Introduction Snakebite is a neglected tropical disease that leads to more than 120,000 deaths every year. In 2019, World Health Organization (WHO) launched a strategy to decrease its global burden by 2030. There is a range of issues around different interventions for the management of snakebite. Decisions around these interventions should be informed by evidence from systematic reviews (SR). Methods An overview of SRs was conducted by searching 12 electronic databases, PROSPERO, contacting experts and screening the bibliography of included reviews. Screening, data extraction, and quality assessment (through AMSTAR-2) was done by at least two overview authors independently with discrepancies sorted by consensus. A narrative synthesis was conducted. Principle findings The overview found 13 completed SRs that has looked at various aspects of management of snakebite envenomation. There was one SR on first aid, nine on effectiveness and safety of snake anti-venom (SAV), two on drugs to prevent adverse reactions due to SAV therapy, and one on surgical interventions for management of snakebite envenomation. All, except one, SR was appraised to have critically low confidence as per AMSTAR-2 Criteria. Evidence base was restricted to few studies for most interventions. Discussion High quality evidence from SRs is required to inform guidelines and health system decisions which can bring down the burden of snakebite. The review indicates the need to fund high-quality SRs, evidence gaps and core outcome sets which can inform guideline recommendations, funding priorities for conduct of future trials. Variation in species distribution as well as intra-species variation in venom composition implies the need for conduct of region or, nation or state (sub-national) specific randomised controlled trials and SRs on different SAVs and their dosing regimens.

Leptospirosis is an emerging public health problem in India. We developed an evidence gap map (EGM) on prevention, control and management of leptospirosis in India to inform research priorities. The EGM framework was developed in consultation with stakeholders and noted key parameters to influence state and national level research priorities. We searched six electronic databases and three relevant websites and included 27 studies (humans, 23; animals, 4; both, 0). Most studies (17/27 [63%]) were from three high-burden states. Controlled clinical trials (non-randomised, 6/27 [22%]; randomised, 2/27 [7%]) and pre–post studies (6/27 [22%]) suitable for evaluating interventions were sparse. Only 26% studies (6/23 human studies) included high-risk groups like animal caretakers, tribal people, relief/sanitation workers, pregnant women and people from slums. Nearly 56% of studies (15/27) evaluated pharmacological interventions at an individual level. Community-level interventions were limited (4/27 [15%]) with no studies on vaccination, personal protection, antibiotic policy or water, sanitation and hygiene interventions. Health systems and policy or multicomponent studies were rare (5/27 [19%]) with no reporting of key outcomes like healthcare coverage, quality of care and other relevant outcomes to evaluate interventions. There is a need for prioritising research to evaluate prevention and control interventions, including the One Health approach. Embedding national-level EGMs for research prioritisation exercises should be considered.

Leptospirosis is a zoonotic disease of public health importance in India. A country-level evidence gap map was developed to identify gaps on epidemiology of leptospirosis. It is the first such on leptospirosis globally and on any single disease condition in India. The steps for development of evidence gap map were development of a framework to map evidence, retrieval of evidence, data extraction parameters and mapping of available evidence in evidence gap map framework. The prevalence evidence gap map consisted of 157 studies (102 in humans, 55 in animals, and 12 in both). The evidence gap map on risk factors had 120 studies (102 in humans, 11 in animals and 7 in both). There were inter-state differences in availability of research and disparity between animal and human research. Research on high-risk groups was limited and studies did not use the One Health approach to identify epidemiology, which can help understand the issue more comprehensively. The study demonstrates the potential of evidence gap maps to inform research priorities.

Background: Tobacco consumption is a leading preventable cause of disease and premature deaths. In India bidis are the most common form of smoking tobacco product. Bidi manufacturing is an agro-forest based cottage industry and is generally rolled at home. These workers are exposed to nicotine, tar and other particles through skin leading to occupational health risks in not only themselves but also in their families and communities. There are concerns on environmental risks of bidi manufacturing in home too. Aim: To assess the environmental risks and occupational health hazards of bidi workers and their communities in India. Method: We will conduct a scoping review to identify, map and analyse evidence around environmental risks and occupational health hazards in bidi workers and their families and communities. We will search in seven electronic databases (PubMed, EMBASE+EMBASE Classic, CINAHL, Environment complete-EBSCO, GreenFILE-EBSCO, Web of Science and WHO-IRIS). Screening will be done independently by at least two reviewers, with disagreements resolve by consensus. We will extract data for the included studies using a standardised data extraction in an independent fashion, with disagreements resolved by consensus. We will conduct a narrative synthesis.

Introduction: A core outcome set (COS) is a minimal list of consensus outcomes that should be used in all intervention research in a specific domain. COS enhance the ability to undertake meaningful comparisons and to understand the benefits or harms of different treatments. A first step in developing a COS is to identify outcomes that have been used previously. We did this global systematic review to provide the foundation for development of a region-specific COS for snakebite envenomation.  Methods: We searched 15 electronic databases, eight trial registries, and reference lists of included studies to identify reports of relevant trials, protocols, registry records and systematic reviews. We extracted verbatim data on outcomes, their definitions, measures, and time-points. Outcomes were classified as per an existing outcome taxonomy, and we identified unique outcomes based on similarities in the definition and measurement of the verbatim outcomes. Results: We included 107 records for 97 studies which met our inclusion criteria. These reported 538 outcomes, with a wide variety of outcome measures, definitions, and time points for measurement. We consolidated these into 88 unique outcomes, which we classified into core areas of mortality (1, 1.14 %), life impact (6, 6.82%), resource use (15, 17.05%), adverse events (7, 7.95%), physiological/clinical (51, 57.95%), and composite (8, 9.09%) outcomes. The types of outcomes varied by the type of intervention, and by geographic region. Only 15 of the 97 trials (17.04%) listed Patient Related Outcome Measures (PROMS). Conclusion: Trials evaluating interventions for snakebite demonstrate heterogeneity on outcomes and often omit important information related to outcome measurement (definitions, instruments, and time points). Developing high quality, region-specific COS for snakebite could inform the design of future trials and improve outcome reporting. Measurement of PROMS, resource use and life impact outcomes in trials on snakebite remains a gap.