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. 2022 May 28;14(6):376.
doi: 10.3390/toxins14060376.

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

Gisele Dos Santos Rocha  1   2 , Altair Seabra Farias  1   2 , João Arthur Alcântara  1   2 , Vinícius Azevedo Machado  1   2 , Felipe Murta  1   2 , Fernando Val  1   2 , Joseir Saturnino Cristino  1   2 , Alícia Cacau Santos  1   2 , Mena Bianca Ferreira  1   2 , Leonardo Marques  1   2 , Yasmim Vieira Rocha  1   2 , André Sachett  1   2 , Mailma Costa Almeida  1   2 , Aline Alencar  1   2 , Lisele Brasileiro  1   2 , Érica da Silva Carvalho  1   2 , Pedro Ferreira Bisneto  1   2   3 , Marcus Lacerda  1   2   4 , Anna Tupetz  5 , Catherine A Staton  5 , João R N Vissoci  5 , Elizabeth Teixeira  1 , Charles J Gerardo  5 , Fan Hui Wen  6 , Jacqueline Sachett  1   2   7 , Wuelton Monteiro  1   2
Affiliations

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

Gisele Dos Santos Rocha et al. Toxins (Basel). .

Abstract

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.

Keywords: antivenom; clinical practice guideline; health education; snakebite; validation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Methods overview for development and validation of the clinical practice guideline (CPG). MoH: Brazilian Ministry of Health; LWCT: Lee–White clotting time test.
See this image and copyright information in PMC

References

    1. World Health Organization What Is Snakebite Envenoming? 2020. [(accessed on 9 August 2020)]. Available online: https://www.who.int/snakebites/disease/en/
    1. Gutiérrez J.M., Calvete J.J., Habib A.G., Harrison R.A., Williams D.J., Warrell D.A. Snakebite envenoming. Nat. Rev. Dis. Primers. 2017;5:17079. doi: 10.1038/nrdp.2017.79. - DOI - PubMed
    1. Monteiro W.M., Farias A.S., Val F., Neto A.V.S., Sachett A., Lacerda M., Sampaio V., Cardoso D., Garnelo L., Vissoci J.R.N., et al. Providing antivenom treatment access to all Brazilian amazon indigenous areas: “every life has equal value”. Toxins. 2020;12:772. doi: 10.3390/toxins12120772. - DOI - PMC - PubMed
    1. Williams D.J., Faiz M.A., Abela-Ridder B., Ainsworth S., Bulfone T.C., Nickerson A.D., Habib A.G., Junghanss T., Fan H.W., Turner M., et al. Strategy for a globally coordinated response to a priority neglected tropical disease: Snakebite envenoming. PLoS Negl. Trop. Dis. 2019;21:e0007059. doi: 10.1371/journal.pntd.0007059. - DOI - PMC - PubMed
    1. Fan H.W., Monteiro W.M. History and perspectives on how to ensure antivenom accessibility in the most remote areas in Brazil. Toxicon. 2018;151:15–23. doi: 10.1016/j.toxicon.2018.06.070. - DOI - PubMed

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