Cochrane reviews and evidence certainty for neglected tropical diseases
Rafael Leite Pacheco, Hospital Sírio-Libanês
2Centro Universitário São Camilo / Hospital Sírio-Libanês, Brazil
3Universidade Federal de São Paulo / Hospital Sírio-Libanês, Brazil
Background: Cancer and rare diseases are among the hottest topics for health-related research areas. Innovative technologies and treatments for these conditions have put increasing pressure on health systems and their budgets. Conversely, one billion people worldwide are affected by neglected tropical diseases (NTD) , but neither the pharmaceutical industry nor academia seem to prioritize investments in health care for such conditions.
Objectives: To describe the amount and strength of evidence produced about NTD.
Methods: Rapid review conducted at the Post-graduation Program of Evidence-based Health, Universidade Federal de São Paulo. All Cochrane reviews (CR) on 20 NTD established by the World Health Organization (WHO)  were identified. Cochrane Library, issue 2 202 was searched using MeSH terms with no date restriction. The frequency of systematic reviews according to NTD and the certainty of evidence (GRADE) were analyzed.
Results: From 41 CR retrieved, leishmaniases, soil-transmitted helminthiases and trachoma were covered by five reviews each; leprosy by four; Chagas disease, lymphatic filariases, scabies and schistosomiases by three CR each. Dracunculiases, foodborne trematodiases, mycetoma, chromoblastomycosis, rabies, snakebite envenoming, and yaws have not been the focus of any CR so far. Four CR were published before the adoption of the GRADE approach; nine did not provide formal GRADE assessment and two were empty CR. Pharmacological treatment was the most frequent intervention assessed (73%), followed by surgical (5%), sanitary (5%) and diagnostic (5%). For the outcomes considered and reported in Summary of Findings tables, 9% were from high, 28% moderate, 28% low and 34% were from very low certainty.
Conclusions: Most of the available evidence from CR for supporting decision-making on NTD have very low certainty, and the benefits and harms of current interventions for one billion people worldwide remains unknown.
Patient, public and/or healthcare consumer involvement: The scarcity of CR and the poor evidence from primary studies on NTD are misaligned with the burden that these conditions pose to the world. Strategies and policies must be urgently pursued to stimulate the development of new therapies and evaluate preventive strategies. References:  World Health Organization. Neglected tropical diseases. 16 January 2023 | Q&A. Available from: https://www.who.int/news-room/questions-and-answers/item/neglected-tropical-diseases#:~:text=NTDs%20include%3A%20Buruli%20ulcer%3B%20Chagas,rabies%3B%20scabies%20and%20other%20ectoparasitoses%3B.