Journal Article > CommentaryFull Text
Emerg Med J. 21 August 2024; Volume 41 (Issue 9); 560.; DOI:10.1136/emermed-2024-214173
Potet J
Emerg Med J. 21 August 2024; Volume 41 (Issue 9); 560.; DOI:10.1136/emermed-2024-214173
Journal Article > CommentaryFull Text
Toxicon: X. 26 February 2023; Volume 18; 100152.; DOI:10.1016/j.toxcx.2023.100152
Dalhat MM, Potet J, Mohammed A, Chotun N, Tesfahunei HA, et al.
Toxicon: X. 26 February 2023; Volume 18; 100152.; DOI:10.1016/j.toxcx.2023.100152
Africa remains one of the regions with the highest incident and burden of snakebite. The goal of the World Health Organization to halve the global burden of snakebite by 2030 can only be achieved if sub-optimal access to antivenoms in the most affected regions is addressed. We identified upstream, midstream, and downstream factors along the antivenom value chain that prevent access to antivenoms in the African region. We identified windows of opportunities that could be utilized to ensure availability, accessibility, and affordability for snakebite endemic populations in Africa. These include implementation of multicomponent strategies such as intensified advocacy, community engagement, healthcare worker trainings, and leveraging the institutional and governance structure provided by African governments to address the challenges identified.
Journal Article > CommentaryFull Text
Toxicon: X. 21 December 2022; Volume 17; 100146.; DOI:10.1016/j.toxcx.2022.100146
Potet J, Singh SN, Ritmeijer KKD, Sisay K, Alcoba G, et al.
Toxicon: X. 21 December 2022; Volume 17; 100146.; DOI:10.1016/j.toxcx.2022.100146
The medical humanitarian organization Médecins Sans Frontières (MSF) provides medical care in more than 70 countries and admits more than 7000 cases of snakebite in its facilities each year.
We describe our activities against snakebite in three African countries: Central African Republic, South Sudan and Ethiopia, in which different models of care have been developed. A standard protocol using two different antivenoms depending on the patient's syndrome has been introduced, and a simple blood coagulation test is performed to detect venom-induced coagulopathy. Other services, including surgery for necrotizing wounds, are offered in the facilities where MSF admits a large number of snakebite patients. All services, including provision of antivenom, are offered free-of-charge in MSF-supported facilities. Community-based activities focusing on preventive measures and prompt transport to hospital have been developed in a few MSF projects.
The provision of quality care and treatment, including effective antivenoms, without out-of-pocket payments by the patients, probably explains why MSF has admitted an increasing number of snakebite victims over the last years. This model requires significant resources and monitoring, including regular training of healthcare workers on treatment protocols and a considerable budget for antivenom procurement.
We describe our activities against snakebite in three African countries: Central African Republic, South Sudan and Ethiopia, in which different models of care have been developed. A standard protocol using two different antivenoms depending on the patient's syndrome has been introduced, and a simple blood coagulation test is performed to detect venom-induced coagulopathy. Other services, including surgery for necrotizing wounds, are offered in the facilities where MSF admits a large number of snakebite patients. All services, including provision of antivenom, are offered free-of-charge in MSF-supported facilities. Community-based activities focusing on preventive measures and prompt transport to hospital have been developed in a few MSF projects.
The provision of quality care and treatment, including effective antivenoms, without out-of-pocket payments by the patients, probably explains why MSF has admitted an increasing number of snakebite victims over the last years. This model requires significant resources and monitoring, including regular training of healthcare workers on treatment protocols and a considerable budget for antivenom procurement.
Journal Article > CommentaryFull Text
PLoS Negl Trop Dis. 17 November 2022; Volume 16 (Issue 11); e0010897.; DOI:10.1371/journal.pntd.0010897
Gutiérrez JM, Borri J, Giles-Vernick T, Duda R, Habib AG, et al.
PLoS Negl Trop Dis. 17 November 2022; Volume 16 (Issue 11); e0010897.; DOI:10.1371/journal.pntd.0010897
Journal Article > CommentaryFull Text
BMJ Glob Health. 25 October 2021; Volume 6 (Issue 10); e006913.; DOI:10.1136/bmjgh-2021-006913
Martins D, Ribeiro I, Potet J
BMJ Glob Health. 25 October 2021; Volume 6 (Issue 10); e006913.; DOI:10.1136/bmjgh-2021-006913
SUMMARY POINTS
• Despite inherent differences, Snakebite Envenoming and COVID-19 have much in common in terms of research and development (R&D) challenges and opportunities.
• Both crises require a diversified portfolio of R&D solutions, ranging from diagnostics to treatments, that can effectively work and be accessible in different resource settings.
• Collaborative clinical research and streamlined regulatory pathways are critical to accelerate these candidates in the R&D pipeline.
• Transformative progress is possible with a concerted approach that aligns strong political will, coordinated financing and the needs of the most marginalised communities.
• Despite inherent differences, Snakebite Envenoming and COVID-19 have much in common in terms of research and development (R&D) challenges and opportunities.
• Both crises require a diversified portfolio of R&D solutions, ranging from diagnostics to treatments, that can effectively work and be accessible in different resource settings.
• Collaborative clinical research and streamlined regulatory pathways are critical to accelerate these candidates in the R&D pipeline.
• Transformative progress is possible with a concerted approach that aligns strong political will, coordinated financing and the needs of the most marginalised communities.
Journal Article > CommentaryFull Text
PLoS Negl Trop Dis. 13 December 2012; Volume 6 (Issue 12); DOI:10.1371/journal.pntd.0001950
Hasker E, Lutumba P, Chappuis F, Kande V, Potet J, et al.
PLoS Negl Trop Dis. 13 December 2012; Volume 6 (Issue 12); DOI:10.1371/journal.pntd.0001950
Journal Article > LetterFull Text
BMJ. 30 September 2014; Volume 349; DOI:10.1136/bmj.g5861
Reid J, Potet J, Athersuch K, Grovestock M, Sanjuan J
BMJ. 30 September 2014; Volume 349; DOI:10.1136/bmj.g5861
Journal Article > ResearchFull Text
N Engl J Med. 7 January 2016; Volume 374 (Issue 1); 23-32.; DOI:10.1056/NEJMoa1504605
Gignoux EM, Azman AS, de Smet M, Azuma P, Massaquoi M, et al.
N Engl J Med. 7 January 2016; Volume 374 (Issue 1); 23-32.; DOI:10.1056/NEJMoa1504605
BACKGROUND
Malaria treatment is recommended for patients with suspected Ebola virus disease (EVD) in West Africa, whether systematically or based on confirmed malaria diagnosis. At the Ebola treatment center in Foya, Lofa County, Liberia, the supply of artemether–lumefantrine, a first-line antimalarial combination drug, ran out for a 12-day period in August 2014. During this time, patients received the combination drug artesunate–amodiaquine; amodiaquine is a compound with anti–Ebola virus activity in vitro. No other obvious change in the care of patients occurred during this period.
METHODS
We fit unadjusted and adjusted regression models to standardized patient-level data to estimate the risk ratio for death among patients with confirmed EVD who were prescribed artesunate–amodiaquine (artesunate–amodiaquine group), as compared with those who were prescribed artemether–lumefantrine (artemether–lumefantrine group) and those who were not prescribed any antimalarial drug (no-antimalarial group).
RESULTS
Between June 5 and October 24, 2014, a total of 382 patients with confirmed EVD were admitted to the Ebola treatment center in Foya. At admission, 194 patients were prescribed artemether–lumefantrine and 71 were prescribed artesunate–amodiaquine. The characteristics of the patients in the artesunate–amodiaquine group were similar to those in the artemether–lumefantrine group and those in the no-antimalarial group. A total of 125 of the 194 patients in the artemether–lumefantrine group (64.4%) died, as compared with 36 of the 71 patients in the artesunate–amodiaquine group (50.7%). In adjusted analyses, the artesunate–amodiaquine group had a 31% lower risk of death than the artemether–lumefantrine group (risk ratio, 0.69; 95% confidence interval, 0.54 to 0.89), with a stronger effect observed among patients without malaria.
CONCLUSIONS
Patients who were prescribed artesunate–amodiaquine had a lower risk of death from EVD than did patients who were prescribed artemether–lumefantrine. However, our analyses cannot exclude the possibility that artemether–lumefantrine is associated with an increased risk of death or that the use of artesunate–amodiaquine was associated with unmeasured patient characteristics that directly altered the risk of death.
Malaria treatment is recommended for patients with suspected Ebola virus disease (EVD) in West Africa, whether systematically or based on confirmed malaria diagnosis. At the Ebola treatment center in Foya, Lofa County, Liberia, the supply of artemether–lumefantrine, a first-line antimalarial combination drug, ran out for a 12-day period in August 2014. During this time, patients received the combination drug artesunate–amodiaquine; amodiaquine is a compound with anti–Ebola virus activity in vitro. No other obvious change in the care of patients occurred during this period.
METHODS
We fit unadjusted and adjusted regression models to standardized patient-level data to estimate the risk ratio for death among patients with confirmed EVD who were prescribed artesunate–amodiaquine (artesunate–amodiaquine group), as compared with those who were prescribed artemether–lumefantrine (artemether–lumefantrine group) and those who were not prescribed any antimalarial drug (no-antimalarial group).
RESULTS
Between June 5 and October 24, 2014, a total of 382 patients with confirmed EVD were admitted to the Ebola treatment center in Foya. At admission, 194 patients were prescribed artemether–lumefantrine and 71 were prescribed artesunate–amodiaquine. The characteristics of the patients in the artesunate–amodiaquine group were similar to those in the artemether–lumefantrine group and those in the no-antimalarial group. A total of 125 of the 194 patients in the artemether–lumefantrine group (64.4%) died, as compared with 36 of the 71 patients in the artesunate–amodiaquine group (50.7%). In adjusted analyses, the artesunate–amodiaquine group had a 31% lower risk of death than the artemether–lumefantrine group (risk ratio, 0.69; 95% confidence interval, 0.54 to 0.89), with a stronger effect observed among patients without malaria.
CONCLUSIONS
Patients who were prescribed artesunate–amodiaquine had a lower risk of death from EVD than did patients who were prescribed artemether–lumefantrine. However, our analyses cannot exclude the possibility that artemether–lumefantrine is associated with an increased risk of death or that the use of artesunate–amodiaquine was associated with unmeasured patient characteristics that directly altered the risk of death.
Journal Article > ResearchFull Text
PLoS Negl Trop Dis. 25 October 2018; Volume 12 (Issue 10); DOI:10.1371/journal.pntd.0006716
Taieb F, Dub T, Madec Y, Tondeur L, Chippaux JP, et al.
PLoS Negl Trop Dis. 25 October 2018; Volume 12 (Issue 10); DOI:10.1371/journal.pntd.0006716
Snakebite has only recently been recognized as a neglected tropical disease by the WHO. Knowledge regarding snakebites and its care is poor both at the population level, and at the health care staff level. The goal of this study was to describe the level of knowledge and clinical practice regarding snakebite among health care staff from Cameroon.
Journal Article > CommentaryFull Text
PLoS Negl Trop Dis. 10 September 2015; Volume 9 (Issue 9); DOI:10.1371/journal.pntd.0003896
Alirol E, Lechevalier P, Zamatto F, Chappuis F, Alcoba G, et al.
PLoS Negl Trop Dis. 10 September 2015; Volume 9 (Issue 9); DOI:10.1371/journal.pntd.0003896