Echitab Study Group (2006 – 2012)

Echitab logo

A collaboration to address the neglect of snakebite and snakebite therapy in Nigeria

  • Snakebite is a disease of the rural poor who lack the fiscal resources to improve their access to effective treatment
  • Effective antivenom treatment (if available) is expensive (typically >$300/treatment) and this usually unaffordable to the communities and countries that most need it.
  • Antivenom induces adverse effects, causing a loss of confidence in antivenom therapy in the snakebite patient, attending physician and government purchasing authorities.
  • The combined consequences is that the substantial snakebite-induced mortality and morbidity in Africa continues unabated and is too often neglected by governments.

LSTM collaboration to resolve the antivenom crisis in Nigeria

In response to the 2003 request from the Nigerian Federal Ministry of Health, the Centre for Snakebite Research and Intervention and University of Oxford formed the EchiTAb Study Group – a collaboration of clinicians, scientists, and antivenom manufacturers. With Nigerian Government funding, the EchiTAb Study Group imported the most medically-important Nigerian snakes into Liverpool, extracted their venom and provided it to antivenom manufacturers in UK (MicroPharm Ltd) and Costa Rica (Instituto Clodomiro Picado) who developed i) a monospecific antivenom to the saw-scaled viper and (ii) a polyspecific antivenom to treat envenoming for Echis ocellatus (Saw-scale Vipers), Bitis arietans (Puff Adders) and Naja nigricollis (Spitting Cobra).

We next conducted human clinical trials, which demonstrated the efficacy and safety of these antivenoms. The two antivenoms developed by the EchiTAb Study Group are more effective, affordable (less than $75/treatment) and safer than any other antivenom developed for sub-Saharan Africa. We also purchased ambulances to quickly transport snakebite victims to newly constructed hospital wards dedicated to snakebite clinical management.

Through these combined efforts, the EchiTAb Study Group has delivered over 37,000 vials of antivenom (18,500 treatments) to help save the lives, and livelihoods, of many thousands of Nigeria’s disadvantaged snakebite victims.

Echitab organisation

Current and Future Activities of the EchiTab Study Group

  • Constructing, equipping, and staffing an Antivenom Production Facility in Nigeria: comprising a herpetarium, an animal housing/bleeding unit
  • Constructing an International Research Centre in Kaltungo for instruction of national and international students in the clinical treatment of snake envenoming and other studies on:
      • Epidemiological studies to establish the medical burden of snake bite in Nigeria
      •  Preclinical studies to determine the efficacy of the EchiTAb antivenoms against the effects of venoms from other medically-important snakes in Africa – ‘antivenomics’
      • Socioeconomic studies determining the burden of snake bite, and its treatment, to rural African communities and the hospitals serving them
      • Studies identifying effective measures to reduce snakebite incidence that are technologically appropriate to the rural communities that risk snakebite in all their daily activities
  • Establishing a Public Health Education Program on the prevention and treatment of snakebite
  • Raising awareness of the medical problem of snakebite in Africa with International Health and Funding agencies: the WHO, The B&M Gates Foundation, World Bank, DIFID etc

The Challenge

We now face our greatest challenge: ensuring sustained political and fiscal support to maintain the delivery of this life-saving therapy to Nigeria.