Journal of clinical epidemiology 2016 8 23() pii 10.1016/j.jclinepi.2016.07.017
Low and middle-income countries adapt World Health Organization (WHO) guidelines instead of ‘de novo’ development for financial, epidemiological, socio-political, cultural, organizational and other reasons.
To systematically evaluate reported processes employed in the adaptation of WHO guidelines for HIV and Tuberculosis.
We searched three online databases/repositories: USAID AIDSTAR-One National Treatment Database; the AIDSspace Guideline Repository and WHO Database of national HIV and TB guidelines. We assessed the rigor and the quality of reported adaptation methodology using the ADAPTE process as benchmark.
Out of 170 eligible guidelines, only 32 (19%) reported documentation on the adaptation process. The median and inter-quartile range (IQR) of the number of ADAPTE steps fulfilled by the eligible guidelines were 11.5 (10, 13.5) (out of 23 steps). The number of guidelines (out of 32) fulfilling each ADAPTE step was 18 (IQR 5-27). Seventeen out of 32 guidelines (53%) met all steps relevant to the setup phase, while none met all steps relevant to the adaptation phase.
The number of well-documented adaptation methodologies in national HIV and/or TB guidelines is very low. There is a need for the use of standardized, and systematic framework for guideline adaptation and for improved reporting of processes employed.