TY - JOUR
T1 - African League Against Rheumatism (AFLAR) preliminary recommendations on the management of rheumatic diseases during the COVID-19 pandemic
AU - Akintayo, Richard Oluyinka
AU - Bahiri, Rachid
AU - El Miedany, Yasser
AU - Olaosebikan, Hakeem
AU - Kalla, Asgar Ali
AU - Adebajo, Adewale Olukayode
AU - Migowa, Angela Nyangore
AU - Slimani, Samy
AU - Koussougbo, Ouma Devi
AU - Kawther, Ben Abdelghani
AU - Akpabio, Akpabio Akanimo
AU - Ghozlani, Imad
AU - Dey, Dzifa
AU - Hassan, Waleed A.
AU - Govind, Nimmisha
AU - Makan, Kavita
AU - Mohamed, Abdelgaffar
AU - Genga, Eugene Kalman
AU - Ghassem, Mohamed Khattry Ahmed
AU - Mortada, Mohamed
AU - Hamdi, Wafa
AU - Wabi, Moudjib O.
AU - Tikly, Mohammed
AU - Ngandeu-Singwe, Madeleine
AU - Scott, Christian
N1 - Publisher Copyright:
© 2020, The Author(s).
PY - 2021/9
Y1 - 2021/9
N2 - Objectives: To develop recommendations for the management of rheumatic and musculoskeletal diseases (RMDs) during the COVID-19 pandemic. Method: A task force comprising of 25 rheumatologists from the 5 regions of the continent was formed and operated through a hub-and-spoke model with a central working committee (CWC) and 4 subgroups. The subgroups championed separate scopes of the clinical questions and formulated preliminary statements of recommendations which were processed centrally in the CWC. The CWC and each subgroup met by several virtual meetings, and two rounds of voting were conducted on the drafted statements of recommendations. Votes were online-delivered and recommendations were pruned down according to predefined criteria. Each statement was rated between 1 and 9 with 1–3, 4–6 and 7–9 representing disagreement, uncertainty and agreement, respectively. The levels of agreement on the statements were stratified as low, moderate or high according to the spread of votes. A statement was retired if it had a mean vote below 7 or a ‘low’ level of agreement. Results: A total of 126 initial statements of recommendations were drafted, and these were reduced to 22 after the two rounds of voting. Conclusions: The preliminary statements of recommendations will serve to guide the clinical practice of rheumatology across Africa amidst the changing practices and uncertainties in the current era of COVID-19. It is recognized that further updates to the recommendations will be needed as more evidence emerges.Key Points• AFLAR has developed preliminary recommendations for the management of RMDs in the face of the COVID-19 pandemic.• COVID-19 is an unprecedented experience which has brought new concerns regarding the use of some disease-modifying anti-rheumatic drugs (DMARDs), and these recommendations seek to provide guidelines to the African rheumatologists.• Hydroxychloroquine shortage has become rampart across Africa as the drug is being used as prophylaxis against COVID-19 and this may necessitate a review of treatment plan for some patients with RMDs.• Breastfeeding should continue for as long as possible if a woman is positive for SARS-CoV-2 as there is currently no evidence that the infection can be transmitted through breast milk.
AB - Objectives: To develop recommendations for the management of rheumatic and musculoskeletal diseases (RMDs) during the COVID-19 pandemic. Method: A task force comprising of 25 rheumatologists from the 5 regions of the continent was formed and operated through a hub-and-spoke model with a central working committee (CWC) and 4 subgroups. The subgroups championed separate scopes of the clinical questions and formulated preliminary statements of recommendations which were processed centrally in the CWC. The CWC and each subgroup met by several virtual meetings, and two rounds of voting were conducted on the drafted statements of recommendations. Votes were online-delivered and recommendations were pruned down according to predefined criteria. Each statement was rated between 1 and 9 with 1–3, 4–6 and 7–9 representing disagreement, uncertainty and agreement, respectively. The levels of agreement on the statements were stratified as low, moderate or high according to the spread of votes. A statement was retired if it had a mean vote below 7 or a ‘low’ level of agreement. Results: A total of 126 initial statements of recommendations were drafted, and these were reduced to 22 after the two rounds of voting. Conclusions: The preliminary statements of recommendations will serve to guide the clinical practice of rheumatology across Africa amidst the changing practices and uncertainties in the current era of COVID-19. It is recognized that further updates to the recommendations will be needed as more evidence emerges.Key Points• AFLAR has developed preliminary recommendations for the management of RMDs in the face of the COVID-19 pandemic.• COVID-19 is an unprecedented experience which has brought new concerns regarding the use of some disease-modifying anti-rheumatic drugs (DMARDs), and these recommendations seek to provide guidelines to the African rheumatologists.• Hydroxychloroquine shortage has become rampart across Africa as the drug is being used as prophylaxis against COVID-19 and this may necessitate a review of treatment plan for some patients with RMDs.• Breastfeeding should continue for as long as possible if a woman is positive for SARS-CoV-2 as there is currently no evidence that the infection can be transmitted through breast milk.
KW - African rheumatology
KW - COVID-19
KW - DMARD
KW - Rheumatic and musculoskeletal diseases
KW - Rheumatology
UR - http://www.scopus.com/inward/record.url?scp=85090186158&partnerID=8YFLogxK
U2 - 10.1007/s10067-020-05355-2
DO - 10.1007/s10067-020-05355-2
M3 - Article
C2 - 32876786
AN - SCOPUS:85090186158
SN - 0770-3198
VL - 40
SP - 3445
EP - 3454
JO - Clinical Rheumatology
JF - Clinical Rheumatology
IS - 9
ER -