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


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.

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Journal Article
Rocha G
Farias A
Alcântara J
Machado V
Murta F
Val F
Cristino J
Santos A
Ferreira M
Marques L
Rocha Y
Sachett A
Almeida M
Alencar A
Brasileiro L
Carvalho É
Bisneto P
Lacerda M
Tupetz A
Staton C
Vissoci J
Teixeira E
Gerardo C
Wen F
Sachett J
Monteiro W