Egyptian Pediatric Guidelines are Available Now Online.

Introduction

There is no doubt that the existence of guidelines is an important and great work in any of medical branches especially in the field of pediatrics and neonatology like the National Institute for Health and Care Excellence (Nice guidelines) [1], American Academy of Pediatrics (AAP guidelines) [2], Massachusetts Pediatric Preventive Care (MHQP’s 2021 guidelines) [3], GINA guidelines for management of asthma [4] and European Resuscitation Council Guidelines 2021[5]. 

Especially for novice junior doctors who are looking for the best sources guiding them how to deal with different clinical scenarios especially those whose treatment plans may differ from one country to another in the light of the possible aetiology and outcome.

The idea for the Egyptian pediatric clinical practice guidelines (EPG) project aspired to set standardized safe practice that is pertinent to our community needs. The mission of the Egyptian pediatric clinical practice guidelines (EPG) committee was to oversee the adaptation of guidelines that will improve the practice of pediatricians and neonatologists all over Egypt.

The Egyptian pediatric clinical practice guidelines (EPG) had achieved many guidelines in pediatric pulmonology, infections, immunology, neurology, neonatology, gastroenterology and rheumatology. All revised and approved guidelines are available for download http://epg.edu.eg. [6]

In the field of neonatology; there are 3 guidelines had already finished and published in its final format; these are guidelines for management of neonatal jaundice, neonatal sepsis and feeding of low birth weight infants.

When and how?

About 4 years ago, the Egyptian pediatric clinical practice guidelines committee (EPG) was affiliated with the supreme council of the university hospitals followed by a decision from Minister of Higher Education, Prof. Dr. Khaled Abdel-Ghaffar to establish this committee. The committee is responsible for reviewing the other international guidelines which are approved by major scientific organizations and adapting these guidelines according to our Egyptian resources and facilities.

The committee had already started its work by adapting the other international guidelines with participation of a group of professors from different universities along the Republic and under the leadership of Prof. Dr./Ashraf Abdel Baky, Chair of the Committee and Head of Pediatrics Department AFCM, Prof. of Pediatrics, Ain Shams University. So far, about twenty-two guidelines have been completed in various branches of pediatrics (Neonatology, hematology, neurology, hepatology, pulmonology, infection, gastroenterology and hepatology) and are available on the website http://epg.edu.eg

In the field of neonatology; there were 3 guidelines already finished and published in its final format. Guidelines for neonatal jaundice, neonatal sepsis and feeding of low birth weight infants. I had the honor of joining this distinguished group and participating in the guidelines of feeding of low birth weight infants as well as neonatal sepsis with a group of eminent professors of neonatology from different Egyptian universities.

Challenges and how to overcome?

There are many challenges facing this work including:

First: Despite the achievement of 22 work within 4 years, it is relatively little if we know that we have more than hundred issues that need guidelines. So, the group's work area must be expanded and more professors from different universities should be included and sharing with their time and effort.

Second: The lack of pediatrician awareness of these guidelines, so other ways should be taken to increase the awareness of junior doctors through various media, scientific conferences, workshops, scientific medical journals and other communications are advised.

Third: This work is still optional and not officially adopted by the health care authorities, so these guidelines applied only in few hospitals, especially university hospitals, but what about the other hospitals of the Ministry of Health, Health Insurance and other hospitals. I think that the majority of them did not know anything about these guidelines until the time of writing this editorial.

Fourth: The most important is how to these guidelines to be included in the approved different scientific courses for practical application in various certificates such as undergraduate pediatric course, master's, M.D, fellowship and others medical official courses. Therefore, a joint meeting may be held between the major members of this committee and both the Minister of Health and the Minister of Higher Education to take decisions to approve such guidelines officially in the different scientific courses and certificates.

Other methods for application of such guidelines include, for example, not accrediting any hospital to work within the comprehensive health insurance until after its implementation of these guidelines in its policy. Another idea is to send a printed copy of the latest edition of this guidelines to the different Ministry of Health hospitals, insurance and other health units that provide medical service directly to children especially neonates.

Adding, a ministerial decision was issued to adopt these guidelines as a part of the teaching curriculum for the certificates of medical students and fellowship students may be highly appreciated.

Fifth: updating of these guidelines will be upgraded every 3-years according to the mission of Egyptian pediatric clinical practice guidelines committee (EPG) with more burden.

Finally: I am optimistic about the emergence of this work, and I pray to Allah that this work will be completed in the near future; its application and benefits from its application and lastly, that everyone who contributed to this work will be rewarded well from Allah.

In conclusion

Existence of Egyptian pediatric guidelines is a great scientific work started four years ago and still updating by group of eminent professors from different Egyptian universities who shared as volunteers in this work. Many guidelines in pediatric pulmonology, neonatology and gastroenterology are available now on the website. Many challenges are facing this work which needs more and more effort and decisions to overcome.