Abstract：
The Sudan virus disease outbreak in Uganda in 2022 showed our vulnerability to viral haemorrhagic fevers (VHFs). Although there are regular outbreaks of VHFs with high morbidity and mortality, which disproportionally affect low-income settings, our understanding of how to treat them remains inadequate. In this systematic review, we aim to explore the availability, scope, standardisation, and quality of clinical management guidelines for VHFs. We identified 32 guidelines, 25 (78%) of which were low quality and did not have supporting evidence and eight (25%) of which had been produced or updated in the past 3 years. Guidance on supportive care and therapeutics had little detail and was sometimes contradictory. Guidelines based on uncertain evidence are a risk to patients, an ethical challenge for clinicians, and a challenge to implementing trials due to heterogeneous standards of care. We recommend a standard living guideline framework to improve the quality, scope, and applicability of guidelines. Furthermore, investments into trials should aim to identify optimal treatment strategies for VHFs and prioritise affordable and scalable interventions to improve outcomes globally.
摘要：
2022年在乌干达爆发的苏丹病毒病表明我们容易感染病毒性出血热（VHF）。尽管VHFs经常爆发，发病率和死亡率都很高，不成比例地影响低收入环境，我们对如何对待他们的理解仍然不足。在这次系统审查中，我们的目标是探索可用性，范围,标准化,和VHFs临床管理指南的质量。我们确定了32条指南，其中25（78％）质量低且没有支持证据，其中8（25％）是在过去3年中生产或更新的。关于支持性护理和治疗的指导几乎没有细节，有时是矛盾的。基于不确定证据的指南对患者有风险，对临床医生来说是一个道德挑战，以及由于不同的护理标准对实施试验的挑战。我们建议一个标准的生活指南框架来提高质量，范围,和准则的适用性。此外，对试验的投资应旨在确定VHFs的最佳治疗策略，并优先考虑可负担且可扩展的干预措施，以改善全球结局。
