Medical toxicology needs in Sub-Saharan Africa: Protocol for a multi-country study

Carine Marks, Lana Van Niekerk, Janet Perkins, Michael Eddleston, Daniel Van Hoving

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Acute poisoning is a significant but underreported public health issue in Sub-Saharan Africa (SSA), driven by exposures such as pesticides, paraffin, toxic alcohols, traditional medicines, and snake envenomation. Existing Poison Information Centre (PIC) models from high-income countries often fail to meet SSA's specific clinical and systemic needs. A context-adapted assessment method is needed to inform regionally appropriate toxicology services.

Methods
This multi-country qualitative study will apply a collective case study design in Botswana, Malawi, Nigeria, and Zambia. Data will be collected from national referral hospitals through an electronic semi-structured survey, in-person interviews, and non-intrusive participant observation. Purposive sampling will target diverse healthcare providers, including physicians, nurses, and pharmacists. Interviews will explore poisoning case experiences, training gaps, systemic barriers, and access to toxicology support. Observational data will assess clinical practices, antidote availability, and the integration of toxicology into emergency care. Ethical approval has been secured.

Expected outcomes
This protocol offers a replicable approach for needs assessment in resource-limited settings. It will inform the design of sustainable toxicology education and services tailored to Sub-Saharan African health systems and contribute broadly to toxicology development in low- and middle-income countries.
Original languageEnglish
Article number2602112
Pages (from-to)1-7
Number of pages7
JournalToxicology Communications
Volume9
Issue number1
Early online date15 Dec 2025
DOIs
Publication statusPublished - 2025

Keywords / Materials (for Non-textual outputs)

  • medical toxicology
  • poisoning exposure
  • Sub-Saharan Africa
  • qualitative research
  • poison information centers

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