Epidemiological patterns of poisoning worldwide: A comparative narrative review of high-income and low-income countries

Poisoning remains a major global public health concern and a significant cause of morbidity and mortality worldwide. This narrative review synthesizes current evidence on poisoning patterns across countries, with emphasis on epidemiological characteristics including affected populations, causal agents, routes of exposure, and circumstances of poisoning. Particular attention is given to differences between high-income and low-income settings. Relevant literature was identified through online searches and bibliographic screening of databases including PubMed, Medline, JSTOR, EBSCOhost, Publons, and Google Scholar. Evidence was extracted from original studies, systematic reviews, narrative reviews, and institutional reports. Findings suggest that poisoning epidemiology differs substantially by national income level. In high-income countries, medications—particularly paracetamol—are the leading agents of poisoning, with children aged 0–5 years representing the most affected group. Most cases occur unintentionally, mainly through accidental ingestion. In contrast, in low-income countries, pesticides are the predominant toxic agents, and young adults are the most affected population. Poisoning in these settings is frequently intentional, commonly associated with suicide and interpersonal conflict. Despite limitations related to data scarcity in low-income countries, consistent patterns highlight important epidemiological disparities. Strengthening poison control centers, improving toxicovigilance, and implementing regulatory policies targeting pesticide access are strongly recommended in resource-limited settings.