Pesticide-specific case fatality and clinical outcomes among poisoning cases in Tanzania: a retrospective cross-sectional study.
Paraquat poisoning carries a 93.3% case fatality rate among Tanzanian pesticide cases.
Pesticide-specific case fatality and clinical outcomes among poisoning cases in Tanzania: a retrospective cross-sectional study.
Pesticide poisoning remains a major public health challenge in low- and middle-income countries, particularly where highly hazardous pesticides (highly hazardous pesticides) remain accessible and toxicovigilance systems are limited.
This study assessed clinical outcomes, pesticide-specific case fatality, and mortality risk among pesticide poisoning cases reported in selected Tanzanian hospitals.
A retrospective cross-sectional study was conducted using hospital records from Regional Referral Hospitals and District Hospitals in Arusha, Kilimanjaro, Morogoro, Iringa, and Mwanza regions between January 2017 and November 2024.
Most patients poisoned by paraquat died, far higher than other pesticides studied.
Most patients were male (64.1%) and aged 16-35 years (61.3%).
Intentional exposure accounted for 70.2% of cases, while unintentional exposure represented 20.3%.
Most patients fully recovered (67.9%; 95% CI: 64.1-71.4), whereas 18.4% (95% CI: 15.5-21.6) died following pesticide poisoning.
Compared with lower-risk pesticide exposures, paraquat poisoning was associated with markedly increased odds of death (aOR = 21.5; 95% CI: 9.4-48.2), while glyphosate poisoning was associated with elevated mortality risk (aOR = 5.2; 95% CI: 1.8-14.6).
Mortality following pesticide poisoning in Tanzania was strongly concentrated among a small number of highly hazardous pesticides, particularly paraquat.
These findings support continued restriction and removal of highly hazardous pesticides, strengthening of pesticide-specific surveillance systems, improved clinical toxicology capacity, and enhanced poisoning prevention strategies.
Continued monitoring will be important to evaluate the public health impact of recent pesticide regulatory reforms in Tanzania.