Appraisal of World Health Organization guidelines for priority infectious diseases with potential to cause public health emergencies

Abstract

Objectives

To map and assess the quality of guidelines developed by or in partnership with the WHO on infectious diseases with a high risk of causing public health emergencies.

Study design

Cross-sectional audit study.

Methods

A search of the WHO website and MAGICapp was conducted to identify guidelines on treatment, management, diagnosis, prevention, and surveillance of the WHO's priority list of diseases. When these sources yielded no results, the AI search engine Perplexity was used to expand the search for locally developed WHO partner guidelines. Eligible guidelines were evaluated by three to four appraisers using the Appraisal of Guidelines for Research and Evaluation (AGREE II).

Results

Of the thirty-three guidelines assessed, 73 % were developed by the WHO and 27 % were in partnership with external organisations. Guidelines scored highest in clarity of presentation (73.71 %) but were weakest in editorial independence (26.63 %) and rigour of development (30.05 %). Thirteen guidelines (40 %) were suitable for practical use, with high scores in scope, rigour, and clarity. Fourteen (42 %) were recommended for clinical use with modifications due to insufficient rigour, stakeholder involvement, or editorial independence, whilst six (18 %) were not recommended because of significant methodological flaws. Furthermore, WHO's sole-produced guidelines had higher quality than those developed with external collaborators, except for one partnership. Moreover, no WHO guidelines were found for Crimean-Congo haemorrhagic fever, Lassa fever, Rift Valley fever, Nipah and henipaviral diseases, and SARS.

Conclusions

The rigour of development and editorial independence of WHO-supported guidelines require improvement, particularly for diseases where comprehensive guidelines are lacking.