NIHR RIGHT4 Methanol (POC) Study Investigators' Meeting

30th November, 2024

The NIHR Right4 Methanol (POC) Study Investigators' Meeting took place on October 30, 2024 at the Hotel Sea Palace, Cox's Bazar, Bangladesh. Prof. Aniruddha Ghose opened the meeting by warmly welcoming everyone in attendance. He shared an overview of the NIHR Right4 Project, emphasizing its main goals and its importance in promoting research that enhances health equity and patient outcomes. Prof. Ghose also announced the launch of the Methanol PoC Study, highlighting its potential to foster innovative treatment solutions. The start of this study represents a significant milestone in ongoing research efforts, and Prof. Ghose conveyed his enthusiasm for the progress that lies ahead.

Among those present were distinguished professionals such as Prof. Md Sayedur Rahman, Prof. Michael Eddleston, Prof. Md Robed Amin, Prof. Aniruddha Ghose, Dr. Fazle Rabbi Chowdhury, and Dr. Suvodip Shaw, all of whom have played crucial roles in the study.

Prof. Michael Eddleston presented a detailed overview of the Methanol PoC Study, walking through the entire trial process. He clarified the inclusion and exclusion criteria to provide a clear understanding of how patients were selected. Additionally, Prof. Eddleston elaborated on the recruitment process, outlining the steps taken to enroll participants. He also described the study's methodology, highlighting key stages, timelines, and protocols. The discussion included treatment protocols, study objectives, and expected outcomes. During this segment, Dr. Fazle Rabbi and Prof. Aniruddha Ghose shared valuable insights, enhancing the understanding of the study design and its execution. Their contributions helped clarify essential aspects of the study, ensuring that all important points were thoroughly covered.

Dr. Fazle Rabbi Chowdhury led an engaging discussion on recruitment challenges, particularly the issue of patients concealing their drinking history. The group emphasized the need for thorough screening and ethical considerations to maintain the integrity of the study.

Zakir Hassan reported on the progress of the Methanol PoC Study in Bangladesh, confirming ethical clearances for five selected sites. The sites are equipped with the required laboratory facilities. Data collection has also begun, providing crucial information to guide participant recruitment and ensure the study's success.

Additionally, he updated the status of the Investigator Site File (ISF) at each site, confirming that all required documentation was being completed as scheduled. Zakir emphasized the importance of data collection on methanol poisoning patients, which will be crucial for the study's recruitment process, laying a solid groundwork for participant enrollment.

Mahjabin Tasnim Sadia conducted an anthropological study on methanol poisoning, delving into the social dynamics, patient experiences, and the reasons behind the consumption of methanol-laced beverages despite their dangers. She examined the sources and accessibility of these drinks, which are influenced by socio-economic factors, and pointed out the stigma, fear, and lack of awareness that often hinder patients from seeking medical assistance. Sadia also looked into how often poisoning cases occur and their geographic spread.

The discussion prompted inquiries about whether these incidents were isolated or indicative of a larger trend. Prof. Michael Eddleston, Prof. M.A. Faiz, Dr. Fazle Rabbi, and Prof. Aniruddha Ghose shared their insights, highlighting the necessity of understanding the wider social and cultural context. Prof. Faiz further emphasized the critical need for proper training to effectively tackle methanol poisoning.

Md. Mutaraddid Rahman Khan provided an update on the Community Engagement and Involvement (CEI) efforts for the Methanol PoC Study. He shared data on methanol poisoning cases from the past two years and highlighted the challenges in identifying case origins.

Prof. Eddleston and Prof. Faiz inquired about cases involving both methanol and ethanol, and the role of CEI in understanding community perceptions. Prof. Eddleston clarified that CEI focuses on gathering community insights, not data collection, and does not require ethical approval.

Mutaraddid also pointed out discrepancies between hospital records and newspaper reports, suggesting underreporting or misdiagnosis of cases. He emphasized the cultural barriers to seeking treatment and stressed the need for increased awareness and community support. He stressed the importance of community support and awareness in addressing methanol poisoning. This update highlighted the complex social factors influencing methanol poisoning and the critical role of ongoing community engagement.

Mr. Fahad Arefeen addressed laboratory progress, noting challenges such as reagent shortages and high testing costs. Fahad also mentioned the completion of Standard Operating Procedures (SOPs) and the drafting of a new SOP to optimize reagent usage. He introduced a microplate spectrophotometer to optimize reagent usage, which uses 10 times less reagent, with promising early results and ongoing validation. He reported that 7 samples from Rajshahi Medical College Hospital were analyzed for methanol poisoning, with one confirmed case and two suspicious results. The lab is continuing to collect additional samples for testing.

During the discussion, experts such as Dr. Shaw, Prof. Eddleston, and Prof. Ghose raised questions about the microplate spectrophotometer’s validation and its cost-effectiveness. Fahad acknowledged the logistical and financial challenges but emphasized efforts to improve the efficiency and capacity of testing.

Prof. Aniruddha Ghose wrapped up the meeting with his concluding remarks, summarizing the main points discussed. He announced that the Methanol PoC Study is set to officially begin. While they await final approvals from the Bangladesh Medical Research Council (BMRC) and the Directorate General of Drug Administration (DGDA), Prof. Ghose assured the team that site setup activities will proceed as planned.

He urged everyone involved to keep up the momentum and strive for the successful implementation of the study at the designated sites. Prof. Ghose expressed his heartfelt gratitude for the efforts made thus far and emphasized the importance of ongoing collaboration to meet the study's goals.