Prevalence and Related Factors of Pediatric Acute Poisoning In Iran: A Systematic Review and Meta-Analysis

Abstract

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 this systematic review and meta-analysis study. Methods: In order to find relevant studies published between January 2002 to December 2020, Valid English and Persian databases, were searched, using the following keywords: prevalence, epidemiology, children, poisoning, intoxication, envenomation, Iran. Random effect models were used to estimate pooled prevalence and 95% confidence intervals (CIs). Findings: 30articles, with a total of 12,994 participants, were included in the meta-analysis. 54.7%, were male, and 88.1% of them were unintentional. The most children were in the age range of 3-5 years. 59.2 % of poisonings were due to Non-pharmaceutical agents (95%CI: 54.5-63.8, I2 =96.1%). Amon them, illicit drugs (19.3%) followed by hydrocarbons (16.4%) were more common. There was an increasing trend in illicit poisonings especially opioids from 8% (n=260) in 2002 to 44.9%(n=1670) in 2020. Among pharmaceuticals, Central Nervous System (CNS) drugs, responsible for 50.4 % of cases. Among symptoms, 51.8 % were CNS complaints. Ingestion was responsible for 22.1% of poisonings. There was a remarkable reduction in the rate of hospitalization (40.3% in 2002 to 5.3% in 2020), as well as mortality rate (0.9% in 2002 to 0.6% in 2020). Conclusion: Male gender and the age range of toddlers were the most affected group by poisoning. Non-pharmaceutical toxicity, especially illicit drugs and hydrocarbons were the most common cause of poisoning in our study. In contrast to hydrocarbons, pesticides, and pharmaceuticals, we found an increasing trend in opioid poisoning during the time period of our study.