Currently submitted to: JMIR Research Protocols
Date Submitted: May 31, 2026
Open Peer Review Period: Jun 1, 2026 - Jun 29, 2026
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PAWS: Prevalence and Warning Signs of Dog Bites- A Protocol for Systematic Review
ABSTRACT
Background:
Dog bites represent a significant global public health concern, particularly among children and adolescents. Approximately 330,000 emergency department visits occur annually in the United States alone due to dog bite injuries, with pediatric populations bearing a disproportionate burden. Despite this, existing systematic reviews remain fragmented, focusing on isolated aspects such as breed-specific risk, educational interventions, or legislative measures without comprehensively addressing the global incidence, prevalence, and multifactorial risk profile in pediatric cohorts.
Objective:
This protocol describes a planned systematic review aimed at synthesizing international evidence on the incidence and prevalence of dog bites in pediatric populations (aged ≤18 years), with concurrent analysis of demographic, behavioral, and environmental risk and protective factors.
Methods:
A comprehensive search of PubMed, Embase, and Web of Science will be conducted, with no date restrictions, limited to English-language observational studies (cross-sectional, case-control, cohort) and population-based surveys. The PECOS framework will guide inclusion and exclusion criteria. Two independent reviewers will screen records and extract data using a standardized codebook, with discrepancies resolved by consensus or a third reviewer. Study quality will be assessed using validated tools appropriate to each study design. Findings will be synthesized narratively with descriptive statistics; meta-analysis will be pursued where sufficient homogeneity exists.
Results:
This review is anticipated to be the first comprehensive global synthesis of pediatric dog bite burden, stratified by age group (newborns through adolescents), geographic region (developed vs developing countries), sex, and socioeconomic context. It will identify critical gaps in the evidence base and provide actionable evidence to inform targeted prevention strategies, clinical pathways, and public health policy.
Conclusions:
By aggregating data across diverse populations and settings, this systematic review will deliver the most comprehensive global assessment of pediatric dog bite epidemiology to date, with direct implications for reducing the burden of these preventable injuries worldwide. Clinical Trial: Trial Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251129292
Citation
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