Background: In 2011, Belgian Red Cross developed first aid and prevention guidelines adapted to the sub-Saharan African context, according to the principles of Evidence-Based Practice. In 2016, these guidelines were updated, taking into account the latest scientific evidence, expert opinions and target group preferences, and using a vastly improved methodology.
Objectives: We aimed to assess the impact of this update, by determining how changes in scientific evidence, expert opinions and target group preferences between 2011 and 2016, as well as methodological improvements, led to alterations in the current recommendations and manual.
Methods: Changes in scientific evidence were determined by comparing the number of studies that were included as a basis for the 2011 and 2016 guidelines. Expert opinions were gathered during a 2016 online multidisciplinary African expert panel meeting. Feedback from the target group was collected via African Red Cross societies.
Results: In 2011, 27 topics (e.g. burns, diarrhoea) were addressed using 27 questions and corresponding search strategies. In contrast, during the 2016 update, 114 individual PICO questions (including 50 PICOs with interventions specific to the African context) and search strategies were defined for the same 27 topics, thereby increasing search sensitivity. The total number of studies included as scientific evidence increased from 248 in 2011 to 295 in 2016. This new scientific evidence led to changes in 10 recommendations, of which the majority addressed first aid (2 changes) and prevention (4 changes) of diarrhoea. Four other recommendations were altered because of changes in expert opinions. At the request of the target group, additional background information on several topics was added to the manual.
Conclusions: Updating the African first aid and prevention guidelines has exposed new scientific evidence, fine-tuned expert opinions and revealed new target group preferences. Moreover, methodological improvements have led to more sensitive searches of evidence and identification of additional relevant evidence. A five-year update of evidence-based guidelines is therefore worthwhile and warranted.