Document Type : systematic review


1 Pediatric Resident, Department of Pediatrics, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran.

2 Birjand atherosclerosis and coronary artery research center, Assistante professor of pediatric

3 Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.

4 School of Medicine, University of Colorado, Aurora, CO, USA

5 Cardiovascular Diseases Research Center, Department of Epidemiology and Biostatistics, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran


Background: The epidemiology of pediatric poisoning differs from one country to another. Due to the scarcity of reviews on this issue in Iran, we performed a systematic review and meta-analysis of studies providing data on Iranian pediatric poisoning epidemiology.
Methods: PubMed, Web of Sciences, Science direct, Embase, Scopus and the Persian databases Magiran, Scientific Information Database (SID), and Iranmedex were searched. Twenty-seven studies published between 2002 and 2019 were included, based on the inclusion and exclusion criteria.
Results: 54.7% of the participants in the reviewed studies were male, and 88.1% of them were unintentional. Most of the children were in the age range of 3-5 years. Non-pharmaceutical agents were the most common causes of poisonings (n=7175, 59.2%) and among them, illicit drugs (19.3%) followed by hydrocarbons (16.4%) constituted the most common non-pharmaceutical poisonings. Illicit drugs, especially opioids, showed an upward trend from 2002 to 2019. Among pharmaceuticals, central nervous system (CNS) drugs (50.4%), especially benzodiazepines (BZDs) (25.8%) and analgesics (14.5%), were the most frequent agents implicated. CNS complaints (51.8%), followed by gastrointestinal complaints (27.6%), were the most common symptoms. Ingestion was the most common route of poisoning (22.1%). Most of the poisoning cases occurred in summer (28.2%). 21.7% of the cases were hospitalized and the mortality rate was 0.8%. A remarkable downward trend in both hospitalization and death rates occurred over time.
Conclusion: Overall, non-pharmaceutical toxicity was found to be the most common cause of poisoning. However, considering the agents separately, pharmaceuticals, illicit drugs, and hydrocarbons were the most common causes of poisoning, respectively. In contrast to the decreasing trend in hydrocarbons, pesticides, and pharmaceutical poisonings, we found an increase in opioid poisoning during our study period.


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