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Polyvalent Antivenom (Premium-PANAF) for Snakebite Envenoming in Ethiopia
A Prospective Cohort Study of Polyvalent Antivenom (Premium-PANAF) for Snakebite Envenoming in Ethiopia
Snakebite Envenomation is recognised as a Neglected Tropical Diseases with high lethality in Sub-Saharan Africa. The current syndromic treatment approach is also fraught by supply pipeline constraints and need for cold-chain, thus negatively impacting outcomes in resource limited settings.
Despite the lack of clinical outcome data from studies in humans, after a comprehensive risk-benefit assessment, the World Health Organisation (WHO), in May 2023, recommended the use of Premium-PANAF polyvalent snake antivenom that is lyophilised, and therefore does not require cold-chain conditions. Médecins Sans Frontières (MSF) also updated its treatment protocol with Premium PANAF being standard of care since June 2025 at Abdurafi (Midre Genet) Health Centre in north west Ethiopia.
Real-world effectiveness by means of Phase IV post marketing studies or pharmacovigilance programmes in countries where it has recently been rolled out is not yet available. This prospective observational cohort study, with a capped sample size of 600 patients, would thus provide much needed evidence on the safety and effectiveness of Premium-PANAF in resource limited settings to help inform national and international treatment guidelines.
Studie Overzicht
Toestand
Conditie
Studietype
Inschrijving (Geschat)
Contacten en locaties
Studie Locaties
-
-
Amhara
-
Ābderafī, Amhara, Ethiopië
- Werving
- Abdurafi Health Center
-
Contact:
- Site Principal Investigator
- Telefoonnummer: +251911210229
- E-mail: ethiopia-medco@oca.msf.org
-
-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Kind
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Bemonsteringsmethode
Studie Bevolking
Beschrijving
Inclusion criteria
- Snakebite envenoming patients who receive Premium-PANAF antivenom
- Patients who have given written informed consent .
Exclusion criteria
- Snakebite envenoming patients who do not receive Premium-PANAF antivenom
- Patients referred from other centres who already received other antivenom treatment
- Patients who are unable or unwilling to give informed consent
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
|---|
|
Snakebite Envenomation treated with Premium PANAF
Patients admitted with snakebite envenomation who recieve Premium PANAF antivenom as standard of care and consent for particpation in the study
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Safety (Allergic Reactions)
Tijdsspanne: 6 hours
|
Proportion of patients with severe allergic reactions within 6 hours of antivenom administration according to the Brown grading system
|
6 hours
|
|
Effectiveness (Correction of Coagulopathy)
Tijdsspanne: 6 hours
|
Correction of coagulopathy as measured by the 20-minute whole blood clotting test at 6 hours after antivenom administration
|
6 hours
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Effectiveness (Number of Vials)
Tijdsspanne: 14 days
|
Number of doses (vials) needed to reverse the envenomation syndrome
|
14 days
|
|
Effectiveness (Rescue Treatment)
Tijdsspanne: 14 days
|
Proportion of patients who require rescue treatment with EchiTab-Plus or SAIMR due to lack of responsiveness to Premium-PANAF
|
14 days
|
|
Effectiveness (Mortality)
Tijdsspanne: 42 days
|
Death from any cause within 42 days of treatment with antivenom
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42 days
|
|
Effectiveness (Patient Specific Function Scale)
Tijdsspanne: 42 days
|
Patient-specific Function Scale (PSFS) score
|
42 days
|
|
Effectiveness (Major Bleeding)
Tijdsspanne: 7 days
|
Proportion of patients with in-hospital major bleeding (defined according to the International Society on Thrombosis and Haemostasis criteria)
|
7 days
|
|
Effectiveness (Cessation of Bleeding)
Tijdsspanne: 6 hours
|
Proportion of patients with cessation of bleeding
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6 hours
|
|
Effectiveness (Serial 20WBCT)
Tijdsspanne: 14 days
|
Proportion of patients with reversal of correction of coagulopathy as measured by serial 20min WBCT
|
14 days
|
|
Effectiveness (Blood Transfusion)
Tijdsspanne: 14 days
|
Proportion of patients who require blood transfusion during hospitalization
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14 days
|
|
Effectiveness (Surgical Intervention)
Tijdsspanne: 14 days
|
Proportion of patients who require surgical intervention
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14 days
|
|
Effectiveness (Skin Necrosis)
Tijdsspanne: 48 hours
|
Mean and median total surface area of full thickness skin necrosis in cm2
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48 hours
|
|
Effectiveness (Swelling Reduction)
Tijdsspanne: 6 hours
|
Reduction of swelling extension
|
6 hours
|
|
Effectiveness (Renal Replacement Therapy)
Tijdsspanne: 14 days
|
Proportion of participants referred for renal replacement therapy
|
14 days
|
|
Effectiveness (Creatine Kinase)
Tijdsspanne: 14 days
|
Peak serum creatine kinase in U/L
|
14 days
|
|
Effectiveness (Need for Ventilation)
Tijdsspanne: 48 hours
|
Proportion of participants needing mechanical or manual ventilation
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48 hours
|
|
Safety (Presence of Shock)
Tijdsspanne: 3 hours
|
Proportion of patients with shock (shock defined as systolic blood pressure <90mmHg in adults, or age adjusted blood pressure in children)
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3 hours
|
|
Safety (Need for Adrenaline)
Tijdsspanne: 14 days
|
Proportion of patients requiring adrenaline
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14 days
|
|
Safety (Anaphylaxis)
Tijdsspanne: 2 hours
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Proportion of patients experiencing anaphylaxis after antivenom administration
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2 hours
|
|
Safety (Need for intravenous fluids)
Tijdsspanne: 2 hours
|
Proportion of patients requiring IV fluids following an allergic reaction
|
2 hours
|
|
Safey (Serum Sickness)
Tijdsspanne: 28 days
|
Proportion of patients with confirmed or probable serum sickness
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28 days
|
|
Safety (Any Other)
Tijdsspanne: 7 days
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Any other (serious) adverse events after enrolment in the study among participants with at least one dose of antivenom delivered
|
7 days
|
Medewerkers en onderzoekers
Medewerkers
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- ID2452-Remit-OCA024-07
Plan Individuele Deelnemersgegevens (IPD)
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Beschrijving IPD-plan
IPD-tijdsbestek voor delen
IPD-toegangscriteria voor delen
IPD delen Ondersteunend informatietype
- LEERPROTOCOOL
- ICF
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