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PLoS One. 2016 Mar 31;11(3):e0152676. doi: 10.1371/journal.pone.0152676. eCollection 2016.

The Methanol Poisoning Outbreaks in Libya 2013 and Kenya 2014.

Author information

1
Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.
2
Médecins Sans Frontières International, Geneva, Switzerland.
3
Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
4
Médecins Sans Frontières, Nairobi, Kenya.
5
Department of International Health, School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
6
Libyan Emergency Medicine Association, Tripoli Medical Center, Tripoli, Libya.
7
Medical Department, Tripoli Central Hospital, Tripoli, Libya.
8
Department of Pharmacy, Kenyatta National Hospital, Nairobi, Kenya.
9
Médecins Sans Frontières, Libya Mission, Tripoli, Libya.
10
Médecins Sans Frontières Operational Centre, Brussels, Belgium.
11
Médecins Sans Frontières, Oslo, Norway.
12
Department of Anesthesiology and ICU, Pärnu County Hospital, Pärnu, Estonia.
13
The Norwegian CBRNe Centre of Medicine, Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.

Abstract

BACKGROUND:

Outbreaks of methanol poisoning occur frequently on a global basis, affecting poor and vulnerable populations. Knowledge regarding methanol is limited, likely many cases and even outbreaks go unnoticed, with patients dying unnecessarily. We describe findings from the first three large outbreaks of methanol poisoning where Médecins Sans Frontières (MSF) responded, and evaluate the benefits of a possible future collaboration between local health authorities, a Non-Governmental Organisation and international expertise.

METHODS:

Retrospective study of three major methanol outbreaks in Libya (2013) and Kenya (May and July 2014). Data were collected from MSF field personnel, local health personnel, hospital files, and media reports.

FINDINGS:

In Tripoli, Libya, over 1,000 patients were poisoned with a reported case fatality rate of 10% (101/1,066). In Kenya, two outbreaks resulted in approximately 341 and 126 patients, with case fatality rates of 29% (100/341) and 21% (26/126), respectively. MSF launched an emergency team with international experts, medications and equipment, however, the outbreaks were resolving by the time of arrival.

INTERPRETATION:

Recognition of an outbreak of methanol poisoning and diagnosis seem to be the most challenging tasks, with significant delay from time of first presentations to public health warnings being issued. In spite of the rapid response from an emergency team, the outbreaks were nearly concluded by the time of arrival. A major impact on the outcome was not seen, but large educational trainings were conducted to increase awareness and knowledge about methanol poisoning. Based on this training, MSF was able to send a local emergency team during the second outbreak, supporting that such an approach could improve outcomes. Basic training, simplified treatment protocols, point-of-care diagnostic tools, and early support when needed, are likely the most important components to impact the consequences of methanol poisoning outbreaks in these challenging contexts.

PMID:
27030969
PMCID:
PMC4816302
DOI:
10.1371/journal.pone.0152676
[Indexed for MEDLINE]
Free PMC Article

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