As part of ongoing collaboration between the Ethiopia Ministry of Health (MoH) and the UK Health Security Agency IHR-Strengthening Project, a 6-day training of trainers course on poisoning management was held in Bishoftu, Ethiopia between 21-26 January 2025.

Twenty participants from across 15 of Ethiopia’s hospitals with the highest rates of poisoning cases attended the training. Most participants specialised in emergency or intensive care medicine and regularly manage poisoned patients in daily practice. The primary focus of the training was developing the participants’ knowledge on toxicology and the management of poisoning, utilising the recently updated MoH National Poisoning Management Guidelines.

Using a ‘train the trainer’ (ToT) format will enable participants to subsequently organise their own training delivery to clinicians based at national and regional hospitals across the country.

Image above: IHR-SP technical advisers co-delivered the workshop alongside Ethiopian clinicians

Co-designing a training session driven by evidence and expertise

A programme was co-developed by MoH and UKHSA IHR-SP technical advisers to include many of the primary causes of poisoning in Ethiopia, based on available epidemiological studies, clinician experience, and topics considered to be particularly common or severe across Ethiopia such as pesticide and heavy metal poisoning. Other key poisoning topics included medication overdose, hydrocarbons, carbon monoxide, toxic alcohols, plant poisoning, and management of snakebite.

The IHR-SP team included scientists with extensive experience of working in clinical toxicology, poison centres and the Ethiopian Chemicals Public Health system. Working closely with Ethiopian experts to co-deliver the workshop, approximately 50% of sessions were led by Ethiopian clinicians. Although this was the first time the IHR-SP supported clinician toxicology training, in the future it is planned for Ethiopian experts to deliver this training independently of UKHSA support, to ensure a sustainable training programme is in place.

‘Hands-on’ learning

Interactive presentation sessions were complemented by group case study scenario sessions, encouraging participants to apply their knowledge whilst using the National Poisoning Management Guidelines. 

The training also included practical skill station sessions using mannequins based at Bishoftu General Hospital, which focused on the initial acute management of a poisoned patient (pictured right). Participants were asked to demonstrate specific life support measures to implement when applied to various common toxic presentations, including those from pesticide or corrosive injuries. Students received practical training in toxicologically challenging scenarios such as securing an airway and providing other critical life support measures in severely poisoned patients.

Throughout the workshop, the importance of recognising the potential for wider health impacts to communities from poisoning was emphasised. Participants were encouraged to consider reporting cases regularly via the appropriate mechanism to the Ethiopian Public Health Institute (EPHI). The training reinforced the benefits of a wider toxicovigilance system which may result in better health outcomes, enhanced surveillance in-country and improved understanding of poisoning epidemiology. 

Building on our successes

Feedback collected from participants and facilitators indicated 95% (18) of respondents felt that their expectations were fully realised through the training. In addition, feedback on whether pre-established learning objectives were met was positive, with most respondents expressing the training met the objectives.

With participants due to train Ethiopian health professionals in poisoning management as a result of this ToT, it is expected that the prevention, diagnosis and treatment of poisoning will be enhanced, thereby improving public health and safety across Ethiopia.