Retrospective analysis of the poisoning cases in four different regions of the world

Year 2025, Volume: 29 Issue: 2, 616 - 625

Hananeh Kordbacheh , Lamis F. Shishani1 Kübra Kolci , Rim Alomar Baraa Hamze Ahmet Aydın

https://doi.org/10.12991/jrespharm.1664946

Abstract

Poisoning remains a significant public health concern and continues to be one of the primary reasons for hospital admissions worldwide. Therefore, it is crucial to identify the most common causes of poisoning to reduce morbidity and mortality rates. This study aims to summarize and compare the frequency, patterns, causative agents, and gender distributions of poisoning among the most populous countries in the Middle East, North Africa, and South Asia regions, including Turkey, Jordan, Morocco, and India. The paper reviews literature on poisoning cases admitted to emergency departments between 2010 and 2020. A total of 20 relevant papers were included in the study. In Jordan, Turkey, India, and Morocco, 2545, 4441, 2895, and 3462 poisoning cases were identified, respectively. Ingestion was the primary route of exposure. In Jordan and India, the majority of poisoning cases were observed in males, while in Turkey and Morocco, females were more frequently involved. Non-pharmaceutical substances were the main cause of poisoning in Jordan, India, and Morocco, whereas medication was the primary cause of intoxication in Turkey. Except in Jordan, intentional exposure was the most common type of poisoning among the countries. To the best of our knowledge, there is no systematic review comparing the pattern of poisoning in these countries. The data extracted in this study can be utilized to enhance public awareness regarding both medication and non-medication intoxication.

Keywords

Intentional poisoning, Unintentional poisoning, Emergency departments, Frequency of poisoning, Exposure route

References

• [1] Grandjean P. Paracelsus Revisited: The Dose Concept in a Complex World. Basic Clin Pharmacol Toxicol. 2016;119(2):126. https://doi.org/10.1111/bcpt.12622
• [2] Indu TH, Raja D, Ponnusankar S. Toxicoepidemiology of acute poisoning cases in a secondary care hospital in rural South India: A five-year analysis. J Postgrad Med. 2015;61 (3):159. https://doi.org/10.4103/0022-3859.159310
• [3] Boedeker W, Watts M, Clausing P, Marquez E. The global distribution of acute unintentional pesticide poisoning: Estimations based on a systematic review. BMC Public Health 2020;20 (1):1–19. https://doi.org/10.1186/S12889-020-09939-0
• [4] Khan NU, Khan U, Khudadad U, Ali A, Raheem A, Waheed S, Razzak JA. Trends in mortality related to unintentional poisoning in the South Asian region from 1990 to 2019: analysis of data from the Global Burden of Disease Study. BMJ Open. 2023;13(2):e062744. https://doi.org/10.1136/BMJOPEN-2022-062744
• [5] Dawson AH, Eddleston M, Senarathna L, Mohamed F, Gawarammana I, Bowe SJ, Manuweera G, Buckley NA. Acute human lethal toxicity of agricultural pesticides: a prospective cohort study. PLoS Med. 2010;7(10):e1000357. https://doi.org/10.1371/JOURNAL.PMED.1000357
• [6] Panic N, Leoncini E, De Belvis G, Ricciardi W, Boccia S. Evaluation of the endorsement of the preferred reporting ıtems for systematic reviews and meta-analysis (PRISMA) statement on the quality of published systematic review and meta-analyses. PLoS One 2013;8(12):e83138. https://doi.org/10.1371/JOURNAL.PONE.0083138
• [7] Albals D, Yehya A, Issa R, Fawadleh A. Retrospective assessment of acute poisoning incidents by nonpharmaceutical agents in Jordan: Data from Pharmacy OneTM Poison Call Center, 2014 to 2018—Part I. Pharmacol Res Perspect. 2020;1;8(2): e00582. https://doi.org/10.1002/PRP2.582
• [8] Yehya A, Albals D, Issa R, Fawadleh A. Retrospective assessment of acute poisoning incidents by pharmaceutical agents in Jordan: Data from Pharmacy OneTM Poison Call Center, 2014 to 2018—Part II. Pharmacol Res Perspect 2020;8(2):e00583. https://doi.org/10.1002/PRP2.583
• [9] Raffee L, Daradkeh HM, Alawneh K, Al-Fwadleh AI, Darweesh M, Hammad NH, Almasarweh SA. Impact of COVID-19 lockdown on the incidence and patterns of toxic exposures and poisoning in Jordan: a retrospective descriptive study. BMJ Open. 2021 Dec 9;11(12):e053028. https://doi.org/10.1136/BMJOPEN-2021-053028
• [10] Sungur S, Bilge U, Acar N, Unluoglu I. Retrospective evaluation of adult poisoning cases admitted to emergency department of a University Hospital in Turkey. Niger J Clin Pract 2018;21(8):1023–1028. https://doi.org/10.4103/njcp.njcp_291_17
• [11] Özyurt E, Cerit GN, Karaveli A. Beş Yıllık Dönemde Yoğun Bakım Ünitesinde Takip Edilen Akut Zehirlenme Olgularının Retrospektif Analizi. Akdeniz Med J. 2018;30. https://doi.org/10.17954/amj.2018.1047
• [12] Büyükçavuşoğlu S, Osman Birdane Y. Evaluation of Poisoning Cases in The Emergency Department. Kocatepe Vet J. 2023;(4):563–573. https://doi.org/10.30607/kvj.1373684
• [13] Karaca O, Ertaşkın A. Epidemiology of self-poisoning with drug in the central Anatolian Region in Turkey. Cureus 2020;12(2):e6962. https://doi.org/10.30607/kvj.1373684
• [14] Büyüker SM, Duvar T, Altınbilek E. Retrospective analysis of poisoning cases admitted to the emergency department between 2015 and 2020. Ann Clin Anal Med. 2023;14(06):550–555. https://doi.org/10.30607/kvj.1373684
• [15] Efeoglu Sacak M. An Analysis of 1344 Consecutive Acute Intoxication Cases Admitted to an Academic Emergency Medicine Department in Turkey. North Clin Istanb. 2020;8(4):377–384. https://doi.org/10.30607/kvj.1373684
• [16] Sharma R, Neelanjana, Rawat N, Panwar N. Mortality and morbidity associated with acute poisoning cases in north-east India: A retrospective study. J Family Med Prim Care. 2019;8(6):2068. https://doi.org/10.30607/kvj.1373684
• [17] Asawari R, Atmaram P, Bhagwan K, Priti D, Kavya S, Jabeen GA. Toxicological pattern of poisoning in urban hospitals of western India. J Young Pharm. 2017;9(3):315–320. https://doi.org/10.30607/kvj.1373684
• [18] Bannur V, Jirli PS, Honnungar RS, Koulapur VV, Pujar SS. Pattern of Poisoning Cases at a Tertiary Health Care Centre– A Cross Sectional Study. Medico-legal Update. 2019;19(1):124–129. https://doi.org/10.5958/0974-1283.2019.00025.2
• [19] Pannu AK, Bhalla A, Vamshi V, Upadhyay MK, Sharma N, Kumar S. Changing spectrum of acute poisoning in North India: A hospital-based descriptive study. Turk J Emerg Med. 2022 ;22(4):192–199 https://doi.org/10.4103/2452-2473.357627
• [20] Nadeem MN, Maqdoom M, Akif ME. A prospective observational study on pattern of poisoning cases reported to emergency department of a teaching hospital in south India. Biomed Pharmacol J. 2020;1;13(4):1863–1869. https://doi.org/10.13005/bpj/2061
• [21] Singla N, Behera A, Sharma N, Sharma N. Paradigm shift in pattern and prevalence of poisoning during COVID-19 pandemic. J Family Med Prim Care. 2022;11(1):208. https://doi.org/10.4103/jfmpc.jfmpc_916_21
• [22] Aggarwal N, Sawlani KK, Chaudhary SC, Usman K, Dandu H, Atam V, Rani S, Chaudhary R. Study of pattern and outcome of acute poisoning cases at tertiary care hospital in North India. J Family Med Prim Care. 2023;12(9):2047-2052. https://doi.org/10.4103/JFMPC.JFMPC_592_23
• [23] Nabih Z, Amiar L, Abidli Z, Windy M, Soulaymani A, Mokhtari A, Soulaymani-Bencheikh R. Epidemiology and risk factors of voluntary pesticide poisoning in Morocco (2008-2014). Epidemiol Health. 2017;39:e2017040. https://doi.org/10.4178/epih.e2017040.
• [24] Boukatta B, El Bouazzaoui BB, Guemoune R, Houari N, Sanae A, Sbai H, Kanaa N. An Epidemiological Study of Adult Acute Poisoning in Fez: Morocco. J Clin Toxicol. 2014;04:6. https://doi.org/10.13075/mp.5893.00905
• [25] Detsouli A, Rhalem N, Abidli Z, Jadda S, Fekhaoui M, Amiar L, Souleymani A, Souleymani-Bencheikh R, Mokhtari A. Benzodiazepine poisoning in Morocco: Epidemiological study. Bangladesh J Med Sci. 2021;20(2):396–400. https://doi.org/10.3329/bjms.v20i2.51555
• [26] Birich B, El Hajjaji S, Ghandi M, Ait Daoud N, Ouaide M, Badrane N, Souleymani-Bencheikh R. Toxicological analysis of acute pesticides poisoning among Moroccan population. E3S Web of Conferences 2021;319:01054. https://doi.org/10.1051/e3sconf/202123400012
• [27] Azekour K, Belamalem S, Soulaymani A, El Houate B, El Bouhali B. Epidemiological Profile of Drug Overdose Reported in South-East Morocco from 2004 to 2016. Drugs Real World Outcomes 2019;6(1):11. https://doi.org/10.1007/s40801-019-0148-2
• [28] Ouardi AE, Gazzaz H, Aatik Y El, Feniche MohammedE, El M, Kisra H. Exploration of the Prevalence and Profile of Suicide Cases in the Population of Northern Morocco (2017-2022). Open Public Health J. 2022. http://dx.doi.org/10.2174/18749445-v16-230822-2023-137.
• [29] Sahar AH, Hasnae H, Hajar M, Mohammed C, Sana C, Sanae A, Tadmouri I, Hida M. Children’s poisoning profile during the Covid-19 pandemic – Experience of Hassan II University Hospital in Fez, Morocco. E3S Web of Conferences 2021;319: 01077. https://doi.org/10.1051/e3sconf/202131901077.
• [30] Kadam K, Kocadal K, Etikan İ, Çok İ, Saygı Ş. he Impact of COVID-19 Pandemic on Emergency Department Visits for Substance Addiction and Drug Overdose in North Cyprus. Mersin University School of Medicine Lokman Hekim Journal of History of Medicine and Folk Medicine. 2023; 13(3): 743-749. https://doi.org/10.31020/mutftd.1273596
• [31] Suraweera W, Warrell D, Whitaker R, Menon G, Rodrigues R, Fu SH, Begum R, Sati P, Piyasena K, Bhatia M, Brown P. Trends in snakebite deaths in India from 2000 to 2019 in a nationally representative mortality study. E-life. 2020;7(9):5. https://doi.org/10.7554/eLife.54076
• [32] Gunnell D, Eddleston M, Phillips MR, Konradsen F. The global distribution of fatal pesticide self-poisoning: Systematic review. BMC Public Health. 2007;7(1):1–15. https://doi.org/10.1186/1471-2458-7-357
• [33] Gunnell D, Knipe D, Chang SS, Pearson M, Konradsen F, Lee WJ, Eddleston M. Prevention of suicide with regulations aimed at restricting access to highly hazardous pesticides: a systematic review of the international evidence. Lancet Glob Health. 2017;5(10):e1026-e1037. https://doi.org/10.1016/s2214-109x(17)30299-1.
• [34] Parekh U, Gupta S. Epidemio-toxicological profile of poisoning cases - A five years retrospective study. J Forensic Leg Med. 2019;65:124–132. https://doi.org/10.1016/j.jflm.2019.05.013.
• [35] Yan Y, Hou J, Li Q, Yu NX. Suicide before and during the COVID-19 pandemic: a systematic review with meta-analysis. Int J Environ Res Public Health. 2023;14;20(4):3346. https://doi.org/10.3390/ijerph20043346.
• [36] Al-Sabaileh S, Abusamak M, Jaber H, Al-Buqour A, Al-Salamat HA, Sabayleh RS, Hatamleh H, Deameh MG, Al-Amer RM, Al-Buqour AK, ALSalamat H. Suicide trends in Jordan in correlation with the COVID-19 pandemic: a forensic medicine perspective. Cureus. 2023;(29):15-17. https://doi.org/10.7759/.42636