{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:20:52Z","timestamp":1788355252023,"version":"build-2803163510"},"reference-count":14,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Organophosphate poisoning is a common method of attempting suicide in developing countries, particularly in rural areas. The current WHO protocols emphasize intubation and transfer to a facility with intensive care. Both recommendations are beyond the resources of many rural hospitals in developing countries and their poor patients. Because organophosphate poisoning is a commonly seen condition in Kenya and because intubation is beyond the equipment and training of many rural hospitals, a protocol involving atropine without intubation was developed and used. The protocol includes placement of a nasogastric tube, activated charcoal, intravenous fluids, and atropine along with other supportive measures; the protocol was developed based on a literature search of international medical journals and has been in use for years at Kapsowar Mission Hospital (KMH). Organophosphate poisoning outcome data at KMH were reviewed for 2021\u20132023. One patient died within minutes of presentation to the Casualty Ward, but the rest survived to discharge using the above protocol. The cost of the atropine protocol is over U.S. $200 in Kenya. The recommendations of the WHO are usually helpful to practitioners in underresourced facilities. In the case of organophosphate poisoning, the recommendations are more appropriate to higher-income countries and highest-level hospitals in low- and middle-income countries, facilities that have intubation capability and large quantities of atropine. A protocol using less atropine could be offered as an alternative.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0266","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T15:24:19Z","timestamp":1784215459000},"page":"612-615","source":"Crossref","is-referenced-by-count":0,"title":["A Sustainable Treatment Protocol for Organophosphate Poisoning in Rural Kenya for Facilities without Intensive Care Units and Where Transfer Is Not Possible"],"prefix":"10.4269","volume":"115","author":[{"given":"Jerome","family":"Koleski","sequence":"first","affiliation":[{"name":"Global Health Programs, College of Medicine, University of Arizona, Tucson, Arizona, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sommer","family":"Aldulaimi","sequence":"additional","affiliation":[{"name":"Global Health Programs, College of Medicine, University of Arizona, Tucson, Arizona, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Nthusi","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, School of Medicine and Health Sciences, Kabarak University, Nakuru, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"34","key":"b1","series-title":"J Nepal Health Res Counc","first-page":"131","article-title":"Management of organophosphorus poisoning","volume":"14","author":"Bajracharya","year":"2016"},{"issue":"3","key":"b2","series-title":"Br J Clin Pharmacol","first-page":"462","article-title":"Pharmacological treatment of organophosphorus insecticide poisoning: The old and the (possible) new","volume":"81","author":"Eddleston","year":"2016"},{"issue":"7","key":"b3","series-title":"Trop Anim Health Prod","first-page":"1701","article-title":"Analysis of pastoralists\u2019 perception on challenges and opportunities for sheep and goat production in northern Kenya","volume":"50","author":"Abdilatif","year":"2018"},{"key":"b4","series-title":"Livest Res Rural Dev","first-page":"5","article-title":"Ticks and tick-borne disease control in a pastoral and an agro-pastoral farming systems in Kenya","volume":"24","author":"Mugambi","year":"2012"},{"issue":"3","key":"b5","series-title":"N Am J Med Sci","first-page":"147","article-title":"Clinico-epidemiological characteristics of patients presenting with organophosphorus poisoning","volume":"4","author":"Banerjee","year":"2012"},{"key":"b6","article-title":"Clinical Management of Acute Pesticide Intoxication: Prevention of Suicidal Behaviours.","year":"2008"},{"issue":"1","key":"b7","series-title":"Saudi J Anaesth","first-page":"49","article-title":"Is the World Health Organization-recommended dose of pralidoxime effective in the treatment of organophosphorus poisoning? A randomized, double-blinded and placebo-controlled trial","volume":"9","author":"Syed","year":"2015"},{"key":"b8","series-title":"Rosen\u2019s Emergency Medicine: Concepts and Clinical Practice","year":"2018"},{"issue":"9612","key":"b9","series-title":"Lancet","first-page":"597","article-title":"Management of acute organophosphorus pesticide poisoning","volume":"371","author":"Eddleston","year":"2008"},{"issue":"6","key":"b10","series-title":"J Toxicol Clin Toxicol","first-page":"865","article-title":"Speed of initial atropinisation in significant organophosphorus pesticide poisoning\u2014A systematic comparison of recommended regimens","volume":"42","author":"Eddleston","year":"2004"},{"issue":"2","key":"b11","series-title":"J Med Toxicol","first-page":"143","article-title":"Comparison of current recommended regimens of atropinization in organophosphate poisoning","volume":"10","author":"Connors","year":"2014"},{"key":"b12","series-title":"StatPearls","author":"Jain","year":"2024"},{"key":"b13","article-title":"Pest Control Products Act, Chapter 346.","year":"2012"},{"key":"b14","article-title":"The WHO Recommended Classification of Pesticides by Hazard and Guidelines to Classification, 2019 Edition.","year":"2020"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/3\/article-p612.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/3\/article-p612.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/3\/article-p612.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:54:35Z","timestamp":1788353675000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/3\/article-p612.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":14,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.25-0266","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]}}}