1. Investigate the epidemiology of acute paraquat poisoning in Fiji
2. Assist in the development of a treatment protocol specific to the needs and clinical resources of Fiji
3. Assist in the development of a clinical research infrastructure to conduct state-of-the-art research on optimal approaches for the care of patients with acute paraquat poisoning.
4. Assess the feasibility of establishing a poison control center in Fiji consistent with international standards.
5. Develop a sustainable partnership and academic affiliation between Fiji National University and the University of Illinois at Chicago
Background and Significance:
Paraquat is one of the most widely used herbicides. It has many properties that make it an essential tool in no-till farming worldwide. Paraquat is also a lethal poison. When ingested, individuals typically die within hours-to-days, or days-to-weeks in lesser exposures. Acute symptoms include multi-organ failure. Survival of the acute phase often results in progressive pulmonary fibrosis that often ultimately leads to death. Most paraquat ingestions represent deliberate attempts at self harm. There is currently no standard treatment protocol or algorithm for paraquat poisoning; treatment focuses on gastrointestinal decontamination and supportive care. The fatality rate from paraquat poisoning approaches 80%, representing one of the deadliest poisons in terms of case-fatality ratios.
The University of Illinois at Chicago (UIC) has the distinction of having a Department of Emergency Medicine that has an affiliated medical toxicology fellowship training program and medical toxicology faculty. In addition to having the largest collaboration of medical toxicologists in the United States, UIC has an innovative Center for Global Health. Under the leadership of emergency physician and medical toxicologist, Timothy Erickson, the mission of the Center for Global Health is to “improve the health of populations around the world by conducing collaborative, trans-disciplinary research that addresses critical global health treats; and by building the capacity of the University and its global health partners to respond to the complex health issues that challenge all.” We believe that a collaboration between Fiji National University and the University of Illinois at Chicago can address the problem of paraquat poisoning in Fiji, develop collaborative research efforts, and develop educational and clinical infrastructure that will be self-sustaining and specific to Fiji and the South Pacific Region. We anticipate a three to five year commitment to the development and implementation of this proposal.