School of Public Health, The University of Adelaide, Adelaide Health and Medical Sciences Building, Corner of North Terrace and George Street, Adelaide, SA 5005, Australia.
Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, Corner of North Terrace & George Street, Adelaide, SA 5005, Australia; Robinson Research Institute, The University of Adelaide, Ground Floor, Norwich Centre, 55 King William Road, North Adelaide, SA 5006, Australia.
J Infect Public Health. 2021 Aug;14(8):1069-1074. doi: 10.1016/j.jiph.2021.06.014. Epub 2021 Jun 25.
COVID-19 has focussed public attention on the management of communicable disease like never before. Surveillance, contact tracing, and case management are recognised as key components of outbreak prevention. Development of guidance for COVID-19 has drawn from existing management of other communicable diseases, including Invasive Meningococcal Disease (IMD). IMD is a rare but severe outcome of Neisseria meningitidis infection that can be prevented through vaccination. Cases still occur sporadically, requiring ongoing surveillance and consistent management. To this end, national and international public health agencies have developed and published guidance for identification and management of IMD cases.
To assess national and international guidelines for the public health management of IMD, with a focus on the recommendations for identification and management of "close contacts" to IMD cases.
Guidelines from six national and international public health agencies were assessed using a modified version of the Appraisal of Guidelines, Research and Evaluation (AGREE II) Instrument in four key domains: stakeholder involvement, developmental rigour, clarity, and applicability. A direct comparison of terminology and recommendations for identification and management of close contacts to IMD cases was also conducted.
Guidelines from Europe and the United Kingdom rated most highly using the AGREE II Instrument, both presenting a clear, critical assessment of the strength of the available evidence, and the risks, costs, and benefits behind recommendations for management of close contacts. Direct comparison of guidelines identified inconsistencies in the language defining close contacts to IMD cases.
Discrepancies between guidelines could be due to limited evidence concerning mechanisms behind disease transmission, along with the lack of a consistent process for development and review of guideline recommendations. COVID-19 management has demonstrated that international collaboration for development of public health guidance is possible, a practice that should be extended to management of other communicable diseases.
COVID-19 前所未有地引起了公众对传染病管理的关注。监测、接触者追踪和病例管理被认为是预防疫情爆发的关键组成部分。COVID-19 指南的制定借鉴了其他传染病（包括侵袭性脑膜炎球菌病（IMD））的现有管理经验。侵袭性脑膜炎球菌病是脑膜炎奈瑟菌感染的罕见但严重的后果，可以通过疫苗接种来预防。这种疾病仍时有发生，需要持续监测和一致的管理。为此，国家和国际公共卫生机构制定并发布了侵袭性脑膜炎球菌病病例的识别和管理指南。
评估国家和国际公共卫生管理侵袭性脑膜炎球菌病的指南，重点关注对侵袭性脑膜炎球菌病病例“密切接触者”的识别和管理建议。
使用改良的评估、研究和评估（AGREE II）工具评估来自六个国家和国际公共卫生机构的指南，重点关注以下四个关键领域：利益相关者参与、发展严谨性、清晰度和适用性。还对侵袭性脑膜炎球菌病病例密切接触者的识别和管理建议的术语和建议进行了直接比较。
使用 AGREE II 工具，来自欧洲和英国的指南评分最高，对现有证据的强度以及管理密切接触者的建议背后的风险、成本和收益进行了清晰、批判性的评估。对指南的直接比较确定了与侵袭性脑膜炎球菌病病例密切接触者定义的术语不一致。
指南之间的差异可能是由于疾病传播机制的证据有限，以及缺乏一致的指南建议制定和审查过程。COVID-19 的管理表明，国际合作制定公共卫生指南是可行的，这种做法应该扩展到其他传染病的管理。
