News

Successes, challenges, and stories from the field

Welcome to our dedicated news page, sharing advancements aimed at mitigating acute poisoning in low and middle-income countries. This initiative focuses on developing and implementing strategies to reduce fatalities from acute poisoning through interdisciplinary research and collaboration.

Key areas of our project include:

  • Methanol (Work Package 1): Evaluation of a new diagnostic method for its effectiveness, sensitivity, and cost-efficiency.
  • Pesticides (Work Package 2): Research on the acceptance of pre-hospital antidotes and the epidemiology of occupational poisoning due to modern pesticides.
  • Guidance (Work Package 3): Collaboration with the World Health Organisation to formulate international management guidelines for pesticide poisoning.
  • Research Capacity (Work Package 4): Enhancement of clinical toxicology and public health research capabilities in LMICs through education and practical experience.
  • Poison Information Centres (Work Package 5): Support for the development of LMIC Poison Information Centres.

Stay tuned as we share successes, challenges, and stories from the field, illustrating our journey towards a safer, healthier world free from the threat of acute poisoning.

 

Global Research Academy for Clinical Toxicology Scholarships

Date: August 2024

The NIHR RIGHT4 team is pleased to welcome scholarship recipients to the Global Research Academy for Clinical Toxicology. This initiative supports emerging researchers and practitioners in developing  skills to address toxicological challenges in their regions. By fostering international collaboration and knowledge exchange, the program aims to strengthen global capacity.

Upcoming Webinar Tackles Critical Toxicology Issues in Asia and Middle East

Upcoming Webinar Tackles Critical Toxicology Issues in Asia and Middle East

Date: August 2024

A webinar on September 2, 2024 will address toxicology challenges in Bangladesh and Kuwait. Hosted by MENATOX, the event features experts discussing snakebite management in Bangladesh and emerging street drug trends in Kuwait.

 

Prof Mohammad Abul Faiz will present on snakebite treatment obstacles in resource-limited settings, drawing from a case study of a young farmer with severe symptoms. Dr Abdullatif Aloumi will provide updates on Kuwait's evolving drug landscape and the KPCC's role in addressing it.

 

The webinar aims to improve regional preparedness for chemical emergencies, overdose prevention, and toxicological outbreaks. It's part of a series covering toxicology issues across Asia, the Middle East, Africa and Europe.

 

Interested participants can register via the provided Zoom link. For more information, visit the official website at www.apamt.org.

Global Perspectives on Poison Control: Innovating for Rapid Response

Global Perspectives on Poison Control: Innovating for Rapid Response

Date: July 2024

This upcoming webinar will bring together experts in toxicology and poison control to address challenges in monitoring and responding to drug threats. Scheduled for August 5, 2024, the event will feature presentations from Ms. Carine Marks of South Africa and Prof. Shaun Greene from Australia, offering insights into the development of poison centers in Africa and drug monitoring systems in Victoria, respectively.

 

The webinar highlights the limitations of traditional data sources in tracking new psychoactive substances and presents new approaches to overcome these challenges. Prof. Greene will discuss a system implemented in Victoria that collects comprehensive clinical and analytical data from 17 emergency departments, enabling rapid identification and response to potentially harmful substances. This system has already analysed over 2,500 acute cases, leading to the detection of 66 distinct NPS and the issuance of critical public health alerts.

 

Organised by NIHR, APAMT, and MENATOX, the webinar aims to foster global collaboration in addressing complex issues surrounding drug toxicity and poisoning.

 

For registration and more information, visit www.apamt.org or contact: contactapamt@gmail.com.

Work Package 2a

WP2a: Pesticide Poisoning Surveillance and Pre-Hospital Treatment Study in Sri Lanka

Date: June 2024 

As part of Work Package 2A, an ethnographic study investigates the feasibility and challenges of providing pre-hospital emergency care for pesticide poisoning in rural Anuradhapura District, Sri Lanka. The research, set to conclude its data collection phase by the end of June, focuses on three villages and uses a variety of methods. These include semi-structured interviews with healthcare workers and community members, participatory mapping exercises, focus group discussions, and oral history interviews with individuals affected by pesticide self-poisoning.

 

Data analysis is currently underway, with the possibility of additional field data collection based on initial findings. To further interpret the results, two data analysis workshops are scheduled. The first will take place in Sri Lanka, followed by a session at the University of Edinburgh in early July. These workshops aim to synthesise the ethnographic data and inform potential strategies for improving pesticide poisoning surveillance and pre-hospital treatment in rural communities.

Work Package 2b

WP2b: Prospective Cohort Study on Unintentional Acute Pesticide Poisoning in Rural Sri Lanka

Date: June 2024

This community-based surveillance study investigates unintentional acute pesticide poisoning among pesticide sprayers in Anuradhapura and Vavuniya Districts of Sri Lanka. The research uses a prospective cohort design, following 1,200 purposely selected pesticide sprayers over 30 months.

 

The cohort is stratified into four risk categories based on pesticide exposure levels: medium to high-level sprayers (vegetable, fruit, and field crop farmers), low-level sprayers (paddy farmers), commercial sprayers (daily wage workers), and farm pesticide sprayers (regular farm employees).

 

Data collection began on January 1, 2024, using a web-based tool developed by the Pesticide Action Network. The study includes a baseline survey followed by 14 longitudinal surveys at two-month intervals. As of June 2024, the baseline and two follow-up surveys have been completed, with the third survey set to begin on July 1, 2024.

 

This comprehensive approach aims to provide insights into the prevalence and patterns of acute pesticide poisoning among rural farming communities in Sri Lanka, potentially informing future prevention strategies and policy decisions.

Chile Congress
Carine at the Congress on Toxicology in Developing Countries.

NIHR RIGHT4 Represented at the Congress on Toxicology in Developing Countries (CTDC) in Santiago, Chile

Date: May 2024

In April 2024, Carine Marks (Director, Tygerberg Poison Information Center) had the privilege of attending the Congress on Toxicology in Developing Countries (CTDC) in the city of Santiago, Chile. This event, sponsored by the International Union of Toxicology (IUTOX), brought together toxicologists from around the world to discuss the challenges faced by developing nations in the field of toxicology.

 

During the congress, Carine had the opportunity to present on NIHR RIGHT4 Work Package 5, which consists of:

  • Delivering interdisciplinary research addressing acute poisoning in ODA-eligible countries;
  • Increasing knowledge on how and where poisoning occurs;
  • Providing novel tools to diagnose and treat poisoned patients;
  • Generating international guidance on the diagnosis and management of acutely poisoned patients, used by the World Health Oragnization.

 

The poster demonstrated the key findings and implications of the research, generating interest among attendees. Presenting at the CTDC allowed Carine to receive valuable feedback and establish new connections within the toxicology community.

Apply for Scholarships to APAMT in Penang, Malaysia

Date: May 2024

Join us at the G Hotel Gurney in Penang, Malaysia, from November 11-12, 2024, for a series of workshops hosted by the Asia Pacific Association of Medical Toxicology (APAMT) and the University of Edinburgh. This opportunity will allow you to advance your knoweldge, network with peers, and gain hands-on experience in research methods and poison centre operations.

 

We are thrilled to offer a limited number of scholarships to support researchers and professionals from low-and-middle-income countries. These scholarships include attendance at the APAMT conference from November 11-14, a $1000 travel and accommodation grant, and access to the Poison Centre Workshop on November 11 and the Research Training Symposium on November 12. To apply for this scholarship, contact Annie Watt at annie.watt@nhslothian.scot.nhs.uk by July 31, 2024.

Apply for APAMT Researcher and Poison Centre Scholarships
Apply for APAMT Scholarship, due to 31st July 2024

MENATOX Virtual Seminar: 4 March 2024

Date: March 2024

 

The MENATOX Virtual Seminar was held on 4th March 2024 for a practical session on medical toxicology, organised by MENATOX, APAMT, and the NIHR RIGHT4 Project. This online seminar was designed to explore key topics in poison treatment and clinical toxicology. 

 

The session featured two experts in the field. Professor Bruno Mégarbane discussed a challenging case of a patient with multiple health issues who had suffered from self-poisoning. His insights provided a detailed understanding of how to approach complex toxicology cases. Following him, Lucy Shieffelbien provided a virtual tour of the New Zealand National Poisons Centre, identifying the vital work done behind the scenes to manage poisoning cases.

 

This seminar series is valuable for professionals looking to enhance their knowledge in poison control and medical toxicology. Register for future sessions here.

MENATOX 2024: A Global Gathering for Poison Prevention and Care

Date: 11 February 2024

  • On February 11th, 2024, a training workshop was held during the Middle East and North Africa Clinical Toxicology Association (MENATOX) conference in Abu Dhabi, UAE. This event was part of the NIHR RIGHT 4 Preventing Death from Acute Poisoning in Low- and Middle-Income Countries project. Participants in the workshop were those who had received scholarships granted by the NIHR Project to attend MENATOX, along with other attendees interested in toxicology. The majority were those working in or with an interest in toxicology from low- and middle-income countries with participants from countries in Africa, Asia and the Middle East.

     

  • The day was divided into two main sessions. The morning session focused on research capacity, offering presentations and interactive discussions on the role of clinical research and randomised control trials (RCTs) in toxicology. One of the highlights was a presentation on different clinical research designs, providing insights into conducting effective studies. Additionally, this session tackled the serious issue of methanol poisoning by introducing new research and the development of a formate point-of-care test (WP1), which represents an innovative tool in the fight against this type of poisoning.

     

  • In the afternoon, the emphasis shifted to Poison Information Centres (PICs), with discussions on how to develop and train Specialists in Poisons Information (SPIs). The session also covered essential resources needed to start and maintain a PIC, such as Patient Information Databases and Poisons Information Databases. Through interactive discussions and demonstrations, participants were given a practical look at these resources, enhancing their understanding of how to effectively use them.

     

  • The workshop received positive feedback from attendees, demonstrating its success in covering both theoretical and practical aspects of toxicology. It served as an opportunity for participants from low- and middle-income countries to gain valuable knowledge and skills, as well as to network with other professionals in the field. The event highlighted the importance of continuous education and collaboration in advancing the practice of toxicology, particularly in regions most affected by acute poisoning.

 

MENATOX February Group Photo

Upcoming: NIHR RIGHT4 and MENATOX Collaborate to Strengthen Toxicology Research and Poison Information Services

Date: January 2024

To advance research and information sharing, NIHR RIGHT4 will host a post-congress workshop alongside the Middle East and North Africa Clinical Toxicology Association (MENATOX) in Abu Dhabi. Scheduled for 11th February 2024, this presents an opportunity for toxicology professionals to develop their knowledge and connect with peers.

The workshop will commence at the Mezzanine with registration beginning at 8:30 am, followed by an introduction to the NIHR's RIGHT4 project by Professor Michael Eddleston at 9:00 am.

Session Highlights:

  • Session 1: Focus on increasing research capacity through scholarships, mentoring, and clinical trial development. This includes a deep dive into Randomized Controlled Trials (RCTs) design in clinical toxicology, led by Professor Michael Eddleston and Professor Chris Weir.
  • Session 2: Dedicated to building capacity and resilience in Poison Information Centres (PICs). Key speakers include Dr. Euan Sandilands and Dr. Stephanie Hon will cover crucial aspects of PICs and the use of Patient Information Databases.

Participants will have the chance to engage in breakout sessions, including hands-on workshops on RCT design and demonstrations on the use of Poisons Information Databases. These are designed to foster practical skills and encourage collaborative discussions.

Interested individuals who have not yet registered are encouraged to do so. For registration details and further inquiries, participants should follow the link to the program or reach out to Dr Raúl Pardinaz-Solis.

2023 News

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Date: 20 November - 1 December 2023

Poisoning incidents, whether accidental or intentional, pose a significant healthcare challenge globally, and Nigeria is no exception. Recognising the need for specialised knowledge and resources to handle such cases, a select group of professionals from Nigeria underwent a comprehensive training program aimed at establishing and operating a Poison Information Centre in the country. This article delves into the specifics of the training, its participants, and the anticipated impact on Nigeria's healthcare landscape.

The training session was organised at Stellenbosch University's Tygerberg Poisons Information Centre, located in Cape Town, South Africa. This center is a part of the university's Division of Clinical Pharmacology and is known for its expertise in managing poisoning incidents. The training was conducted under the auspices of the NIHR RIGHT4 initiative.

The training spanned two weeks, from 20th November to 1st December 2023. It was strategically scheduled just before the launch of the Toxicology Information Centre in Nigeria, which was set to commence operations on 15th December 2023. This timing ensured that the participants could immediately put their newfound knowledge and skills into practice.

The training session saw the participation of key personnel from the Toxicology Information Centre, Nigeria. The participants included: Anoka A. Njan (Project Lead), Eze Chukwu NWOYE, Auwal Isma’il AHMAD, Mubarak Muhammed ADAMU, Keziah Samson KASSON.

The primary aim of the training was to equip the participants with the necessary knowledge and skills to efficiently manage a Poison Information Centre. The curriculum was tailored to address the unique healthcare challenges and the resource landscape of Nigeria. Key areas of focus included:

  • comprehensive insights into poisons, their sources, and their effects on the human body.
  • developing protocols for managing different poisoning cases, considering the healthcare infrastructure in Nigeria.
  • communication methods for disseminating vital information to the public and healthcare professionals.
  • given resource constraints in LMICs, the training included strategies for optimal resource allocation and management.
  • trained in managing data related to poisoning incidents and conducting research to improve the centre's operations.

The establishment of the Toxicology Information Centre in Nigeria, bolstered by the training at Stellenbosch University, is expected to have a positive impact on the country's healthcare sector. The centre aims to reduce the incidence and mortality from poisoning cases by providing timely and accurate information and intervention strategies. Furthermore, the center is expected to become a point for research and education on poisoning and toxic substances, contributing to the overall health and safety of the Nigerian population.


Nigeria PIC

Date: December 2023

Penang, Malaysia is set to host the 22nd Scientific Congress of the Asia Pacific Association of Medical Toxicology (APAMT) from the 11th to the 14th of November 2024. This congress promises to be a key event, with the theme "Transforming Toxicology Landscape for Safer and Sustainable Tomorrow."

APAMT 2024 will bring together medical professionals, toxicologists, pharmacologists, and researchers. The event is jointly organized by the Malaysian National Poison Centre, Malaysian Society of Toxicology, and the College of Emergency Physicians (Academy of Medicine Malaysia). The congress will include keynote speeches, symposia, workshops, and poster sessions aimed at advancing the knowledge and practice of medical toxicology. The congress will cover dimensions of toxicology, including:

  • the latest on managing acute and chronic poisoning, antidote development, and clinical best practices.
  • the impact of toxins on the environment and public health, and explore measures to mitigate these effects.
  • systems for monitoring and preventing toxic exposures and poisoning incidents.
  • workplace exposures and promote occupational health and safety.
  • the complex interactions between drugs and poisons, focusing on patient safety and therapeutic interventions.

Registration for APAMT 2024 is now open. Financial support may be available for emerging researchers, aimed for toxicologists in low- and middle-income countries who may otherwise be unable to attend. For further information about the application process, contact Dr Raul Pardinaz-Solis.


APAMT

Date: 11 November 2023

In a move to address the pressing issue of methanol poisoning in Bangladesh, the NIHR RIGHT4 project team organised a workshop on November 11, 2023, in Dhaka. The session brought together key national stakeholders to delve into the social and cultural facets of alcohol consumption in Bangladesh and the complex problem of methanol poisoning within this framework.

The workshop, a collaborative effort by the Toxicology Society of Bangladesh (TSB) and the Centre for Injury Prevention and Research, Bangladesh (CIPRB), was chaired by Professor Aniruddha Ghose of Chattogram Medical College and Hospital. The NIHR RIGHT4's Dr. Fazle Rabbi Chowdhury and Dr. Janet Perkins led the workshop, with Professor Md Robed Amin and Professor M A Faiz attending the event as special and chief guests, respectively.

The event was marked by the presence of 14 stakeholders from various sectors, including government, academia, and clinical practice. Their contributions were crucial to understanding the context of methanol poisoning, a topic that, while critical, often remains on the margins of public health discourse.

The NIHR RIGHT4 team presented a comprehensive overview of the methanol poisoning situation in Bangladesh, setting the stage for a proposed rapid ethnographic study. The study's aim is to establish a socially informed approach for testing an innovative rapid diagnostic test, which could significantly improve the diagnosis and treatment of methanol poisoning. Key points included the factors that govern the illicit alcohol market in Bangladesh, the clinical and toxicological aspects of methanol poisoning in the local context, and effective strategies for engaging with communities on the sensitive issue of alcohol consumption and methanol poisoning.

Participants engaged in group work to explore the themes and refine the methodology for the rapid ethnographic study. The collaborative effort underscored the need for a nuanced understanding of the cultural dimensions of alcohol use and the systemic challenges in addressing methanol poisoning.

The workshop concluded with a strong consensus on the importance of the study and the need for community-tailored interventions. The insights garnered from the stakeholders are set to influence the adaptation and fine-tuning of the research protocol for the upcoming ethnographic study.

The NIHR RIGHT4 project team extends its thanks to all the participants whose enthusiasm and insights have laid a strong foundation.


Meeting

Date: June 27-28, 2023

The African Network of Poison Control Centres (ANPCC) convened for its network meeting in Kitwe, Zambia, from June 27 to 28, 2023. Established in 2018, the ANPCC is a organisation supporting World Health Organisation (WHO) Member States in the African Region (AFRO) to bolster their poison prevention and control systems. This meeting in Kitwe was crucial in advancing the network’s goal of reducing the health impacts of chemicals, toxic substances, toxins, and hazardous wastes.

The network meeting brought together representatives from poison control centers across Africa to exchange knowledge and strategies. Ms. Carine Marks, from the Tygerberg Poisons Information Centre in Cape Town, South Africa, and representative of the NIHR RIGHT4 project was among the attendees.

The agenda for the second ANPCC meeting focused on critical aspects of toxicology and poison control:

  • the adoption of standardised toxicovigilance practices.
  • strengthened regional cooperation in data collection and sharing.
  • improved logistical pathways for antidote distribution.
  • enhanced technological infrastructure for poison center operations.
  • strategies to address the root causes of pesticide-related suicides.
  • a clearer understanding of regional toxicological risks and the development of relevant resources.
  • a framework for continuous professional development in toxicology.

The network meeting marked a significant step in the collective effort to strengthen poison control capabilities within the African region. By focusing on capacity building, access to resources, and regional collaboration, the meeting reaffirmed the commitment of member states to safeguarding public health against the risks of poisoning.


Afro Meeting

Date: 25 April 2023

The NIHR has funded five new research projects to help tackle the global burden of unintentional injuries, urgent and emergency care.

Worldwide, more than 5 million people die every year as a result of road traffic accidents, falls, burns, drowning, snakebite and other unintentional injuries. Tens of millions more suffer harm from these injuries, often resulting in life-long disabilities.

Injuries and accidents account for nearly 10% of the global burden of disease, and around 90% of injury-related deaths and disability occur in low and middle income countries (LMICs). However, this area has long been under-researched and under-funded.

The new awards, each of between £1 million and £5 million over four years, are made through the NIHR's Research and Innovation for Global Health Transformation (RIGHT) programme. RIGHT Call 4 was developed by NIHR working with the World Health Organisation (WHO) to fund projects aimed at preventing injury and improving emergency care in LMICs eligible for Official Development Assistance.

Preventing Deaths from Acute Poisoning in Low- and Middle-Income Countries

Professor Michael Eddleston, University of Edinburgh, and Professor Indika Gawarammana, University of Peradeniya, Sri Lanka

Poisoning is a neglected problem that kills more than 300,000 people each year, many of them in LMICs. Prof Eddleston and Prof Gawarammana’s research will focus on two major problems: methanol and occupational pesticide poisoning. They will be studying new tests for methanol poisoning in major hospitals in India and Bangladesh. They will also investigate whether treatment for pesticide poisoning can be made directly available in Sri Lankan villages, before patients are transferred to hospital. Other parts of the work will focus on developing international guidelines with the WHO, and on developing increased capacity for poisoning research and Poison Information Centres worldwide. This work will be a collaboration with partnering institutions in Bangladesh, Sri Lanka, India, Iran, South Africa, China, Australia, Denmark, Norway and the UK over the course of 5 years.

https://www.nihr.ac.uk/news/nihr-research-funding-awarded-to-address-the-global-burden-of-injuries-and-accidents-and-urgent-and-emergency-care/33224


Image

Date: December 2023

A four-day workshop, as part of NIHR RIGHT4, was held in Anuradhapura, Sri Lanka, from December 4-7, 2023. This marked the start of a crucial qualitative data collection phase, aimed at understanding the context of pesticide poisoning, evaluating current healthcare provisions, and the community perception of autoinjector usage in emergency scenarios.

The workshop was attended by 12 Sri Lankan participants, bringing together a diverse group dedicated to addressing this public health issue. Assistant Professor Jane Brandt Sørensen from the University of Copenhagen's Department of Public Health led the team through qualitative and ethnographic methods. Contributing to this were postdoctoral research fellows Janet Perkins (University of Edinburgh), Upul Wickramasinghe (Sri Lanka Ministry of Health), and Manjula Weerasinghe (Rajarata University). This initiative is vital for representing communities where pesticide poisoning poses a significant health challenge. 

The data collection, set to continue over the next six months, will play a crucial role in shaping future strategies to prevent acute poisoning deaths in low- and middle-income countries. The outcomes of this workshop and the subsequent research are anticipated, promising to better healthcare provision and emergency response mechanisms in rural communities.


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