Pediatric neurotoxicity in Morocco: Epidemiology, clinical profile, toxicology findings and outcomes.

BACKGROUND AND

OBJECTIVES

Pediatric neurotoxicity remains a major cause of morbidity and mortality in low- and middle-income countries. In Morocco, the burden of toxic exposures leading to neurological disorders is still underexplored. This study aimed to describe the epidemiology, clinical profile, toxicological features, and outcomes of pediatric neurotoxic poisonings in a tertiary care hospital in Fez, Morocco.

METHODS

A prospective cross-sectional study was conducted from January 2021 to January 2023 at the Pediatric Emergency Units of Hassan II University Hospital. Pediatric patients under 18 years presenting with neurological symptoms secondary to confirmed or suspected toxic exposures were included. Demographic, clinical, and toxicological data were collected using standardized forms, complemented by biological sampling and advanced toxicological analyses.

RESULTS

Among 4183 pediatric emergency admissions, 743 (17.8%) presented with neurological disorders, of which 384 (51.7%) were attributed to toxic exposures. Of these 384 cases, major agents included pharmaceuticals, traditional herbal remedies, pesticides, venoms, and illicit substances. Multiple exposures were observed in 55% of cases, and 70% resulted from repeated exposure. Intensive care was required in 29.1% of patients, and overall mortality reached 11.9%, with phytotherapy, illicit drugs, and pesticides being the leading causes of death. Delayed consultation and limited antidote availability were major challenges.

CONCLUSIONS

Pediatric neurotoxicity is highly prevalent in Morocco, shaped by a unique combination of cultural and environmental risk factors. These findings underscore the urgent need for strengthened toxicovigilance, regulation of hazardous substances, public education, and improved diagnostic and therapeutic resources.