Bangladesh has had remarkable success in reducing pesticides suicide rates.
Around 20 years ago, the Bangladesh government started to introduce laws to control the use of pesticides. Twenty one highly hazardous pesticides were partially or completely banned in the 1990s and 2000s, resulting in a 65% reduction in pesticide suicides. It is estimated than 35,000 deaths have been prevented between 2001 and 2014 as a result of the bans.
However, organophosphorus (OP) insecticides are still used widely in agriculture and poisoning remains a substantial clinical problem in Bangladesh.
CPSP is supporting a large scale clinical trial, exploring new treatments for patients with organophosphorus (OP) or carbamate poisoning.
Organophosphorus pesticides and carbamate insecticides are responsible for two thirds of pesticide poisoning deaths across the world. Current treatments do not always work and, despite thousands of studies and millions of deaths, no new treatments have been introduced in 50 years.
Previous studies have suggested that calcium channel blocking medicines [CCB] or magnesium may help to reduce the pesticides’ effects and prevent deaths. However, there is no clear information on whether these medicines work. This study hopes to prove that these relatively cheap, widely available treatments can help treat poisoned patients.
The study involves around 3,100 patients with OP or carbamate poisoning who have been admitted to 4 large Bangladeshi hospitals. One third will receive routine treatment, one third will receive additional CCB medicines and one third will receive additional magnesium. We will measure how many patients die and how many need help with their breathing across the three groups.
The results will be shared with the World Health Organization and our colleagues in poison centres and hospitals across Asia, to help promote better treatment options. If successful, the study will result in the first new treatment for these forms of poisoning for 50 years.
The study is being conducted in collaboration with colleagues at the Mahodol Oxford Research Unit, Chittagong Medical College, Bangabandhu Sheikh Mujib Medical University and Dhaka Medical College.