Work packages

The Wellcome Trust programme has five main work packages to address this question and provide additional information pertinent to snakebite envenoming (SBE) in eSwatini.

1. Determination of the number and location of eSwatini snakebite victims that could be enrolled into a trial. The number and location of SBE in eSwatini will be determined using:

i) a hospital based snakebite-patient questionnaire to capture all admissions,
ii) a country-wide household based survey and
iii) antivenom stock and usage data from health facilities.

2. Assessment of the clinical, logistic and governance capacity for potential clinical trials. The clinical, logistic and governance capacity of selected health facilities will be assessed to determine their suitability for potential clinical trials

3. Identify the most appropriate antivenoms for a clinical trial based upon preclinical efficacy. Pre-clinical testing will be conducted using the venom of the most common venomous snakes in eSwatini (Naja mossambica, Naja annulifera, Bitis arietans, Hemechatus haemachatus, Dendroaspis polylepis). These venoms will be tested to determine their LD50 and ED50 and tested against antivenom produced from key manufactures.

 4. Characterization of the natural history of venom-induced tissue damage and identification of the most appropriate outcome measures in a prospective clinical observation study of envenomed patients. A prospective clinical observation study will be conducted in selected health facilities to characterize the natural history of venom-induced tissue damage and identification of the most appropriate outcome measures.