The weeks of 2023 continue to fly by! As the end of 2023 approaches, the Cochrane Infectious Diseases Group (CIDG) editorial base in Liverpool conveys thanks to its readers, authors, referees, Editors, and READ-It Partners for their continued support to the CIDG’s work. In this newsletter we reflect on the past 12 months at the CIDG.

CIDG/READ-It Liverpool team (L-R): Christianne Esparza, Tilly Fox, Rebecca Kuehn, Dee Walshe, Kerry Dwan, Marty Chaplin, Melissa Taylor, Paula Waugh, Phil Hinds (not pictured: Vittoria Lutje).

CIDG editorial team message

At the CIDG, we have a lot to be proud of. Throughout 2023, we have continued to adapt to changes to Cochrane’s structure and that of our own CIDG editorial team. Our work continues to be valued, as evidenced by the continued requests and use by host governments and the WHO. The CIDG is a strongly performing group, and is recognized as such in Cochrane. This is thanks to the continued, well-placed efforts and expertise of our CIDG Editors, editorial team, authors, peer reviewers, and READ-It Partners. We’re delighted to continue collaborations, producing high-impact, timely systematic reviews and providing vital input into national and global guidelines. 

Key focus areas in 2023 have been development of methods around qualitative evidence synthesis, challenging misinformation (with publication of our first post-COVID condition review), and timely reviews and updates. We have a number of exciting projects in the pipeline, which we look forward to publishing in 2024. We continue to follow our CIDG strategic plan, focusing on high-impact reviews.

Importantly, this year we have welcomed Dr Kerry Dwan, who brings her rich background in evidence synthesis methodology, statistics, and complex methods across a variety of clinical areas. Kerry will be considering future funding opportunities, and continued and new collaborations.

As always, you can keep updated on CIDG activities by visiting our website, our overarching programme Research, Evidence and Development Initiative (READ-It) website, and our Twitter account.

Your support and contributions throughout this year are much appreciated.

Dee Walshe, on behalf of the CIDG editorial team.

Message from Kerry Dwan, LSTM Senior Lecturer in Evidence Synthesis

I am thrilled to have joined LSTM in May 2023 as a Senior Lecturer in Evidence Synthesis. I am a statistician by background, undertaking research on review methodology, and a co-author on many systematic reviews. I have worked for Cochrane in different capacities over the past 15 years, more recently setting up and leading Cochrane’s Methods Support Unit (MSU). The CIDG is a strong Cochrane review group and with the structural changes within Cochrane, joining CIDG and working towards the future of Cochrane is an exciting opportunity for me.

Over the past six months, I have been getting to know colleagues at LSTM and across the wider READ-It partnership, and discussing with clinical and WHO colleagues the questions of high priority that still need to be addressed. With the ever-concerning impact of climate change, climate-related arboviruses are of increasing concern and high-quality up-to-date systematic reviews are lacking. As we have seen in recent years with the impact of COVID-19, the world was not ready for a pandemic. Therefore, pandemic and health emergency preparedness is key, especially in trying to maintain routine care. The CIDG produced high-impact reviews on COVID-19 during the pandemic and we need to continue the important work in this area. It is also vital that we work with early career researchers in terms of capacity building and strengthening so that the next generation can continue to build on existing evidence synthesis methodology work. I am keen to collaborate with other groups within low- and middle-income countries (LMICs) in terms of conducting reviews and capacity strengthening.

Funding

In April 2023, the CIDG entered Year 5 as a Research, Evidence and Development Initiative (READ-It) Partner. READ-It is a six-year Foreign, Commonwealth and Development Office (FCDO)-funded programme grant (project number 300342-104). Earlier this year, FCDO granted a 6-month extension, which will allow the READ-It programme to continue to 30 September 2024. READ-It's key achievements are outlined here.

Cochrane 2022 Journal Impact factor 

The 2022 Journal Impact Factor (JIF) for the Cochrane Database of Systematic Reviews (CDSR) is 8.4. The CDSR JIF is calculated by taking the total number of citations in a given year (2022) to all Cochrane reviews published in the past 2 years (2021 and 2020) and dividing that number by the total number of reviews published in the past 2 years (2021 and 2020). The report is available here.

The unofficial 2022 Cochrane Review Group (CRG) Impact Factor (IF) for the Infectious Diseases Group is 28.1 (42 publications cited 1179 times). This means that a review published by the Infectious Diseases Group in 2020 and 2021 was cited, on average, 28.1 times in 2022. Again, this year, the COVID-19 diagnostic and intervention portfolio of reviews have been well cited, which contributed to this increase in individual CRG IF from 7.537 in 2020 to 34.275 in 2021, and now 28.1 in 2022. This IF value justifies our strategy set some years ago to concentrate on only high-impact, timely reviews and updates.

Some highlights from the CDSR 2022 Journal Citation Report:  

• The CDSR is ranked 22nd of the 167 journals in the Medicine, General & Internal category (in the 87th percentile)
• The CDSR received 83,897 cites in the 2022 JIF period, compared with 92,845 in 2021 (continuing to remain in the top 5 in the CDSR’s JCR category)
• The 5-Year JIF is 10.9 compared with 11.956 in 2021

Cochrane’s future

As Cochrane closes a year of significant restructure and change, it has reached several major milestones in its transition to a more sustainable and streamlined organization. To keep the Cochrane community updated with these and other developments, the Future Cochrane website is regularly updated with:

• key information about Cochrane’s new model and organizational structure;
• series profiling the people, partnerships, and priorities of each new Cochrane Thematic Group;
• access to this year’s entire webinar series on various aspects of transition plans, projects, and processes;
• the aims, milestones, and estimated timelines for the major projects underway to deliver Cochrane’s new model of production.

CIDG editorial team

We are extremely grateful to our CIDG Editors and Specialist Advisors who provide invaluable contributions to the CIDG. Below is a brief synopsis of the CIDG editorial staff's activities throughout 2023.

	Marty Chaplin, CIDG Statistical Editor, acts as co-author for systematic reviews with meta-analysis, undertakes research into review methodology, and completes statistical peer review. This year, she has contributed to CIDG reviews as an author on various topics, and has also developed a tutorial on the inclusion of cluster-randomised controlled trials in systematic reviews. In September, Marty delivered a talk at the Cochrane Colloquium in London, presenting key examples of interesting study designs that CIDG review authors have encountered in recent years.
	Kerry Dwan, Senior Lecturer, has co-authored several systematic review protocols this year, and a review on Lay health workers in primary and community health care for maternal and child health: identification and treatment of wasting in children with READ-It Partners. She led the published guidance on Using risk of bias 2, and launched a methods and statistics tutorial series including interactive content in the new journal Cochrane Evidence Synthesis and Methods, contributing to the published articles on cluster trials and dichotomous outcomes. In September, she presented a poster on Risk of bias 2 at the Cochrane Colloquium, and in October presented on practical author and editor guidance for ROBINS-I in a Cochrane MSU web clinic.
	Christianne Esparza, Administration Assistant, continues to provide valued administrative assistance, particularly with article retrieval for CIDG authors working on high-impact reviews.
	Tilly Fox is a Research Associate with the role of CIDG Review Synthesis Delivery Specialist. This year she led the development and publication of two Cochrane reviews: ‘Therapeutics for treating mpox in humans’ and 'Plasmapheresis to remove amyloid fibrin(ogen) particles for treating the post‐COVID‐19 condition', and one protocol ‘Wolbachia‐carrying Aedes mosquitoes for preventing dengue infection’. She also co-authored the review protocol on 'Digital devices for tuberculosis treatment adherence’, and has co-developed two reports for WHO guidelines alongside the team in Liverpool. In her role, she has been working with new and existing author teams to develop review topics and assist with review delivery and dissemination. She also teaches systematic review methods and critical appraisal at LSTM.
	Philomena Hinds, Editorial Assistant, provides a high level of administrative support towards the editorial management of Cochrane reviews. She contributes to communications and dissemination for the CIDG, and in the effective development and delivery of READ-It programme objectives.
	Rebecca Kuehn is a Clinical Research Associate. Since joining the CIDG, Rebecca has led the evidence synthesis for the WHO Guidelines on cystic echinococcosis, and infection prevention and control measures for mpox. Rebecca has also authored several Cochrane reviews on topics including cephalosporins for treating typhoid fever and oral medication for COVID-19. In addition, she has been involved in teaching critical appraisal skills, systematic review methods, and GRADE to students on LSTM DTMH and Masters programmes.
	Vittoria Lutje, CIDG Information Specialist, continues to provide invaluable assistance with preparing search strategies and conducting literature searches for most of our CIDG systematic reviews. In 2023 she also co-authored publications on non-Cochrane systematic reviews of tuberculosis diagnosis and long Covid.
	Melissa Taylor, Research Assistant and PhD student, is continuing her work on qualitative evidence synthesis (QES); both in producing reviews on topics such as mass drug administration for soil-transmitted helminths, and tuberculosis active case finding (in progress), and in exploring how QES could be used in global guidelines as part of her PhD. Currently she is conducting a rapid appraisal of how QES is used in guidelines, as well as conducting interviews with key experts in the field. She also recently published a Cochrane review on growth monitoring and promotion for children under five in low- and middle-income countries.
	Dee Walshe, Managing Editor, continues to support the development and production of high-impact CIDG reviews. Throughout 2023, she has assisted the CIDG editorial team, Editors, and authors in navigating changes to Cochrane processes.

CIDG contributions to guidelines in 2023

Malaria guidelines
 

The WHO Guidelines for malaria is a compilation of existing WHO recommendations on malaria and supersedes two previous WHO publications: the Guidelines for the treatment of malaria, third edition and the Guidelines for malaria vector control. Over 20 CIDG reviews are cited, with CIDG reviews typically the main reference used for the specific PICO examined.

The latest version of the WHO Guidelines for malaria was updated in October 2023, and includes a conditional recommendation against the use of topical repellents to control malaria at the community level. This recommendation is informed by a CIDG Cochrane review: Gabaldón Figueira 2023.

At a WHO guideline development group (GDG) meeting (13-15 November 2023), Tilly Fox and Kerry Dwan provided input on the malaria treatment guidelines, in relation to tafenoquine for preventing relapse in people with Plasmodium vivax malaria. The updated WHO guidelines will be published in 2024. 

COVID-19 guidelines

Dutch national guidelines, prepared by the Dutch College of General Practitioners, were informed by the Cochrane review ‘Ivermectin for preventing and treating COVID-19’.

HIV guidelines

A Cochrane review published in READ-It Year 1, ‘Rapid initiation of antiretroviral therapy for people living with HIV’, informed the 2023 interim update of the British HIV Association (BHIVA) guidelines on antiretroviral treatment for adults living with HIV-1.

Sexually-transmitted enteric infections guidelines

The British Association of Sexual Health and HIV (BASHH) United Kingdom national guideline for the management of sexually transmitted enteric infections was informed by a Cochrane review, published in READ-It Year 2: ‘Hand-washing promotion for preventing diarrhoea'.

Guidelines in progress

Mpox

CIDG researchers Tilly Fox, Rebecca Kuehn, Susie Gould (to 2022), and Vittoria Lutje, have synthesized and presented evidence on two specific topics for the WHO: infection prevention and control measures to reduce the transmission of mpox in community and healthcare settings; and therapeutics for treating mpox. One WHO GDG meeting was held in December 2022, with a further meeting in October 2023 due to new evidence emerging. Publication of the WHO ‘Guidelines for clinical management and infection prevention and control for Mpox’ is scheduled for publication in early 2024.

WHO Treatment of cystic echinococcosis guidelines

Rebecca Kuehn has completed evidence syntheses related to PICO questions, a report of the values and preferences consultation, and GRADE tables for the treatment of cystic echinococcosis for a WHO GDG panel. Panel meetings have been ongoing in 2023 to address 10 PICO questions. The CMC Vellore team, a READ-It Partner, has provided methodological input for the GDG Evidence-to-Decision (EtD) process and formatting recommendations.

Other news

Qualitative evidence synthesis

We continue to develop our capacity in qualitative evidence synthesis, and have embarked on research considering how qualitative research and synthesis could improve guideline development. We look forward to sharing additional QES publications with you in 2024, including an upcoming Cochrane review on community views on active case finding for tuberculosis. 

Challenging the thrombosis hypothesis for post-COVID-19 condition

Many patients with post-COVID-19 condition struggle with understanding what is causing this condition and which treatments to seek out to help address their symptoms. A partnership between Liverpool School of Tropical Medicine, King’s Healthcare Partners, University of Leeds, University College London, and Imperial College London sought to examine the evidence around plasmapheresis as a treatment to remove “microclots” for post-COVID-19 condition. Specialist methodologists (Tilly Fox, Dr Rebecca Kuehn, and Professor Paul Garner; CIDG) and specialists in thrombotic disorders, vascular biology, molecular biology and infectious diseases (Professor Beverley J Hunt, Professor Robert AS Ariens, Professor Greg J Towers, and Dr Robert Lever) worked together and summarized the evidence in a Cochrane review. Ultimately, the review showed that there is an absence of reliable evidence to elucidate the role of “microclots” in the post-COVID-19 condition and concluded that there is no rationale for plasmapheresis to remove these particles.

CIDG authors Tilly Fox and Rebecca Kuehn were featured discussing their review in a recent New Scientist article on long COVID. You can also read the LSTM news story here.

Cochrane Colloquium 2023

CIDG Colloquium attendees (L-R): Melissa Taylor, Rebecca Kuehn, Vittoria Lutje, Marty Chaplin, Kerry Dwan, Deirdre Walshe, Tilly Fox 

The annual Cochrane Colloquium brings people together from around the world to discuss research into important global health questions and promote evidence-informed health care. The 2023 theme, ‘Forward together for trusted evidence’, explored the challenges for the future around trustworthiness of healthcare data and information whilst also celebrating 30 years of Cochrane producing trusted evidence. CIDG team members showcased CIDG outputs at this year's Colloquium, hosted by Cochrane UK at the Queen Elizabeth II (QEII) Centre in London (4th to 6th September 2023), including the following presentations:

• Dr Marty Chaplin (Oral presentation: Incorporating data from atypical experimental study designs in systematic reviews: experiences from Cochrane Infectious Diseases).
• Dr Kerry Dwan (Poster presentation: Reporting of Risk of bias 2 (ROB2) in Cochrane protocols and reviews.
• Tilly Fox (Oral presentation: Misinformation in COVID-19: nimble innovation within Cochrane to appraise the source.
   

In this article, Vittoria Lutje (CIDG Information Specialist), Marty Chaplin (CIDG Statistical Editor), and Kerry Dwan (Senior Lecturer in Evidence Synthesis, LSTM) reflect on their experiences and highlights.

READ-It Partner: CMC Vellore

CMC Vellore held the launch of the new Centre for Guidelines Development (CGD) in Vellore on 27th July 2023 and a workshop on systematic guideline and guideline development on 28th July 2023. READ-It Partners from the CIDG, University College London (UCL), Stellenbosch University (SU), and the South African Medical Research Council (SAMRC), and members of the READ-It Advisory Group attended the launch both virtually and in person. CIDG staff Rebecca Kuehn, Marty Chaplin, and Vittoria Lutje, and CIDG Editors Paul Garner and Sandy Oliver provided lectures on systematic review methodology from conception through to publication and on the importance of evidence-informed guidelines.

Cochrane Emeritus and Lifetime Membership Awards

Since 2022, Cochrane has bestowed new lifetime and emeritus memberships, recognizing the extraordinary contributions of individuals who have made an exceptional, long-standing contribution to Cochrane’s work and leadership. Three CIDG Editors were recognized at this year’s Cochrane Colloquium for their outstanding work.

Paul Garner was awarded Emeritus Cochrane Membership, for his significant long-standing contribution to the leadership of the organization.

Patricia Graves and Karen Steingart were awarded Lifetime Cochrane Membership, which is given to individuals at all levels of the organization who have made an exceptional, long-standing commitment to Cochrane's work.

We congratulate Paul, Patricia, and Karen on these well-deserved awards. Read the full article on the Cochrane website.

Cochrane Protocols, Reviews, and Updates in 2023

As of December 2023, the CIDG published 6 new Cochrane reviews, 1 updated Cochrane review, and 6 Cochrane protocols on the Cochrane Library. Click each title below to access the full-text open access article.

New reviews

1. Taylor M, Tapkigen J, Ali I, Liu Q, Long Q, Nabwera H. The impact of growth monitoring and promotion on health indicators in children under five years of age in low‐ and middle‐income countries. Read the LSTM news story.
    
2. Gabaldón Figueira JC, Wagah MG, Adipo LB, Wanjiku C, Maia MF. Topical repellents for malaria prevention. 
    
3. Fox T, Hunt BJ, Ariens RAS, Towers GJ, Lever R, Garner P, Kuehn R. Plasmapheresis to remove amyloid fibrin(ogen) particles for treating the post‐COVID‐19 condition. Read the LSTM news story.
    
4. Florez ID, Sierra J, Pérez-Gaxiola G. Balanced crystalloid solutions versus 0.9% saline for treating acute diarrhoea and severe dehydration in children.
    
5. Fox T, Gould S, Princy N, Rowland T, Lutje V, Kuehn R. Therapeutics for treating mpox in humans.
    
6. Bauza V, Ye W, Liao J, Majorin F, Clasen T. Interventions to improve sanitation for preventing diarrhoea. 
    

Updated reviews

1. Reis S, Metzendorf M-I, Kuehn R, Popp M, Gagyor I, Kranke P, Meybohm P, Skoetz N, Weibel S. Nirmatrelvir combined with ritonavir for preventing and treating COVID‐19. 
    

New Protocols

1. Toriro R, Nevin W, Kuehn R, Ryan H, Beeching N, Fletcher T, Burns D. Antibiotic treatment to reduce the duration and severity of travellers’ diarrhoea.
    
2. Inbaraj LR, Daniel J, Sathya Narayanan MK, Srinivasalu VA, Bhaskar A, Rajendran P, Daniel BD, Epsibha T, Scandrett K, Rose W, Takwoingi Y. TB‐LAMP (loop‐mediated isothermal amplification) for diagnosing pulmonary tuberculosis in children. 
    
3. Vilyte G, Fox T, Rohwer AC, Volmink J, McCaul M. Digital devices for tuberculosis treatment adherence.
    
4. Gloeck NR, Leong T, Iwu-Jaja CJ, Katoto Pd, Kredo T, Wiysonge CS. Typhoid conjugate vaccines for preventing typhoid fever (enteric fever).
    
5. Fox T, Sguassero Y, Chaplin M, Rose W, Doum D, Arevalo-Rodriguez I, Villanueva G. Wolbachia ‐carrying Aedes mosquitoes for preventing dengue infection.
    
6. Inbaraj LR, Daniel J, Rajendran P, Bhaskar A, Srinivasalu VA, Narayanan MKS, Shewade HD, Kirubakaran R, Scandrett K, Malaisamy M, Takwoingi Y, Padmapriyadarsini C. Truenat MTB assays for pulmonary tuberculosis and rifampicin resistance in adults.
    

Other publications

In addition, CIDG editorial base staff were involved as authors on the following publications.

1. Moore, THM, Higgins, JPT, Dwan, K. Ten tips for successful assessment of risk of bias in randomized trials using the RoB 2 tool: early lessons from Cochrane.  Cochrane Evidence Synthesis and Methods. 2023; 1:e12031. DOI: 10.1002/cesm.12031
    
2. Page MJ, Sterne JAC, Boutron I, Hróbjartsson A, Kirkham JJ, Li T, et al. ROB-ME: a tool for assessing risk of bias due to missing evidence in systematic reviews with meta-analysis BMJ. 2023;383:e076754. doi: 10.1136/bmj-2023-076754
    
3. Gallardo-Gómez D, Pedder H, Welton NJ, Dwan K, Dias S. Variability in meta-analysis estimates of continuous outcomes using different standardization and scale-specific re-expression methods. Journal of Clinical Epidemiology. 2023;165:111213. DOI: 10.1016/j.jclinepi.2023.11.003
    
4. Chaplin M, Dwan K. Cluster-randomized controlled trials: a tutorial (2023). Cochrane Evidence Synthesis and Methods, Volume 1, Issue 7. DOI: 10.1002/cesm.1202
    
5. Woodrow M, Carey C, Ziauddeen N, Thomas R, Akrami A, Lutje V, et al (2023) Systematic review of the prevalence of long COVID. Open Forum Infectious Diseases 10(7): ofad233, DOI: 10.1093/ofid/ofad233
    
6. Shringarpure K, Gurumurthy M, Sagili KD, Taylor M, Garner P, Tonsing J, et al (2023). Patient adherence to tuberculosis treatment in the Indian subcontinent: systematic review and meta-synthesis of qualitative research BMJ Open;13:e063926. DOI: 10.1136/bmjopen-2022-063926
    
7. Kuehn R, Fox T, Guyatt G, Lutje V, Gould S (2023) ‘Infection prevention and control measures to reduce the transmission of mpox: a systematic review’. medRxiv 2023.02.13.23285871; DOI: 10.1101/2023.02.13.23285871
    

Podcast

• Listen to Tilly Fox, lead author on the review and CIDG Review Synthesis Delivery Specialist, describe the latest findings from the 2022 updated Cochrane review ‘House modifications for preventing malaria’ on this Cochrane Podcast. 
   

Cochrane Editorial

• Cochrane at 30: what our 30th year can tell us about the future. This editorial features several CIDG reviews, including 'Topical repellents for malaria prevention', ‘Interventions to improve sanitation for preventing diarrhoea’, and 'The impact of growth monitoring and promotion on health indicators in children under five years of age in low‐ and middle‐income countries'. 

The CIDG editorial base will close at 5pm Tuesday 19th December 2023, and re-open on Tuesday 2nd January 2024.

We look forward to sharing more publications and developments with you in 2024.

With best wishes from the CIDG editorial team