Validação dos requisitos mínimos para unidades que realizam tratamento de envenenamentos ofídicos no Brasil

Abstract

Snakebite envenoming’s are classified as a neglected disease with about 2.7 million cases worldwide even though there is already effective treatment and management. In Brazil, an average of 29 thousand cases and 130 deaths are recorded per year, which, the highest incidence is reported in the Amazon associated with the highest rates of permanent complications and lethality, where there are barriers and difficulties in accessing health services. Action plans around the world are created to reduce mortality associated with envenoming, investing in health strategies that ensure access to safe and effective clinical management. In view of this, the aim of this work was to develop and validate an instrument in checklist format for the evaluation of minimum requirements for the storage of antivenom and clinical management offer in public health units in Brazil. The construction of the instrument was carried out by a committee of leaders and researchers in the area, where they stipulated a checklist of potential items and were divided into: Site Information, human resources, equipment, consumables, and medicines necessary for the management of snake envenoming. The validation of this instrument was performed by qualified judges and experts, who were selected by inclusion criteria, validation occurred in two stages, in the first was evaluated item by item according to the type of unit, in the second was performed with the pending validation items and new items included by the judges of the first phase. In this study, as in other validation studies of instruments for health, the knowledge and experience of the judges was considered. 80 items were included in each type of unit, in general, the same items were considered important in the three types of health units. What varied between units was that in Type 1 units an important portion of the items was considered desirable, unlike in Type 2 and 3 units, in which essential items predominated. The validated instrument is an important step towards the decentralization of antivenom treatment to health units in Brazil and will assist in the classification and requirements for the provision of specialized clinical management, thus evidencing the minimum resources necessary for the storage and administration of antivenom.