Low-tech international health: Simple injection could save thousands

International health researchers have published findings from a large trial supporting a relative simple intervention that could save thousands of accident victims around the world. Each year, accidents are the second leading cause of death for individuals aged 5 to 45, second only to HIV/AIDS. Of those accident victims, 600,000 bleed to death. In an effort to reduce that toll, international health researchers from the London School of Hygiene and Tropical Medicine enrolled some 20,000 accident victims in 274 hospitals across 40 countries in a study of TXA, or tranexamic acid. An off-patent injection that costs about $4.50 per dose, TXA helps reduce death and complications from bleeding by encouraging clotting. Since clots themselves can be a major cause of harmful health events such as stroke and heart attack, there was a concern that injecting it into accident victims might promote other unwanted consequences.

Those enrolled in the trial were adults who had suffered a severe injury within a few hours that resulted in significant bleeding, or the risk of developing significant bleeding. Patients were randomly given either one TXA injection followed by a second TXA IV-dosage within 8 hours, or an identical placebo regimen. Over the next four weeks researchers found that those receiving TXA were one-sixth as likely to die from blood loss as those receiving placebo. They estimate that this simple injection could potentially reduce the international health burden of premature death by some 100,000 lives a year, including some 13,000 in India, 12,000 in China,  and 2,000 in the US.

Naturally, designing effective drug delivery into clinical international health pathways is fraught with complications, not to mention drug and material supply chain issues. But discovering the potential for this simple intervention to save so many lives is most certainly a boon for international health efforts to reduce premature mortality. The research was published online in The Lancet.

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