Systematic review on paraquat poisoning in IRAN

Abstract The use of paraquat as a pesticide exposes users to a high risk of death and morbidity in various organ systems. In Iran, poisoning from this deadly chemical occurs frequently as a result of suicide or accidental use. As such, knowledge about paraquat is essential for this region, and in this study, we conducted a systematic review of the available evidence on paraquat poisoning in Iran. We utilized databases including PubMed, Google Scholar, Web of Science, and ResearchGate to conduct a systematic literature review on paraquat poisoning in Iran up to June 2025. Studies involving human subjects who reported paraquat poisoning in any province of Iran were included in this systematic review. Two independent researchers searched and extracted the results using a predefined table in Microsoft Excel. After screening 14 studies including 752 cases in this review, we concluded that the mortality rate was about 40% and the first symptoms were typically nausea and vomiting. Also, the main side effects were renal and respiratory failure. All reported paraquat poisoning cases in the Iranian population were included in this systematic review, including an overview of the patient population, symptoms, comorbidities, hospital stays, and treatments. The data revealed a lack of an effective antidote and highlighted the urgent need for prevention strategies in Iran, offering actionable insights for health authorities. This review may also serve as a useful guide for clinicians in diagnosing, preventing, and treating paraquat poisoning.