E-SRIC is part of a wider network of African snakebite research and intervention centres – currently in Kenya, Nigeria and soon to be Ghana.
More info to follow.
LINKS:
Kenya snakebite research and intervention center (K-SRIC) – https://ksric-asrg.org/
Background:
Eswatini Antivenom Foundation – Snake Antivenom Clinical Trial Development Project
Background
Snakebite envenoming is recognised by the World Health Organisation (WHO) as a neglected tropical disease that is accountable for suffering, permanent disabilities and death. This medical threat is responsible for approximately 2.7 million cases of envenoming, 400 000 disabilities and 81 000–138 000 deaths a year, globally. It predominantly affects those in the tropical and sub-tropical regions, and particularly the poor and rural communities where access to health care can be a challenge.
Eswatini is no exception to this. Being a sub Saharan country with a large rural population, Eswatini’s preliminary data estimates over 500 people are bitten by snakes annually. The Eswatini Ministry of Health (MoH) has followed WHO’s lead and officially classified snakebite as a neglected tropical disease.
The Eswatini Antivenom Foundation (EAF) is a non-profit organization which aims to raise funds to treat snakebite victims through the purchase of polyvalent anti-venom and other medical supplies necessary for snakebite treatment. In addition, the Foundation facilitates educational sessions for schools, companies and communities to teach correct first-aid and medical treatment of snake bites.
EAF in collaboration with MoH and the Liverpool School of Tropical Medicine (LSTM) are currently involved in an Antivenom Clinical Trial Development project. The project will explore and prepare Eswatini to host potential clinical trial(s) for critically needed new snake anti-venoms for victims.
The project has four objectives that are structured across four work packages as follows:
- Determine location and number of snakebite cases in Eswatini for enrolment into a potential trial.
The objective of this work package is to establish the snakebite burden in Eswatini. Details of clinical cases presenting to 15 health centres and hospitals across Eswatini with confirmed and/or suspected snakebites are recorded in the Eswatini Snakebite Data Collection tool. EAF is currently in discussions with the MoH-NTD in rolling out this form to more health facilities in Eswatini.
- Assess the clinical, logistic and governance capacity for potential clinical trials.
This work package will assess the readiness and needs of Eswatini health facilities to participate in a clinical trial through a survey. Fifteen health centres and hospitals in Eswatini were surveyed in 2020 and analysis of results is in progress.
- Identify the most appropriate antivenoms for a clinical trial.
Several antivenom products against African snakes will be pre-clinically tested for efficacy in comparison to the antivenom currently used in Eswatini. This testing will be done in LSTM laboratories in the UK.
- Assess the natural history of venom-induced necrosis and potential outcome measures in a prospective clinical observation study of patients envenomed by cytotoxic snakes.
This work package seeks to better understand the efficacy of the existing antivenom in the treatment of bites from cytotoxic snake venoms, particularly from the Mozambique Spitting Cobra (Mfeti) which is responsible for most bites in Eswatini and causes local tissue damage. The activity will develop indicators to measure efficacy of antivenoms for any follow-on clinical trials. Nine health facilities across all four regions of Eswatini are participating in this observational study. The study began in October 2020 and is expected to end April 2021.
