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Validation of a Culturally Relevant Snakebite Envenomation Clinical Practice Guideline in Brazil

2022; Multidisciplinary Digital Publishing Institute; Volume: 14; Issue: 6 Linguagem: Inglês

10.3390/toxins14060376

2072-6651

Gisele dos Santos Rocha, Altair Seabra de Farias, João Arthur Alcântara, Vinícius Azevedo Machado, Felipe Murta, Fernando Val, Joseir Saturnino Cristino, Alícia Cacau Santos, Mena Ferreira, Leonardo Lincoln Gomes Marques, Yasmim Vieira Rocha, André Sachett, Mailma da Costa Almeida, Aline Alencar, Lisele Brasileiro, Érica da Silva Carvalho, Pedro Ferreira Bisneto, Marcus Lacerda, Anna Tupetz, Catherine A. Staton, João Ricardo Nickenig Vissoci, Elizabeth Teixeira, Charles J. Gerardo, Fan Hui Wen, Jacqueline de Almeida Gonçalves Sachett, Wuelton Marcelo Monteiro,

Rabies epidemiology and control

Snakebite envenoming (SBE) is a neglected tropical disease with significant global morbidity and mortality. Even when antivenom is available in low-resource areas, health workers do not receive adequate training to manage SBEs. This study aims to develop and validate a clinical practice guideline (CPG) for SBE management across Brazil. A panel of expert judges with academic and/or technical expertise in SBE management performed content validation. The content validity index (CVI) score was 90% for CPG objectives, 89% for structure and presentation and 92% for relevance and classified the CPG as valid. A semantic validation was performed by analyzing focus group discussions with doctors and nurses from three municipalities of the Brazilian Amazon, after a 5-day meeting during which the CPG was presented. Two central themes emerged: knowledge acquired during the meeting and recommendations for improving the CPG. Based on these results, the CPG was revised into a final version. This study presents the successful development and validation process of a CPG for SBE management, which is targeted to a specific low-resource, high-burden setting. This development and validation process can be adapted to other settings and/or other neglected tropical diseases.