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Cochrane Database of Systematic Reviews

Ribavirin for treating Crimean Congo haemorrhagic fever

Overview of attention for article published in Cochrane database of systematic reviews, June 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (96th percentile)
  • High Attention Score compared to outputs of the same age and source (83rd percentile)

Mentioned by

news
9 news outlets
twitter
1 X user
facebook
1 Facebook page
wikipedia
1 Wikipedia page

Citations

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60 Dimensions

Readers on

mendeley
243 Mendeley
Title
Ribavirin for treating Crimean Congo haemorrhagic fever
Published in
Cochrane database of systematic reviews, June 2018
DOI 10.1002/14651858.cd012713.pub2
Pubmed ID
Authors

Samuel Johnson, Nicholas Henschke, Nicola Maayan, Inga Mills, Brian S Buckley, Artemisia Kakourou, Rachel Marshall

Abstract

Crimean Congo haemorrhagic fever (CCHF) is a tick-borne disease that occurs in parts of Asia, Europe and Africa. Since 2000 the infection has caused epidemics in Turkey, Iran, Russia, Uganda and Pakistan. Good-quality general supportive medical care helps reduce mortality. There is uncertainty and controversy about treating CCHF with the antiviral drug ribavirin. To assess the effects of ribavirin for treating people with Crimean Congo haemorrhagic fever. We searched the Cochrane Infectious Diseases Group Specialized Register; the Central Register of Controlled Trials (CENTRAL); MEDLINE (PubMed); Embase (OVID); Science Citation Index-Expanded, Social Sciences Citation index, conference proceedings (Web of Science); and CINAHL (EBSCOHost). We also searched the WHO International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for trials in progress. We conducted all searches up to 16 October 2017. We also contacted experts in the field and obtained further studies from these sources. We evaluated studies assessing the use of ribavirin in people with suspected or confirmed Crimean Congo haemorrhagic fever. We included randomised control trials (RCTs); non-randomised studies (NRSs) that included more than 10 participants designed as cohort studies with comparators; and case-control studies. Two review authors assessed eligibility, risk of bias, and extracted data. For non-randomized studies we used the ROBINS-I tool to assess risk of bias. The main effects analysis included all studies where we judged the risk of bias to be low, moderate or high. We summarized dichotomous outcomes using risk ratios (RRs) and continuous outcomes using mean differences (MDs), and used meta-analyses where appropriate. We carried out a subsidiary appraisal and analysis of studies with critical risk of bias for the primary outcome, as these are often cited to support using ribavirin. For the main effects analysis, five studies met our inclusion criteria: one RCT with 136 participants and four non-randomized studies with 612 participants. We excluded 18 non-randomized studies with critical risk of bias, where none had attempted to control for confounding.We do not know if ribavirin reduces mortality (1 RCT; RR 1.13, 95% confidence interval (CI) 0.29 to 4.32; 136 participants; very low-certainty evidence; 3 non-randomized studies; RR 0.72, 95% CI 0.41 to 1.28; 549 participants; very low-certainty evidence). We do not know if ribavirin reduces the length of stay in hospital (1 RCT: mean difference (MD) 0.70 days, 95% CI -0.39 to 1.79; 136 participants; and 1 non-randomized study: MD -0.80, 95% CI -2.70 to 1.10; 50 participants; very low-certainty evidence). We do not know if it reduces the risk of patients needing platelet transfusions (1 RCT: RR 1.23, 95% CI 0.77 to 1.96; 136 participants; very low-certainty evidence). For adverse effects (including haemolytic anaemia and a need to discontinue treatment), we do not know whether there is an increased risk with ribavirin in people with CCHF as data are insufficient.We do not know if adding ribavirin to early supportive care improves outcomes. One non-randomized study assessed mortality in people receiving ribavirin and supportive care within four days or less from symptom onset compared to after four days since symptom onset: mortality was lower in the group receiving early supportive care and ribavirin, but it is not possible to distinguish between the effects of ribavirin and early supportive medical care alone.In the subsidiary analysis, 18 studies compared people receiving ribavirin with those not receiving ribavirin. All had a critical risk of bias due to confounding, reflected in the mortality point estimates favouring ribavirin. We do not know if ribavirin is effective for treating Crimean Congo haemorrhagic fever. Non-randomized studies are often cited as evidence of an effect, but the risk of bias in these studies is high.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 243 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 243 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 31 13%
Researcher 24 10%
Student > Ph. D. Student 23 9%
Student > Bachelor 22 9%
Other 12 5%
Other 33 14%
Unknown 98 40%
Readers by discipline Count As %
Medicine and Dentistry 50 21%
Nursing and Health Professions 19 8%
Immunology and Microbiology 10 4%
Biochemistry, Genetics and Molecular Biology 9 4%
Social Sciences 8 3%
Other 37 15%
Unknown 110 45%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 69. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 March 2022.
All research outputs
#650,368
of 26,304,916 outputs
Outputs from Cochrane database of systematic reviews
#1,116
of 13,206 outputs
Outputs of similar age
#13,797
of 346,326 outputs
Outputs of similar age from Cochrane database of systematic reviews
#30
of 183 outputs
Altmetric has tracked 26,304,916 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 13,206 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 34.9. This one has done particularly well, scoring higher than 91% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 346,326 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 96% of its contemporaries.
We're also able to compare this research output to 183 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 83% of its contemporaries.