change impacts on tropical disease distribution, point-of-care diagnostics in resource-limited settings, and cost-effective interventions for tropical diseases in pregnancy
Rationale for Systematic Reviews
The need for systematic reviews in these areas is highlighted by the high variability between studies, as seen in the systematic review and meta-analysis of the aetiology of fever in returning travellers and migrants 1, 2.
Expected Outcomes of Systematic Reviews
Systematic reviews in these areas would help standardize approaches to tropical diseases, particularly important in resource-constrained environments where evidence-based medicine can maximize limited healthcare resources and improve patient outcomes. By prioritizing these areas for systematic reviews, we can improve our understanding of tropical diseases, develop evidence-based guidelines, and ultimately reduce morbidity, mortality, and improve quality of life for patients affected by these diseases.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Areas Requiring Systematic Reviews in Tropical Medicine
- Neglected tropical diseases (NTDs) such as leprosy, trachoma, dengue, leishmaniasis, and Chagas disease, which have a higher representation in systematic reviews than their disease burden would suggest 3
- Diagnostic test accuracy reviews for NTDs, with only three of the 18 NTDs having reviews or protocols of diagnostic test accuracy 3
- Malaria research, where systematic reviews have been used to guide policy and maximize their uptake in policy and practice 4
- Tropical infections such as diarrheal diseases, malaria, dengue, typhoid, rickettsial diseases, and leptospirosis, which form a significant proportion of ICU admissions in tropical countries 5
- Antimicrobial resistance (AMR) in NTDs, where monitoring and surveillance systems need to be strengthened to enable the early detection of AMR and the mitigation of its global spread 6
Gaps in Research Prioritization
- Poor correlation between the number of systematic reviews and protocols in the Cochrane Database of Systematic Reviews (CDSR) and the disease burden of NTDs, as measured by disability-adjusted life years (DALYs) 3
- Underrepresentation of certain NTDs, such as cysticercosis, human African trypanosomiasis, ascariasis, lymphatic filariasis, and hookworm, in systematic reviews and protocols 3
Need for Systematic Reviews
- To address the gaps in research prioritization and provide a more accurate representation of the disease burden of NTDs 3
- To guide policy and practice in the prevention and treatment of tropical diseases, including malaria and other NTDs 4
- To strengthen monitoring and surveillance systems for AMR in NTDs and mitigate its global spread 6