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Martin T, Nanjebe D, Atwine D. Assessment of the proportion of households with burn victims, associated risk factors and knowledge of burn injury prevention strategies in South Western Uganda. A population based cross sectional survey. Burns 2023; 49:1756-1764. [PMID: 37032274 DOI: 10.1016/j.burns.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Burn injuries are a major cause of morbidity and mortality within Low- and Middle-income countries (LMICs). Most of these burn injuries occur at home with children most at risk. The majority of burn related deaths and disability in LMICs have been described as preventable. Burns prevention requires adequate knowledge of the epidemiological characteristics and associated risk factors. The aim of this study was to assess the proportion of households with burn victims, the associated risk factors and knowledge of prevention strategies of burn injuries in Kakoba division, Mbarara city. METHODS We did a population based cross sectional survey of households in Kakoba division. This is the most populous division in Mbarara city. Face-to-face interviews were conducted using a pretested structured questionnaire. Descriptive analysis was performed to establish prevalence and knowledge of preventive strategies for household burns. Univariate and multivariate logistic regression models were fitted to establish the factors influencing burn injuries at household level. RESULTS Of the households in Kakoba Division, 41.2% had individuals who had previously sustained burn injuries within the household. Children were the most affected population with scald burns the most common type. The highest risk of burn injuries was associated with overcrowding in the households. Electricity as a light source was found to be protective. Candles and Kerosene lamps were the commonest alternative light sources. Majority 98% of the individuals in the households knew at least one burns prevention strategy with 93% practicing at least one. CONCLUSION Burns within the household are still high despite knowledge of risk factors with children being the most affected. Overcrowding still plays a significant role in household burn injuries. We therefore recommend closer supervision of children within the households. Cooking areas need to be properly designated and secured to limit access. Safer alternative light sources need to be explored such as solar lamps. Political leaders need to be involved in setting up and monitoring community-based fire safety practices to ensure compliance.
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Affiliation(s)
- Tungotyo Martin
- Department of Surgery, Mbarara University of Science and Technology (MUST), P.O. Box 1410, Uganda.
| | | | - Daniel Atwine
- Soar Research Foundation, P.O. Box 1596, Mbarara, Uganda
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Opriessnig E, Luze H, Smolle C, Draschl A, Zrim R, Giretzlehner M, Kamolz LP, Nischwitz SP. Epidemiology of burn injury and the ideal dressing in global burn care - Regional differences explored. Burns 2023; 49:1-14. [PMID: 35843806 DOI: 10.1016/j.burns.2022.06.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/07/2022] [Accepted: 06/27/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE Burn injuries are to this day a major cause of morbidity and mortality, especially within low- and middle-income countries. Understanding the etiology of burn injury and epidemiologic- and hospital-specific factors associated with burns is vital for allotting resources for prevention and treatment. Therefore, the purpose of this study was to develop a profile of epidemiological differences in burn care and the ideal burn dressing among the different continents based on a global online survey. OBJECTIVES This analysis evaluated trends in demographics, epidemiology of burn care, burn incidence, infection, related mortality and burn treatment (e.g., dressing changes and materials). The objective of this study was to investigate and compare the epidemiological profile of burn injury/care amongst the continents and a global control group to determine their utility for guiding evidence-based burn care and identify differences and/or similarities in their clinical practice. METHODS A retrospective analysis of data was performed that was acquired during a previous study investigating the ideal burn dressing on a global perspective. The data was analyzed depending on the continent, on which the respondent indicated their hospital to be (Africa, Australia & New Zealand, Asia, Europe, Middle and South America, North America). Statistical analysis was performed to evaluate patient and hospital demographics and variables associated with burn injuries and their treatment. Outcomes of interest also included infections, mortality, length of stay on the ICU and important burn dressing characteristics. RESULTS Healthcare providers in different areas of the world share similar views and needs regarding burn care management and on what constitutes an ideal burn dressing. We found significant differences in the various continents regarding hospitalization and length of stay on the ICU, with Australia taking the lead. Africa, with a high proportion of low-income-countries, reported the highest rate of burn infections, mortality, and a disproportionally high number of burn incidences amongst children. In general, men were mostly obtaining burn injuries amongst all continents. We found no significant differences regarding the most important characteristics of an ideal burn dressing. CONCLUSION Our results suggest significant epidemiological differences regarding burn injuries and care amongst the continents, possibly resulting from the different infrastructure and/or circumstances on the various continents. Future scientific studies need to focus on adequate pain management and designing longer lasting materials that contain the "ideal" properties, by also taking individual regional needs/desires and the patient's perspective and economic boundaries into account. This analysis has delivered valuable insights into the epidemiological differences and/or similarities amongst the various continents.
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Affiliation(s)
- Elisa Opriessnig
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
| | - Hanna Luze
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Christian Smolle
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Alexander Draschl
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Robert Zrim
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria; International University of Monaco, Monaco
| | - Michael Giretzlehner
- Research Unit for Medical-Informatics, RISC Software GmbH, Johannes Kepler University Linz, Linz, Austria
| | - Lars-Peter Kamolz
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria; COREMED - Cooperative Centre for Regenerative Medicine, Joanneum research Forschungsgesellschaft mbH, Graz, Austria
| | - Sebastian P Nischwitz
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
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Mulatu D, Zewdie A, Zemede B, Terefe B, Liyew B. Outcome of burn injury and associated factor among patient visited at Addis Ababa burn, emergency and trauma hospital: a two years hospital-based cross-sectional study. BMC Emerg Med 2022; 22:199. [PMID: 36494642 PMCID: PMC9733383 DOI: 10.1186/s12873-022-00758-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Burn is one of the critical health problems worldwide. Developing countries with sub-Saharan and Asian populations are affected more. Its mortality and non-fatal complications depend on several factors including age, sex, residency, cause, the extent of the burn, and time and level of care given. OBJECTIVE The purpose of this study was to assess the outcome of burn injury and its associated factor among patients who visited Addis Ababa burn emergency and trauma hospital. METHODS The institutional-based, retrospective cross-sectional study design was conducted from April 1, 2019, to March 30, 2021. After checking the data for its consistency the data were entered and analyzed by using SPSS version 25. A total of 241 patients who had visited Addis Ababa burn, emergency and trauma Hospitals after sustained burn injury were recruited through convenience sampling method for final analysis. Model goodness-of-fit was checked by Hosmer and Lemeshow test (0.272). After checking multi-collinearity both the bi-variable and multivariable logistic regression model was fitted and variables having a p-value less than or equal to 0.05 at 95% CI in the multivariable analysis were considered statistically significant. RESULT Adults (age 15 to 60 years) are the most affected groups accounting for 55.2% followed by pediatric age groups (age <15 years) (43.6%) and the elderly (age > 60 years) (1.2%). Scald burn was the major cause accounting for 39 % followed by Flame burn (33.6%), Electrical burn (26.6%), and chemical burn (0.8%). The mean TBSA% was 15.49%, ranging from1% to 64%. Adult males are more affected by electrical burns while adult females and the elderly encounter flame burn. 78.4% of patients were discharged without complications, 14.9% were discharged with complications and 6.6% died. The commonest long-term complication is the amputation of the extremity (19, 7.9%). Age greater than 60 years and TBSA% greater than 30% is a strong predictors of mortality with odds of 2.2 at 95% CI of [1.32, 3.69] and 8.7 at 95% CI of [1.33, 57.32] respectively. CONCLUSION AND RECOMMENDATION The mortality rate show decrement from previous studies. Overall scald burn is common in all age groups but electrical burns and flame burns affected more adult and elderly age groups. Extremities were by far, the commonest affected body parts. The extent of burn injury and the age of the patient independently predict mortality. Early intervention will reduce mortality and complications.
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Affiliation(s)
- Damena Mulatu
- grid.59547.3a0000 0000 8539 4635Department of internal medicine, School of medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayalew Zewdie
- grid.460724.30000 0004 5373 1026Department of Emergency Medicine and Critical Care, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Biruktawit Zemede
- grid.460724.30000 0004 5373 1026Department of Emergency Medicine and Critical Care, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Bewuketu Terefe
- grid.59547.3a0000 0000 8539 4635Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bikis Liyew
- grid.59547.3a0000 0000 8539 4635Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, P.O.BOX 196, Gondar, Ethiopia
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Purcell LN, Banda W, Akinkuotu A, Phillips M, Hayes-Jordan A, Charles A. Characteristics and predictors of mortality in-hospital mortality following burn injury in infants in a resource-limited setting. Burns 2022; 48:602-607. [PMID: 34284937 PMCID: PMC8755851 DOI: 10.1016/j.burns.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 06/17/2021] [Accepted: 07/07/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE Burn outcome data in infants is lacking from sub-Saharan Africa. We, therefore, sought to assess the characteristics and predictors of in-hospital burn mortality in a resource-limited setting. METHODS We performed a retrospective study of the prospectively collected Burn Injury Surveillance database from June 2011 to December 2019. We performed bivariate analysis and Poisson regression to assess risk factors for mortality in our infant burn population. RESULTS 115 (7.3%) infants met inclusion criteria. The median age of 8 months (IQR: 6-10) and primarily male (n = 67, 58.8%). Most burns were from scald (n = 62, 53.9%). Infant burn mortality was 12.2%. Poisson multivariable regression to determine burn mortality risk in infants showed that increased %TBSA burns (RR 1.04, 95% CI 1.01-1.07) and flame burns (RR 3.08, 95%CI 1.16-8.16) had a higher risk of mortality. Having surgery reduced the relative risk of death for infants with burns. CONCLUSION We show that factors that increase infant burn mortality risk include percent total body surface area burn, flame burn mechanism, and lack of operative intervention. Increasing burn operative capability, particularly for infants and other children, is imperative.
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Affiliation(s)
- Laura N. Purcell
- Department of Surgery, University of North Carolina at Chapel Hill
| | - Wone Banda
- Kamuzu Central Hospital, Lilongwe, Malawi
| | | | - Michael Phillips
- Department of Surgery, University of North Carolina at Chapel Hill
| | | | - Anthony Charles
- Department of Surgery, University of North Carolina at Chapel Hill,Kamuzu Central Hospital, Lilongwe, Malawi,Anthony Charles MD, MPH, UNC School of Medicine, 4008 Burnett Womack Building, CB 7228, P:9199664388, F:9199660369,
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Gyedu A, Stewart BT, Otupiri E, Mehta K, Donkor P, Mock C. Incidence of childhood injuries and modifiable household risk factors in rural Ghana: a multistage, cluster-randomised, population-based, household survey. BMJ Open 2021; 11:e039243. [PMID: 34301645 PMCID: PMC8311320 DOI: 10.1136/bmjopen-2020-039243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE We aimed to describe the incidence of childhood household injuries and prevalence of modifiable household risk factors in rural Ghana to inform prevention initiatives. SETTING 357 randomly selected households in rural Ghana. PARTICIPANTS Caregivers of children aged <5 years. PRIMARY AND SECONDARY OUTCOME MEASURES Childhood injuries that occurred within 6 months and 200 metres of the home that resulted in missed school/work, hospitalisation and/or death. Sampling weights were applied, injuries were described and multilevel regression was used to identify risk factors. RESULTS Caregivers from 357 households had a mean age of 35 years (SD 12.8) and often supervised ≥2 children (51%). Households typically used biomass fuels (84%) on a cookstove outside the home (79%). Cookstoves were commonly <1 metre of the ground (95%). Weighted incidence of childhood injury was 542 per 1000 child-years. Falls (37%), lacerations (24%), burns (12%) and violence (12%) were common mechanisms. There were differences in mechanism across age groups (p<0.01), but no gender differences (p=0.25). Presence of older children in the home (OR 0.15, 95% CI 0.09 to 0.24; adjusted OR (aOR) 0.26, 95% CI 0.13 to 0.54) and cooking outside the home (OR 0.28, 95% CI 0.19 to 0.42; aOR 0.25, 95% CI 0.13 to 0.49) were protective against injury, but other common modifiable risk factors (eg, stove height, fuel type, secured cabinets) were not. CONCLUSIONS Childhood injuries occurred frequently in rural Ghana. Several common modifiable household risk factors were not associated with an increase in household injuries. Presence of older children was a protective factor, suggesting that efforts to improve supervision of younger children might be effective prevention strategies.
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Affiliation(s)
- Adam Gyedu
- Department of Surgery, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Barclay T Stewart
- Department of Surgery, University of Washington, Seattle, Washington, USA
- Global Injury Control Section, Harborview Injury Prevention & Research Center, Seattle, Washington, USA
| | - Easmon Otupiri
- Department of Community Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kajal Mehta
- Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Peter Donkor
- Department of Surgery, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Kwame Nkrumah University of Science and Technology, Kumais, Ghana
| | - Charles Mock
- Surgery, University of Washington, Seattle, Washington, USA
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Stewart B, Gyedu A, Otupiri E, Nakua E, Boakye G, Mehta K, Donkor P, Mock C. Comparison of childhood household injuries and risk factors between urban and rural communities in Ghana: A cluster-randomized, population-based, survey to inform injury prevention research and programming. Injury 2021; 52:1757-1765. [PMID: 33906741 DOI: 10.1016/j.injury.2021.04.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/11/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Childhood household injuries incur a major proportion of the global disease burden, particularly in low- and middle-income countries (LMICs). However, household injury hazards are differentially distributed across developed environments. Therefore, we aimed to compare incidence of childhood household injuries and prevalence of risk factors between communities in urban and rural Ghana to inform prevention initiatives. METHODS Data from urban and a rural cluster-randomized, population-based surveys of caregivers of children <5 years in Ghana were combined. In both studies, caregivers were interviewed about childhood injuries that occurred within the past 6 months and 200 meters of the home that resulted in missed school/work, hospitalization, and/or death. Sampling weights were applied, injuries and incidence rate ratios (IRRs) were described, and multi-level regression was used to identify and compare risk factors. RESULTS We sampled 200 urban and 357 rural households that represented 20,575 children in Asawase and 14,032 children in Amakom, Ghana, respectively. There were 143 and 351 injuries in our urban and rural samples, which equated to 594 and 542 injuries per 1,000 child-years, respectively (IRR 1.09, 95%CI 1.05-1.14). Toddler-aged children had the highest odds of injury both urban and rural communities (OR 3.77 vs 3.17, 95%CI 1.34-10.55 vs 1.86-5.42 compared to infants, respectively). Urban children were more commonly injured by falling (IRR 1.50, 95%CI 1.41-1.60), but less commonly injured by flame/hot substances (IRR 0.51, 95%CI 0.44-0.59), violence (IRR 0.41, 95%CI 0.36-0.48), or motor vehicle (IRR 0.50, 95%CI 0.39-0.63). Rural households that cooked outside of the home (OR 0.36, 95%CI 0.22-0.60) and that also supervised older children (OR 0.33, 95%CI 0.17-0.62) had lower odds of childhood injuries than those that did not. CONCLUSIONS Childhood injuries were similarly common in both urban and rural Ghana, but with different patterns of mechanisms and risk factors that must be taken into account when planning prevention strategies. However, the data suggest that several interventions could be effective, including: community-based, multi-strategy initiatives (e.g., home hazard reduction, provision of safety equipment, establishing community creches); traffic calming interventions in rural community clusters; and passive injury surveillance systems that collect data to inform violence and broader prevention strategies.
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Affiliation(s)
- Barclay Stewart
- Harborview Injury Prevention & Research Center, Seattle, WA, USA; Department of Surgery, University of Washington, Seattle, WA, USA.
| | - Adam Gyedu
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Easmon Otupiri
- Department of Population, Family and Reproductive Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Nakua
- Department of Epidemiology and Biotatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Kajal Mehta
- Department of Surgery, University of Washington, Seattle, WA, USA.
| | - Peter Donkor
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Mock
- Harborview Injury Prevention & Research Center, Seattle, WA, USA; Department of Surgery, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA.
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An Epidemiological Study of Burn Cases from a Single Referral Hospital in Indore, Central Part of India and a Proposal for Burn Prevention and Care Program. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02124-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Gallaher JR, Purcell LN, Banda W, Charles A. The effect of traditional healer intervention prior to allopathic care on pediatric burn mortality in Malawi. Burns 2020; 46:1952-1957. [DOI: 10.1016/j.burns.2020.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 12/13/2022]
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Dinesh A, Polanco T, Khan K, Ramcharan A, Engdahl R. Our Inner-city Children Inflicted With Burns: A Retrospective Analysis of Pediatric Burn Admissions at Harlem Hospital, NY. J Burn Care Res 2020; 39:995-999. [PMID: 29771374 DOI: 10.1093/jbcr/iry026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/15/2018] [Indexed: 11/14/2022]
Abstract
Pediatric burns in the urban environment present special problems. Communities in the inner-city may be unique with hardships due to various socioeconomic factors. Few, if any, papers have specifically sought to analyze pediatric burns in the inner-city, and there has been no report to date reviewing Harlem New York City, one of the most challenged areas in the nation. The aim of this study is to understand the prehospital circumstances and socioeconomic factors of affected patients, hospital care, and management of pediatric patients admitted with burns in Harlem. A retrospective review was performed of all the patients aged 0 to 18 years old admitted to the burn care unit from January 2006 to May 2017. Data collected included age, gender, ethnicity, burn mechanism, total burn surface area, first aid and management, socioeconomic factors including parental supervision, single or binary parenting, caregiver financial and employment status, New York City Administration for Children's Services (ACS) child protective services reporting for child abuse or neglect. Analysis was done using Microsoft Excel 2016 and SPSS statistics v23. A total of 177 pediatric burn patient admissions were included. The majority of the patients were toddlers (1-5 years of age). The most common type was scald burns. The average TBSA burnt was approximately 9%. Nearly all the injuries occurred at home with more being during winter months. Strikingly, the majority of patients, over 75%, did not receive appropriate first aid measures. Moreover, socioeconomic issues were significant with 60% of patients having single parents, approximately 35% with lack of supervision and neglect or abuse reported in 25% of these cases. Unemployment rate of the caregiver was high, with 50% unemployed or in between jobs. In 73% of the patients, their parents were receiving some form of social aid for childcare and sustenance of family needs. Pediatric burns are a major public health issue. An understanding of community variations with these injuries is essential taking into account socioeconomic challenges that these children face. Our inner-city hospital pediatric burn admissions have substantial caregiver and socioeconomic challenges in excess of traditionally reported in the literature. Most injuries occurred at home and the majority lacked proper prehospital first aid care. This analysis is informative, providing professionals and caregivers topics of consideration regarding safe practices at home, appropriate first aid measures, prevalent socioeconomic issues in our community in Harlem. There is a need to address socioeconomic factors which may potentially prevent pediatric burn admissions in these inner-city communities.
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Affiliation(s)
- Anant Dinesh
- Department of Surgery, Harlem Hospital Center, Columbia University, New York, New York
| | - Thais Polanco
- Department of Surgery, Harlem Hospital Center, Columbia University, New York, New York
| | - Khuram Khan
- Department of Surgery, Harlem Hospital Center, Columbia University, New York, New York
| | - Alexius Ramcharan
- Department of Surgery, Harlem Hospital Center, Columbia University, New York, New York
| | - Ryan Engdahl
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Harlem Hospital Center, Columbia University, New York, New York
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First aid management of paediatric burn and scald injuries in Southern Malawi: A mixed methods study. Burns 2019; 46:727-736. [PMID: 31732221 DOI: 10.1016/j.burns.2019.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/06/2019] [Accepted: 08/29/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND In sub-Saharan Africa, burn and scald injuries occur more commonly in children aged less than five years, than in any other age group, and carry a high lifetime morbidity. The optimal first aid at the time of injury includes the use of cool running water, which can reduce pain, scarring, and skin grafting. Data on the types of first aid used in Malawi is lacking, as is an in-depth understanding of the underlying factors which may influence this health behaviour. This study sought to: (a) document the types of first aid after paediatric burn and scald injuries in Southern Malawi; and (b) explore factors affecting the choice of first aid used. METHODS ANDFINDINGS We conducted a sequential explanatory mixed methods study. Quantitative analysis of a prospectively collected database of all patients aged less than 17 years admitted to the only burn unit in Southern Malawi was followed by thematic analysis of semi-structured interviews with 15 adults who had witnessed a paediatric burn or scald injury. 1326 patients aged less than 17 years were admitted to the Queen Elizabeth Central Hospital between July 2009 and December 2016. Median age was 3.0 years (IQR 1.9-5.0) and male to female ratio 1:0.9. The commonest cause of injury was hot liquid (45%), followed by open fire (31%) and porridge (12%). First aid was applied in 829 patients (69%), the commonest applications used were water (31%) and egg (21%). There was a statistically significant association between the type of first aid and secondary education of the father (p = 0.009) or mother (p = 0.036); however, the type of first aid used was more likely to be egg rather than water. Analysis of qualitative interviews identified four main themes: perceived roles and responsibilities within the community, drivers of individual behaviours, availability, and trust. Participants reported using eggs as a first aid treatment, as these were readily available and were seen to reduce the occurrence of blisters and prevent peeling of the skin. By comparison, there was a strong underlying fear of using water on burn injuries due to its association with peeling of the skin. Intergenerational learning appeared to play a strong role in influencing what is used at the time of injury, and mothers were the key source of this information. CONCLUSIONS This study provides the largest description of first aid use in sub-Saharan Africa, strengthening the evidence that remedies aside from water are commonly used and that higher parental education levels do not translate to increased use of water, but rather use of alternative treatments. Our qualitative findings allow improved understanding of how first aid for paediatric burns is perceived in rural Malawi communities, providing insight as to why certain first aid choices are made and the possible barriers and facilitators to the adoption of water as a first aid treatment.
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First aid is associated with improved outcomes in large body surface area burns. Burns 2019; 45:1743-1748. [PMID: 31606315 DOI: 10.1016/j.burns.2019.05.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 05/02/2019] [Accepted: 05/15/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Animal studies indicate treating burn injuries with running water (first aid) for 20 min up to 3 h after burn reduces healing time and scarring. We have previously demonstrated the benefits of first aid in minor burn injuries with respect to a reduction in wound depth, faster healing, and decreased skin grafting utilisation. The purpose of this cohort study was to assess the effect of first aid on clinical outcomes in large body surface area burn injuries (≥20%). METHODS Data was prospectively collected for patients with ≥20% TBSA burns from 2004- 2018. Multivariate regression analysis was used to determine the association of adequate first aid with 8 outcomes - mortality, total length of stay, total body surface area (TBSA), percentage/proportion of TBSA that was full thickness [PFTI], TBSA grafted, number of re-grafting sessions, intensive care admission, and intensive care length of stay. Adequate first aid was defined as the application of 20 min of cool, running tap water up to 3 h following the burn injury. FINDINGS 390 patients were identified. Adequate first aid was received in 35.6% (139) of patients. There was a trend towards a reduction in mortality (OR 0.37; 95% CI 0.12-1.13; P = 0.08). Patients who received adequate first aid had a statistically significant 9.8% reduction in TBSA (95% CI -13.6% to -6.1%; P < 0.0001) as well as a 12% lower PTFI compared to patients who received inadequate first aid (95% CI -19% to -4%; P < 0.01). Whilst there was no significant effect of adequate first aid on the TBSA grafted (P = 0.37), adequate first aid was associated with a significantly less number of re-grafting sessions (95% CI --0.29 to -0.08; P < 0.001). INTERPRETATION Adequate first aid with 20 min of running water is associated with improved outcomes in large burn injuries. Significant benefits are seen in a reduction in TBSA, proportion of the burn wound that is full thickness, as well as decreased re-grafting. This has significant patient and health system benefits and adds to the body of evidence supporting 20 min of cooling in burns care.
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Harish V, Tiwari N, Fisher OM, Li Z, Maitz PKM. First aid improves clinical outcomes in burn injuries: Evidence from a cohort study of 4918 patients. Burns 2018; 45:433-439. [PMID: 30337155 DOI: 10.1016/j.burns.2018.09.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/23/2018] [Accepted: 09/13/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Animal studies indicate treating burn injuries with running water (first aid) for 20min up to 3h post-burn reduces healing time and scarring. There is a lack of human data to support such a recommendation. The purpose of this cohort study was to assess the effect of first aid on clinical outcomes. METHODS Data was prospectively collected for patients with <10% total body surface area (TBSA) burns from 2007-2012. Multivariate regression analysis was used to determine the association of adequate first aid with four outcomes - wound depth, requirement for skin grafting, healing time (in non-grafted patients), and TBSA not grafted (in grafted patients). Adequate first aid was defined as the application of 20min of cool, running tap water up to 3h following the burn injury. FINDINGS 4918 patients were identified. Adequate first aid was received in 58.1% (2859) of patients. It was associated with a statistically significant reduction in burn wound depth (OR 1.39; 95% CI 1.24-1.55; P<0.001) but was not associated with a reduction in TBSA (P=0.86) or requirement for grafting (P=0.47). In patients not requiring grafting, those who received adequate first aid were healed on average 10% (HR 1.10; 95% CI 1.03-1.18; P<0.01) or 1.9 days faster (95% CI -2.9 to -0.9; P<0.001). Adequate first aid in patients requiring grafting was associated with a 15% increase in TBSA that was not grafted (0.27%; 95% CI 0.01-0.52; P=0.04). INTERPRETATION Adequate first aid with 20min of running water is associated with improved outcomes. Benefits are seen in a reduction in wound depth, faster healing, and decreased grafting requirements. This has significant patient and health system benefits, and calls for promotion of 20min of running water globally in burns care.
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Affiliation(s)
- Varun Harish
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia; ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia.
| | - Neha Tiwari
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia
| | - Oliver M Fisher
- Department of Surgery, St George Hospital, Sydney, Australia; Department of Surgery, University of Notre Dame School of Medicine, Australia
| | - Zhe Li
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia; ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia; University of Sydney, Sydney, Australia
| | - Peter K M Maitz
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia; ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia; University of Sydney, Sydney, Australia
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Burn first aid knowledge and its determinants among general population of Rawalpindi. Eur J Trauma Emerg Surg 2018; 45:1121-1128. [PMID: 30167739 DOI: 10.1007/s00068-018-0996-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/20/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To assess the general knowledge and practices related to burn first aid treatment (BFAT) and to examine age, gender, socioeconomic status, education and previous history of exposure to burn (self/family member) as factors influencing burn first aid knowledge among the general population of Rawalpindi. STUDY DESIGN A cross-sectional, descriptive survey. PLACE AND DURATION OF STUDY Three major tertiary care hospitals of Rawalpindi, from August 2017 to May 2018. METHODOLOGY All consenting people ≥ 18 years of age, with or without a prior history of burn, accompanying patients to three major tertiary care centers of Rawalpindi were administered a pre-tested structured questionnaire. The questionnaire was divided into two sections; socio-demographic section and knowledge on BFAT. Those who were illiterate and could not fill the questionnaire were interviewed and their responses were marked by the researchers themselves. Data were analyzed using SPSS version 21. RESULTS A total of 400 participants comprising 205 (51.3%) males and 195 (48.8%) females with a mean age of 38 ± 10.3 years were included. The majority (58%) were educated up to 12th grade or higher. "Toothpaste" (47.5%) followed by "cool running water" (20.3%) were the two most frequently applied items following a burn injury. Only 8.8% respondents applied cold water for the ideal time duration. Overall, 83% of the participants provided correct answers for 25-50% of the survey questions. Socioeconomic and educational status of the participants had a significant association with burn first aid knowledge. CONCLUSION A significant limitation of knowledge regarding BFAT was seen among the general population of Rawalpindi.
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Amissah NA, van Dam L, Ablordey A, Ampomah OW, Prah I, Tetteh CS, van der Werf TS, Friedrich AW, Rossen JW, van Dijl JM, Stienstra Y. Epidemiology of Staphylococcus aureus in a burn unit of a tertiary care center in Ghana. PLoS One 2017; 12:e0181072. [PMID: 28704546 PMCID: PMC5509299 DOI: 10.1371/journal.pone.0181072] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/26/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In developing countries, hospitalized burn victims are at high risk of nosocomial infections caused by Staphylococcus aureus. Risk factors include poor infection control practices, prolonged hospitalisation and limited capacity for laboratory microbiological analyses. These problems are compounded by widespread use of antibiotics that drives the spread of multi-drug resistant bacteria. METHODS During the study period (November 2014-June 2015), nasal and invasive S. aureus isolates were collected consecutively from patients and healthcare workers (HCWs) within the burn unit of the Reconstructive Plastic Surgery and Burn Center of Korle Bu Teaching Hospital in Ghana. Antibiotic prescription, antibiotic susceptibility and bacterial typing were used to assess antibiotic pressure, antibiotic resistance, and possible transmission events among patients and HCWs. RESULTS Eighty S. aureus isolates were obtained from 37 of the 62 included burn patients and 13 of the 29 HCWs. At admission, 50% of patients carried or were infected with S. aureus including methicillin resistant S. aureus (MRSA). Antibiotic use per 100 days of hospitalization was high (91.2 days), indicating high selective pressure for resistant pathogens. MRSA isolates obtained from 11 patients and one HCW belonged to the same spa-type t928 and multi-locus sequence type 250, implying possible transmission events. A mortality rate of 24% was recorded over the time of admission in the burn unit. CONCLUSION This study revealed a high potential for MRSA outbreaks and emergence of resistant pathogens amongst burn patients due to lack of patient screening and extended empirical use of antibiotics. Our observations underscore the need to implement a system of antibiotic stewardship and infection prevention where microbiological diagnostics results are made available to physicians for timely and appropriate patient treatment.
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Affiliation(s)
- Nana Ama Amissah
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Lieke van Dam
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Anthony Ablordey
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Opoku-Ware Ampomah
- The Reconstructive Plastic Surgery and Burn Center, Korle Bu Teaching Hospital, Korle Bu, Ghana
| | - Isaac Prah
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Caitlin S. Tetteh
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Tjip S. van der Werf
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Alexander W. Friedrich
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - John W. Rossen
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Jan Maarten van Dijl
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ymkje Stienstra
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Rybarczyk MM, Schafer JM, Elm CM, Sarvepalli S, Vaswani PA, Balhara KS, Carlson LC, Jacquet GA. A systematic review of burn injuries in low- and middle-income countries: Epidemiology in the WHO-defined African Region. Afr J Emerg Med 2017; 7:30-37. [PMID: 30456103 PMCID: PMC6234151 DOI: 10.1016/j.afjem.2017.01.006] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/03/2016] [Accepted: 01/10/2017] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION According to the World Health Organization (WHO), burns result in the loss of approximately 18 million disability adjusted life years (DALYs) and more than 250,000 deaths each year, more than 90% of which are in low- and middle-income countries (LMICs). The epidemiology of these injuries, especially in the WHO-defined African Region, has yet to be adequately defined. METHODS We performed a systematic review of the literature regarding the epidemiology of thermal, chemical, and electrical burns in the WHO-defined African Region. All articles indexed in PubMed, EMBASE, Web of Science, Global Health, and the Cochrane Library databases as of October 2015 were included. RESULTS The search resulted in 12,568 potential abstracts. Through multiple rounds of screening using criteria determined a priori, 81 manuscripts with hospital-based epidemiology as well as eleven manuscripts that included population-based epidemiology were identified. Although the studies varied in methodology, several trends were noted: young children appear to be at most risk; most individuals were burned at home; and hot liquids and flame are the most common aetiologies. DISCUSSION While more population-based research is essential to identifying specific risk factors for targeted prevention strategies, our review identifies consistent trends for initial efforts at eliminating these often devastating and avoidable injuries.
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Affiliation(s)
- Megan M. Rybarczyk
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, United States
| | - Jesse M. Schafer
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Courtney M. Elm
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, United States
| | - Shashank Sarvepalli
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, United States
| | - Pavan A. Vaswani
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States
| | - Kamna S. Balhara
- Department of Emergency Medicine, The Johns Hopkins Hospital, Baltimore, MD, United States
| | - Lucas C. Carlson
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, United States
| | - Gabrielle A. Jacquet
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, United States
- Boston University School of Medicine, Boston, MA, United States
- Boston University Center for Global Health and Development, Boston, MA, United States
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Kattan AE, AlShomer F, Alhujayri AK, Addar A, Aljerian A. Current knowledge of burn injury first aid practices and applied traditional remedies: a nationwide survey. BURNS & TRAUMA 2016; 4:37. [PMID: 27826592 PMCID: PMC5094133 DOI: 10.1186/s41038-016-0063-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 09/22/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Burn first aid awareness has been shown to reduce morbidity and mortality. We present a report on the knowledge and practices of the Saudi population with regard to burn first aid and the application of traditional remedies. METHODS An internet-based survey was conducted to assess the public's knowledge on first aid practices and home remedies applied for burn injuries among Saudi adults. RESULTS A total of 2758 individuals responded to the survey. There were 1178 (42.7 %) respondents who had previously received burn first aid information. One thousand five hundred fifty respondents had a history of burn exposure in which burn injury first aid was applied as follows: 1118 (72.1 %) removed clothing and accessories from the injured area; water was applied by 990 (63.9 %); among those who applied water, 877 (88.6 %) applied cold water; and only 57 (5.8 %) did so for more than 15 min. Wrapping the burn area was performed by 526 (33.9 %), and 985 (63.5 %) sought medical assistance. When it comes to traditional remedies, 2134 (77.4 %) knew of and/or implemented these remedies as first aid or to treat burns. Honey and toothpaste were the commonest among these remedies with 1491 (69.9 %) and 1147 (53.7 %), respectively. This was associated with female gender (r = 0.87, P < 0.001), younger age group (19-25 years) (r = 0.077, P < 0.001), from central region (r = 0.012, P < 0.001), and university graduate (r = 0.05, P = 0.002). Nearly half of those who knew of traditional remedies did not have previous knowledge of burn first aid. CONCLUSIONS Proper burn first aid is a simple, cheap, and accessible means of managing burns initially. Although the majority of the respondents were university graduates (51.1 %), knowledge and implementation of burn first aid was very poor. Major healthcare agencies should review and promote a consistent guideline for burn first aid in an effort to tackle and minimize the effect of this grave injury.
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Affiliation(s)
- Abdullah E Kattan
- Plastic and Reconstructive Surgery Unit, King Khalid University Hospital, College of Medicine, King Saud University, 37 P. O. Box 7805, Riyadh, 11472 Kingdom of Saudi Arabia
| | - Feras AlShomer
- Plastic and Reconstructive Surgery Unit, King Khalid University Hospital, College of Medicine, King Saud University, 37 P. O. Box 7805, Riyadh, 11472 Kingdom of Saudi Arabia
| | - Abdulaziz K Alhujayri
- Plastic and Reconstructive Surgery Unit, King Khalid University Hospital, College of Medicine, King Saud University, 37 P. O. Box 7805, Riyadh, 11472 Kingdom of Saudi Arabia
| | - Abdullah Addar
- Plastic and Reconstructive Surgery Unit, King Khalid University Hospital, College of Medicine, King Saud University, 37 P. O. Box 7805, Riyadh, 11472 Kingdom of Saudi Arabia
| | - Albaraa Aljerian
- Plastic and Reconstructive Surgery Unit, King Khalid University Hospital, College of Medicine, King Saud University, 37 P. O. Box 7805, Riyadh, 11472 Kingdom of Saudi Arabia
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Blom L, Klingberg A, Laflamme L, Wallis L, Hasselberg M. Gender differences in burns: A study from emergency centres in the Western Cape, South Africa. Burns 2016; 42:1600-1608. [PMID: 27262931 DOI: 10.1016/j.burns.2016.05.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 05/04/2016] [Accepted: 05/07/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Little is known about gender differences in aetiology and management of acute burns in resource-constrained settings in South Africa. METHOD This cross-sectional study is based on burn case reports (n=1915) from eight emergency centres in Western Cape, South Africa (June 2012-May 2013). Male/female rate ratios by age group and age-specific incidence rates were compiled for urban and rural areas along with gender differences in proportions between children and adults for injury aetiology, burn severity, length of stay and patient disposition. RESULTS Children 0-4 years in urban areas had the highest burn incidence but only among adults did male rates surpass females, with fire burns more common among men 20-39 years and hot liquid burns among men 55+ years. Men had a higher proportion of burns during weekends, from interpersonal violence and suspected use of alcohol/other substances, with more pronounced differences for hot liquid burns. Despite similar Abbreviated Injury Scale (AIS) scores, men were more often transferred to higher levels of care and women more often treated and discharged. CONCLUSION Burns were far more common among children although gender differences arose only among adults. Men sustained more injuries of somewhat different aetiology and were referred to higher levels of care more often for comparable wound severity. The results suggest different disposition between men and women despite similar AIS scores. However, further studies with more comprehensive information on severity level and other care- and patient-related factors are needed to explore these results further.
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Affiliation(s)
- Lisa Blom
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Anders Klingberg
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Lucie Laflamme
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; University of South Africa, Pretoria, South Africa
| | - Lee Wallis
- Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Bellville, South Africa
| | - Marie Hasselberg
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Adjorlolo S, Adu-Poku S, Andoh-Arthur J, Botchway I, Mlyakado BP. Demographic factors, childhood maltreatment and psychological functioning among university students' in Ghana: A retrospective study. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2015; 52 Suppl 1:9-17. [DOI: 10.1002/ijop.12248] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 11/12/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Samuel Adjorlolo
- Department of Applied Social Sciences; City University of Hong Kong; Kowloon Hong Kong
| | - Sarah Adu-Poku
- Department of Sociology; University of Ghana; Accra Ghana
| | - Johnny Andoh-Arthur
- Faculty of Health and Social Science; Sør-Trondelag University College; Trondheim Norway
- Department of Psychology; University of Ghana; Accra Ghana
| | - Irene Botchway
- Department of Psychology; University of Ghana; Accra Ghana
| | - Budeba Petro Mlyakado
- Department of Applied Social Sciences; City University of Hong Kong; Kowloon Hong Kong
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Baker B, Amin K, Khor WS, Khwaja N. Response to: Practice of first aid in burn related injuries in a developing country. Burns 2015; 41:1893-1894. [PMID: 26428366 DOI: 10.1016/j.burns.2015.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 04/21/2015] [Indexed: 11/29/2022]
Abstract
Traditional remedies for burns first aid are rarely compliant with current best practice. Greater Manchester is one of the most ethnically diverse regions in the UK. Our burns centre has noted the prevalent use of traditional remedies over recognised first aid prior to presentation. We review traditional burns remedies and highlight the importance of burns first aid education that is accessible to migrant communities.
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Affiliation(s)
- Benjamin Baker
- Burns & Plastic Surgery Department, University Hospital South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, United Kingdom.
| | - Kavit Amin
- Burns & Plastic Surgery Department, University Hospital South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, United Kingdom
| | - Wee Sim Khor
- Burns & Plastic Surgery Department, University Hospital South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, United Kingdom
| | - Nadeem Khwaja
- Burns & Plastic Surgery Department, University Hospital South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, United Kingdom
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Nthumba PM. Burns in sub-Saharan Africa: A review. Burns 2015; 42:258-66. [PMID: 25981292 DOI: 10.1016/j.burns.2015.04.006] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 02/25/2015] [Accepted: 04/17/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Burns are important preventable causes of morbidity and mortality, with a disproportionate incidence in sub-Saharan Africa. The management of these injuries in sub-Saharan Africa is a challenge because of multiple other competing problems such as infectious diseases (HIV/AIDS, tuberculosis and malaria), terrorist acts and political instability. There is little investment in preventive measures, pre-hospital, in-hospital and post-discharge care of burns, resulting in high numbers of burns, high morbidity and mortality. Lack of data that can be used in legislation and policy formulation is a major hindrance in highlighting the problem of burns in this sub-region. METHODS An online search of publications on burns from sub-Saharan countries was performed. RESULTS A total of 54 publications with 32,862 patients from 14 countries qualified for inclusion in the study. The average age was 15.3 years. Children aged 10 years and below represented over 80% of the burn patient population. Males constituted 55% of those who suffered burns. Scalds were the commonest cause of thermal injuries, accounting for 59% of all burns, while flame burns accounted for 33%. The burn mortality averaged 17%, or the death of one of every five burn victims. CONCLUSIONS These statistics indicate the need for an urgent review of burn policies and related legislation across the sub-Saharan region to help reduce burns, and provide a safe environment for children.
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Fadeyibi IO, Ibrahim NA, Mustafa IA, Ugburo AO, Adejumo AO, Buari A. Practice of first aid in burn related injuries in a developing country. Burns 2015; 41:1322-32. [PMID: 25805428 DOI: 10.1016/j.burns.2015.02.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 02/19/2015] [Accepted: 02/21/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION First aid with cool running water reduces the severity of burn. Low level of knowledge of first aid in burns was shown in previous studies with few patients receiving first aid by water lavage. A study investigating the use of water lavage as first aid in patients presenting to hospital with burn in Lagos, Nigeria was carried out. METHODS Patients admitted to a University Teaching Hospital for treatment of burns were recruited for this prospective study. Data detailing demographics, scene and aetiology of burns, material used for first aid, who administered first aid, level of education and relationship of first-aider with patients, length of hospital stay, complications and outcome of treatment were collected and statistical analysis performed. RESULTS 168 patients; 73 (43.4%) children and 95 (56.6%) adults were seen. Burns were sustained at home in 95 (74.2%) cases and outside in 33 (25.8%). Water lavage was used in 49 (29.2%) cases, raw eggs in 21 (12.5%), pap in 16 (9.5%) and other materials in 48.8%. 40 (23.8%) patients had not received any form of first aid at presentation. Patients that received no water first aid had higher complication rate (35.3% versus 18.4%) compared with those that had water first aid. CONCLUSION AND RECOMMENDATIONS The use of water first aid in burns was shown to reduce complication rate in this study. People should be educated on the efficacy of water first aid in pre-hospital care of burns.
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Affiliation(s)
- Idowu Olusegun Fadeyibi
- Burn/Trauma Center, Lagos State University Teaching Hospital (LASUTH)/Burns and Plastic Surgery Unit, Department of Surgery, College of Medicine, Lagos State University (LASU), Ikeja-Lagos, Nigeria.
| | - Nasiru Akanmu Ibrahim
- General Surgery Unit, Department of Surgery, LASUTH/College of Medicine (LASU), Ikeja-Lagos, Nigeria
| | | | - Andrew Omotayo Ugburo
- Burns and Plastic Surgery Unit, Department of Surgery, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | | | - Adedayo Buari
- Burn/Trauma Center, Lagos State University Teaching Hospital (LASUTH)/Burns and Plastic Surgery Unit, Department of Surgery, College of Medicine, Lagos State University (LASU), Ikeja-Lagos, Nigeria
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Zhu L, Zhang H, Shi F, Yi D, Zhu G. Epidemiology and outcome analysis of scalds in children caused by "guo lian kang": an 11-year review in a burn center in China. Burns 2014; 41:289-96. [PMID: 25440853 DOI: 10.1016/j.burns.2014.07.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 07/12/2014] [Accepted: 07/14/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The objective of this study was to investigate the epidemiological characteristics of scalds induced by "guo lian kang" (literally "stove connected to bed") in children. METHODS The demographic, burn features, outcome, and other information of 0-14-year-old children with "guo lian kang"-induced scalds admitted to the burn treatment center of the 322 Hospital of the People's Liberation Army in Datong from 30 September 2001 to 31 December 2011 were analyzed. RESULTS Among the 1993 children clearly documented with scalds due to hot liquid in vessels, 795 (39.89%) had burns due to "guo lian kang." The proportion of the pediatric burns caused by "guo lian kang" was 55.56% in 2002 and 37.30% in 2011, with a decreasing trend. One-year-old children accounted for the highest proportion of children with burns due to "guo lian kang" (male:female=1.54:1). Scalding mostly occurred from October to May; the most common times were around 8:00 AM, 11:00 AM, and 7:00 PM. Most scalds occurred on the upper limbs, 90.22% of which were dermal burns. The median burn area was 11% of the total body surface area. The burn agent was mainly hot water in pots. Scalding mostly occurred when the children accidentally sat on, or fell or stepped into the pot while playing. Among the children with "guo lian kang"-induced scalds, up to 42.26% of the children did not receive any treatment before hospital admission, and 18.86% of the children were admitted to the hospital ≥6h after the occurrence of burns. In addition, 74.97% of the children's families can afford the medical expenses, while 5.28% abandoned treatment because of financial difficulties. There were no significant differences between children with scalds caused by "guo lian kang" and scalds caused due to other reasons considering the age and sex. Compared to scalds due to other reasons, children with "guo lian kang"-induced scalds had greater burn area and depth, shock incidence, surgery rate, blood transfusion rate, length of hospital stay, and hospitalization costs. CONCLUSION Preventive measures against burns should be taken from October to May and mainly during cooking time in order to prevent burns in children less than 3 years of age, especially in 1-year-old boys. The most simple and effective preventive measure is to install a barrier between the pot and bed. The incidence of shock in children may be reduced if parents and primary medical staff undergo training to perform first aid for burns and if there are improvements in the referral system after burns.
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Affiliation(s)
- Liqiang Zhu
- Department of Health Statistics, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China; Department of Information, The 322 Hospital of the Chinese People's Liberation Army, Datong, Shanxi 037006, China
| | - Hong Zhang
- Information Center, Beijing Military Region General Hospital, Beijing 100853, China
| | - Fusheng Shi
- Department of Burn, The 322 Hospital of the Chinese People's Liberation Army, Datong, Shanxi 037006, China
| | - Dong Yi
- Department of Health Statistics, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China.
| | - Guangjun Zhu
- Admin Office, Beidaihe Sanatorium of Beijing Command, Qinhuangdao, Hebei 066105, China.
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Gyedu A, Nakua EK, Otupiri E, Mock C, Donkor P, Ebel B. Incidence, characteristics and risk factors for household and neighbourhood injury among young children in semiurban Ghana: a population-based household survey. Inj Prev 2014; 21:e71-9. [PMID: 24914101 DOI: 10.1136/injuryprev-2013-040950] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND There are few population-based studies on household child injury in African countries. OBJECTIVES To determine the incidence, characteristics and risk factors of household and neighbourhood injury among children in semiurban communities in Kumasi, Ghana. METHODS We conducted a cross-sectional population-weighted survey of 200 randomly selected caregivers of children under 18, representing 6801 households. Caregivers were interviewed about moderate to severe childhood injuries occurring within the past 6 months, for which the child staying home from school or activity, and/or required medical care. Multivariable logistic regression was used to identify factors associated with injury risk. RESULTS Annual injury incidence was 593.5 injuries per 1000 children. Common causes of injury were falls (315.7 injuries per 1000 children), followed by cuts/lacerations and burns. Most injuries (93.8%) were of moderate severity. Children whose caregivers were hourly workers (AOR=1.97; 95% CI 1.06 to 3.68) had increased odds of sustaining an injury compared to those of unemployed caregivers. Girls had decreased odds of injury (AOR=0.59; 95% CI 0.39 to 0.91). Cooking outdoors (AOR=0.45; 95% CI 0.27 to 0.76) and presence of cabinet/cupboards (AOR=0.41; 95% CI 0.24 to 0.70) in the house were protective. Among children under 5 years of age, living in uncompleted accommodation was associated with higher odds of injury compared with living in a rented single room (AOR=3.67; 95% CI 1.17 to 11.48). CONCLUSIONS The incidence of household and neighbourhood child injury is high in semiurban Kumasi. We identified several novel injury risk factors (hourly work, younger children) and protective factors (cooking outdoors, presence of cabinet/cupboards). These data may identify priorities for household injury prevention.
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Affiliation(s)
- A Gyedu
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - E K Nakua
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - E Otupiri
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - C Mock
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, Washington, USA Departments of Surgery, Global Health and Epidemiology, University of Washington, Seattle, Washington, USA
| | - P Donkor
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - B Ebel
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, Washington, USA Departments of Pediatrics and Epidemiology, University of Washington, Seattle, Washington, USA Seattle Children's Hospital, Seattle, Washington, USA
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Wong EG, Groen RS, Kamara TB, Stewart KA, Cassidy LD, Samai M, Kushner AL, Wren SM. Burns in Sierra Leone: a population-based assessment. Burns 2014; 40:1748-53. [PMID: 24767716 DOI: 10.1016/j.burns.2014.03.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 03/08/2014] [Indexed: 11/16/2022]
Abstract
PURPOSE Burns remain disproportionately prevalent in developing countries. This study aims to describe the epidemiology of burns in Sierra Leone to serve as a baseline for future programs. METHODS A cluster randomized, cross-sectional, countrywide survey was conducted in 2012 in Sierra Leone. With a standardized questionnaire demographics and deaths during the previous 12 months of household members were assessed with the household representative. Thereafter, 2 randomly selected household members were interviewed, elucidating whether participants had ever had a burn in six body regions and determining burn mechanisms and patterns of health care seeking behavior. RESULTS This study included 1843 households and 3645 individuals. 3.98% (145/3645) of individuals reported at least one burn-injury. The highest proportions of burns were reported in the age groups 0-4 years old (23/426, 5.4%) and 5-14 years old (37/887, 4.17%). The majority of burns (129/145, 89.0%) were caused by a hot liquid/object and the upper, extremities were the most commonly burned body regions, with 36% (53/145) of cases. 21% (30/145) of individuals with burns sought care from a traditional healer. CONCLUSIONS Burns are highly prevalent in Sierra Leone. Further research and resources should be allocated to the care and prevention of thermal injuries.
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Affiliation(s)
- Evan G Wong
- Centre for Global Surgery, McGill University Health Centre, 1650 Cedar Avenue, L9 411, Montreal, QC, Canada H3G 1A4; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Surgeons OverSeas (SOS), New York, NY, USA.
| | - Reinou S Groen
- Surgeons OverSeas (SOS), New York, NY, USA; Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Thaim B Kamara
- Department of Surgery, Connaught Hospital, Freetown, Sierra Leone; College of Medicine and Allied Health Science (COMAHS), Freetown, Sierra Leone
| | - Kerry-Ann Stewart
- Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Laura D Cassidy
- Institute for Health and Society, and Epidemiology Division, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mohamed Samai
- Institute for Health and Society, and Epidemiology Division, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Adam L Kushner
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Surgeons OverSeas (SOS), New York, NY, USA; Department of Surgery, Columbia University, New York, NY, USA
| | - Sherry M Wren
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
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How much do parents know about first aid for burns? Burns 2013; 39:1083-90. [DOI: 10.1016/j.burns.2012.12.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 12/17/2012] [Accepted: 12/18/2012] [Indexed: 11/17/2022]
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Al-Shaqsi S, Al-Kashmiri A, Al-Bulushi T. Epidemiology of burns undergoing hospitalization to the National Burns Unit in the Sultanate of Oman: a 25-year review. Burns 2013; 39:1606-11. [PMID: 23683661 DOI: 10.1016/j.burns.2013.04.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 04/13/2013] [Accepted: 04/15/2013] [Indexed: 10/26/2022]
Abstract
AIM The aim of this study was to describe the epidemiology of burns admitted to the National Burns Unit (NBU) in the Sultanate of Oman between 1987 and 2011. METHODS This is a retrospective review of burn patients admitted to Oman's National Burns Unit (NBU) between 1987 and 2011. The data extracted from the national burn registry. The study describes the admission rate by gender and age groups, occupation, causes of burns, time-to-admission, length of stay and in-hospital mortality of burns between 1987 and 2011. RESULTS During a 25-year from 1987 to 2011, there were 3531 burn patients admitted to the National Burns Unit in Oman. The average admission rate to NBU is 7.02 per 100,000 persons per year. On average, males were more likely to be admitted to the NBU than females during the study period (P value < 0.04). Patients aged 1-10 years old constituted 46.6% of caseload during the study period. Flames and scalds caused 88.4% of burns. About half of all patients admitted to the NBU have burns to more than 11% of total body surface area (TBSA). The average stay in hospital was estimated to be 15.3 days per patient. The average in-hospital mortality rate was estimated to be 8.2% per year (range 1.9-22%). CONCLUSION Burns are significant public health issue in the Sultanate of Oman. Children are disproportionately over-represented in this study. Prevention programmes are urgently needed to address this "silent and costly epidemic."
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Management of patients in a dedicated burns intensive care unit (BICU) in a developing country. Burns 2013; 39:493-500. [DOI: 10.1016/j.burns.2012.07.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 07/18/2012] [Accepted: 07/18/2012] [Indexed: 11/15/2022]
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Golshan A, Patel C, Hyder AA. A systematic review of the epidemiology of unintentional burn injuries in South Asia. J Public Health (Oxf) 2013; 35:384-96. [DOI: 10.1093/pubmed/fds102] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ji SZ, Luo PF, Kong ZD, Zheng XF, Huang GF, Wang GY, Zhu SH, Xiao SC, Xia ZF. Pre-hospital emergency burn management in Shanghai: Analysis of 1868 burn patients. Burns 2012; 38:1174-80. [DOI: 10.1016/j.burns.2012.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 02/23/2012] [Accepted: 03/17/2012] [Indexed: 10/28/2022]
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Epidemiology of fatal burns in rural South Africa: A mortuary register-based study from Mpumalanga Province. Burns 2011; 37:1394-402. [DOI: 10.1016/j.burns.2011.07.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 07/14/2011] [Accepted: 07/17/2011] [Indexed: 11/23/2022]
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Gupta AK, Uppal S, Garg R, Gupta A, Pal R. A clinico-epidemiologic study of 892 patients with burn injuries at a tertiary care hospital in Punjab, India. J Emerg Trauma Shock 2011; 4:7-11. [PMID: 21633560 PMCID: PMC3097584 DOI: 10.4103/0974-2700.76820] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2010] [Accepted: 10/12/2010] [Indexed: 01/22/2023] Open
Abstract
Aim: To analyze the causes, demographic and socio-cultural aspects, and the magnitude of burn injuries prospectively and to evaluate the outcome of treatment of patients admitted to burns ICU of tertiary care hospital. Materials and Methods: A total of 892 burn patients admitted over a period of 6 years from January 2002 to December 2007 at tertiary care hospital in Punjab, India, were analyzed. Results: 54% patients were males. A majority of the patients, 704(79%), were in the age group of 15-45 years. Six hundred and thirty-four patients (72%) sustained flame burns, while 17% and 7% sustained electrical and scald burns, respectively. A total of 470(53%) patients sustained major two to three degree flame burns involving more than 45% of total body surface area (TBSA). The mortality rate was 40%, i.e. 357 patients died of burns and its related problems, in our study. Six hundred and thirty-nine patients (72%) sustained burns in closed space of which 331 patients (52%) sustained burns in kitchen. Seven hundred and seventy-nine patients sustained accidental burns. Burn victims were mainly Hindus and Sikhs. The mean hospital stay varied depending upon the percentage of burns. On an average, a patient with > 45% TBSA burns received 15 whole blood transfusions. Split skin grafting was done in 416 patients. Most common complication encountered during their hospital stay was wound infection which was seen in 671 patients, followed by ARDS in 221 patients. The most common organisms causing wound infection were Pseudomonas and Acinetobacter. Conclusion: Developing country like India need an aggressive public education program so that people become more literate about various etiological factors causing burns and means of preventing them. Also needed are burn care hospitals which are easily accessible and affordable.
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Affiliation(s)
- Ashok K Gupta
- Department of Plastic Surgery, Dayanand Medical College and Hospital, Ludhiana - 141 001, Punjab, India
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Özyazıcıoğlu N, Polat S, Bıçakcı H. The Effect of Training Programs on Traditional Approaches that Mothers Use in Emergencies. J Emerg Nurs 2011; 37:79-85. [DOI: 10.1016/j.jen.2009.10.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Revised: 09/12/2009] [Accepted: 10/23/2009] [Indexed: 11/16/2022]
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Sadeghi Bazargani H, Arshi S, Ekman R, Mohammadi R. Prevention-oriented epidemiology of burns in Ardabil provincial burn centre, Iran. Burns 2010; 37:521-7. [PMID: 21131133 DOI: 10.1016/j.burns.2010.09.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Revised: 08/13/2010] [Accepted: 09/30/2010] [Indexed: 10/18/2022]
Abstract
In preventing burns, it is essential to know how they occur and which population groups, environments and heating appliances can be targeted for prevention work. The aim of this study was to determine the epidemiological characteristics of burns leading to hospitalisation in the northwest of Iran with a focus on the pre-event phase of injury. Between 2007 and 2008, 237 burn victims hospitalised in Ardabil provincial burn centre were enrolled into a descriptive study. A questionnaire was filled in during hospital stay for all patients, with a focus on obtaining information necessary for prevention purposes. Males constituted 56% of victims. Mean age was 22 years. The most severe burns occurred between the ages of 18 and 32 years, and were mainly flame related. Both in case of flame and non-flame burns, women suffered more severe burns and mortality than men. However, with respect to non-flame burns of which most were scalds, the majority of the severe cases involved children under the age of 5 years. More than 80% of burns occurred at home. The kitchen was the main place of injury in 47% of cases, followed by living rooms in 28%. Nearly 45% of burns were scalds and 47% were flame burns. The main container was the samovar in 37%, followed by kettles in 32% and pots in 22%. The overturning of a container was the major mechanism of contact with hot liquids in 86%. Bumping into a container was the main scenario of a scald injury, constituting nearly 70% of the cases. The difference between flame and non-flame burns in the distribution of burns in extremities was not statistically significant, but head and neck burns were 3.7 times more likely to be caused by flame. The two most important injury patterns, more common among women, were getting burned while using a camping gas stove or while refilling the chamber of kerosene-burning appliances without first extinguishing them. Domestic burns among children and young women are a priority in injury-prevention programmes. Camping gas stoves, valors (traditional dual-purpose heating and cooking appliances) and samovars can be considered as target appliances for burn-specific home-safety-promotion efforts in this area or in similar settings.
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Sadeghi-Bazargani H, Mohammadi R, Svanstrom L, Ekman R, Arshi S, Hekmat S, Malekpour N, Mashoufi M. Epidemiology of minor and moderate burns in rural Ardabil, Iran. Burns 2010; 36:933-7. [DOI: 10.1016/j.burns.2009.10.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Revised: 10/05/2009] [Accepted: 10/22/2009] [Indexed: 11/28/2022]
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Cuttle L, Pearn J, McMillan JR, Kimble RM. A review of first aid treatments for burn injuries. Burns 2009; 35:768-75. [DOI: 10.1016/j.burns.2008.10.011] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2008] [Accepted: 10/31/2008] [Indexed: 11/26/2022]
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Čelko AM, Grivna M, Dáňová J, Barss P. Severe childhood burns in the Czech Republic: risk factors and prevention. Bull World Health Organ 2009; 87:374-81. [PMID: 19551256 PMCID: PMC2678775 DOI: 10.2471/blt.08.059535] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2008] [Revised: 03/03/2009] [Accepted: 03/03/2009] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To assess risk factors for paediatric burn injuries in the Czech Republic and to suggest preventive measures. METHODS This study included all children aged 0-16 years hospitalized during 1993-2000 at the Prague Burn Centre and data from the Czech Ministry of Health on national paediatric burn hospitalizations during 1996-2006. Personal, equipment and environmental risk factors were identified from hospital records. FINDINGS The incidence of burn admissions among 0-14 year-olds increased from 85 to 96 per 100,000 between 1996 and 2006, mainly due to a 13% increase among 1-4 year-olds. Between 1993-2000 and 2006, the proportion of burn victims in the country hospitalized at the Prague Burn Centre increased from 9% to 21%. Detailed data were available on 1064 children (64% boys). Around 31% of all burn hospitalizations were in 1 year-olds. Some 79% of burns occurred at home: 70% in the kitchen, 14% in the living room or bedroom and 11% in the bathroom. Of the 18% occurring outdoors, 80% involved boys. Scalds from hot liquids accounted for 70% of all burns. The mean hospital stay was 22 days for boys and 18 days for girls. CONCLUSION Most burns involved scalds from hot liquids at home: beverages in kitchens and water in bathrooms. There is a need for passive preventive measures, such as redesigned domestic cooking and eating areas, safer electrical kettles and temperature control devices for bathrooms. Educational programmes should be developed for parents and caregivers. A national plan for child burn prevention with specific targets would be helpful.
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Affiliation(s)
| | - Michal Grivna
- Faculty of Medicine and Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
| | - Jana Dáňová
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Peter Barss
- School of Population Health, University of Queensland, Brisbane, Qld, Australia
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Taira BR, Kelly McQueen KA, Burkle FM. Burden of Surgical Disease: Does the Literature Reflect the Scope of the International Crisis? World J Surg 2009; 33:893-8. [DOI: 10.1007/s00268-009-9981-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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39
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Mashreky S, Rahman A, Chowdhury S, Giashuddin S, SvanstrÖm L, Linnan M, Shafinaz S, Uhaa I, Rahman F. Epidemiology of childhood burn: Yield of largest community based injury survey in Bangladesh. Burns 2008; 34:856-62. [DOI: 10.1016/j.burns.2007.09.009] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Accepted: 09/27/2007] [Indexed: 10/22/2022]
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Gosselin RA, Kuppers B. Open versus closed management of burn wounds in a low-income developing country. Burns 2008; 34:644-7. [PMID: 18226462 DOI: 10.1016/j.burns.2007.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2007] [Accepted: 09/24/2007] [Indexed: 11/16/2022]
Abstract
Over a 38 month period, 264 patients were admitted for management of burns at the Emergency referral hospital in the resource-poor West African country of Sierra Leone. 244 charts and records were available for review, and 196 met the study's inclusion criteria. For the first 27 months, 158 patients were treated with the closed method and for the last 11 months of the study, 86 patients were treated with the open (exposure) method. Overall, the open method had as good or better early outcomes than the closed method, at significantly lower costs, and is the recommended treatment for burns in this particular type of environment.
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Chen G, Smith GA, Ranbom L, Sinclair SA, Xiang H. Incidence and pattern of burn injuries among children with disabilities. ACTA ACUST UNITED AC 2007; 62:682-6. [PMID: 17414347 DOI: 10.1097/01.ta.0000203760.47151.28] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Burn injuries are an important cause of severe morbidity and mortality among children. However, the epidemiology of burns among disabled children has received little attention. METHODS Burn injuries were identified for children aged less than 12 years using International Classification of Diseases, Ninth Revision, Clinical Modification codes in Ohio Medicaid claims data. Using FY2002 Ohio Medicaid claims data, incidences and relative risks of burn injuries for disabled and nondisabled children were calculated by age, gender, and race or ethnicity. Logistic regression was used to analyze risk factors for burn injuries. RESULTS There were 4,307 burn injuries identified in the FY2002 Ohio Medicaid claims database. The incidence of burn injuries for disabled children was significantly higher than for nondisabled children (103.00 per 10,000 vs. 77.41 per 10,000, respectively; p < 0.001). Children aged 1 or 2 years had the highest incidence of burn injuries, regardless of disability status. For disabled children, the incidence of burn injuries decreased after 2 years of age and leveled out at approximately 100 per 10,000 children after 3 years of age. However, for nondisabled children, the incidence of burn injuries decreased until 6 years of age, after which it leveled out at approximately 40 per 10,000 children. After controlling for potentially confounding factors, the risk of burn injuries was significantly higher for disabled than nondisabled children (odds ratio = 1.80; 95% confidence interval, 1.50-2.17). CONCLUSIONS Disabled children had a significantly higher incidence of burn injuries than nondisabled children did. The risk of burn injuries, even after controlling for demographic factors, was significantly higher for disabled children than nondisabled children.
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Affiliation(s)
- Guanmin Chen
- Center for Injury Research and Policy, Columbus Children's Research Institute, Columbus Children's Hospital, OH 43205, USA
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Van Niekerk A, Seedat M, Menckel E, Laflamme L. Caregiver experiences, contextualizations and understandings of the burn injury to their child. Accounts from low-income settings in South Africa. Child Care Health Dev 2007; 33:236-45. [PMID: 17439435 DOI: 10.1111/j.1365-2214.2006.00724.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Childhood burn injury is a widespread phenomenon with a disproportionate concentration in Sub-Saharan Africa. Burn injuries may have far-reaching and traumatic interpersonal, social and occupational effects for young children. There has been scant attention to the caregiver's experience of these events. This study sought to explore the caregiver's understanding of the injury to their children, the injury causes and its preventability. METHODS The study is based on interviews with 13 caregivers. All informants were the female parents or grandparent of children who had sustained a moderate to severe burn injury and presented at a children's hospital in Cape Town. The interviews were audio-recorded, transcribed verbatim and analysed using a synthesis of the grounded theory approach with core content analytic steps. RESULTS Analysis of data indicates that information related to the injury event can be separated into the child's activities, the activity undertaken by the caregiver at the time of the event and the environmental hazards coming into play. The remote factors associated with the event were related to the individual caregiver, family circumstances, the area's living conditions and the cultural context. The caregivers' suggestions for the future focused on the isolation of heat sources, caregiver supervision and environmental renovations. CONCLUSIONS Caregivers emphasized the multifactorial nature of the burn injury event and highlighted the adverse environmental, domestic and personal circumstances to their child's burn injury. Their recommendations for burn prevention avoidance and control are consistent with their understanding of the injury aetiology and demonstrate a synergy with public health recommendations for environmental and technological interventions.
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Affiliation(s)
- A Van Niekerk
- Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, Stockholm, Sweden
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Spangenberg K, Mock C. Utilization of health services by the injured residents in Kumasi, Ghana. Int J Inj Contr Saf Promot 2006; 13:194-6. [PMID: 16943164 DOI: 10.1080/17457300500294455] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The objective was to determine the pattern of health service utilization by the injured in Kumasi, Ghana and thus to gain information useful for the strengthening of trauma care in that environment. A household survey was utilized as it was anticipated that many injured might not receive formal medical care and a total of 11,663 persons living in 264 clusters in Kumasi were surveyed. One-third of all injured did not receive any formal medical care, mainly due to financial constraints. Altogether, 37% of the injured attended a hospital and 34% attended a clinic. Among the severely injured (> or =1 month disability) attending a clinic, most (76%) used it as the sole source of care. Most (54%) of these clinics were private. Efforts to strengthen trauma care in urban Africa need to address financial barriers to care and need to consider clinics, as well as the main hospitals.
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Albertyn R, Bickler SW, Rode H. Paediatric burn injuries in Sub Saharan Africa—an overview. Burns 2006; 32:605-12. [PMID: 16713683 DOI: 10.1016/j.burns.2005.12.004] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2005] [Accepted: 12/12/2005] [Indexed: 10/24/2022]
Abstract
Paediatric burn injuries in Sub Saharan Africa are common and often lead to devastating consequences. Unfortunately relevant and accurate data regarding these injuries is sketchy and incomplete. This paper reviews the available information on the epidemiology of paediatric burns in Africa, associated health problems and contributing environmental factors responsible for these burns. The current status of burn care, the lack of infrastructure, and traditional methods of treatment, further contribute to the unsatisfactory status of overall burn management, prevention, and rehabilitation of burn survivors. A strategy for improving burn care in Africa has been formulated. The management of childhood burns will only be successful if educational, social, fiscal and infrastructure standards are improved. Traditional beliefs and methods cannot be discarded as they play an important role in the management of these children. It is furthermore essential that local and central government organisations support these initiatives. Clearly, the children of Africa deserve better burn care.
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Affiliation(s)
- R Albertyn
- Division of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch 7700, Cape Town, South Africa
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Forjuoh SN. Burns in low- and middle-income countries: A review of available literature on descriptive epidemiology, risk factors, treatment, and prevention. Burns 2006; 32:529-37. [PMID: 16777340 DOI: 10.1016/j.burns.2006.04.002] [Citation(s) in RCA: 266] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2006] [Accepted: 04/04/2006] [Indexed: 11/21/2022]
Abstract
Burn prevention requires adequate knowledge of the epidemiological characteristics and associated risk factors. While much has been accomplished in the areas of primary and secondary prevention of fires and burns in many developed or high-income countries (HICs), such as the United States, due to sustained research on the descriptive epidemiology and risk factors, the same cannot be said of developing or low- and middle-income countries (LMICs). To move from data to action and assist preventive efforts in LMICs, a review of the available literature was conducted to assess the current status of burn preventive efforts. A MEDLINE search (1974-2003) was conducted on empirical studies published in English on the descriptive epidemiology, risk factors, treatment, and prevention of burns in LMICs. Review of the 117 identified studies revealed basically the same descriptive epidemiological characteristics but slightly different risk factors of burns including the presence of pre-existing impairments in children, lapses in child supervision, storage of flammable substances in the home, low maternal education, and overcrowding as well as several treatment modalities and preventive efforts including immediate application of cool water to a burned area. Continuous evaluation of promising interventions and those with unknown efficacy that have been attempted in LMICs, along with testing interventions that have proven effective in HICs in these LIMC settings, is needed to spearhead the move from data to action in preventing burns in LMICs.
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Affiliation(s)
- S N Forjuoh
- Department of Family & Community Medicine, Scott & White Memorial Hospital, Scott & White Santa Fe-Century Square, 1402 West Avenue H, Temple, TX 76504, USA.
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Arshi S, Sadeghi-Bazargani H, Mohammadi R, Ekman R, Hudson D, Djafarzadeh H, Delavari A, Sezavar H. Prevention oriented epidemiologic study of accidental burns in rural areas of Ardabil, Iran. Burns 2006; 32:366-71. [PMID: 16529866 DOI: 10.1016/j.burns.2005.10.026] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2005] [Accepted: 10/27/2005] [Indexed: 11/24/2022]
Abstract
PURPOSE OF STUDY Burns are one of the leading causes of injury-related deaths in Iran. We conducted a study to investigate features of burns in rural areas of Ardabil Province from October 2004 through March 2005, with an aim to providing content for effective prevention programs. BASIC PROCEDURES This study employed longitudinal prospective methodology. The study population included all patients presenting with burns to local health care facilities during the study period. MAIN FINDINGS A total of 1179 cases were studied. Most of the cases (59.4%) were females. Mean of age of victims was 22.3+/-19 years in females and 13.6+/-17 years in males. The vast majority (91.2%) of burns occurred at home. More than two-thirds of burns were because of hot liquids or steam. The majority of scald burns resulted during use of heating devices such as samovars, gas stoves, valors and picnic gas stoves. Overturning and spilling of hot liquids were the most common injury mechanisms. PRINCIPLE CONCLUSIONS Prevention programs should focus on children and adult women. Prevention efforts should target home environments and focus on prevention of scalding burns.
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Affiliation(s)
- S Arshi
- Department of Public Health, Ardabil University of Medical Sciences, Ardabil, Iran
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Niekerk AV, Reimers A, Laflamme L. Area characteristics and determinants of hospitalised childhood burn injury: A study in the city of Cape Town. Public Health 2006; 120:115-24. [PMID: 16269158 DOI: 10.1016/j.puhe.2005.08.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2005] [Revised: 06/23/2005] [Accepted: 08/08/2005] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To investigate the impact of local living circumstances on the level of childhood burn injuries. STUDY DESIGN/METHOD This study was an ecological investigation encompassing the 634 residential areas of the city of Cape Town (about 668,900 children aged 12 years and younger). Fifteen socio-physical features of these areas that describe the population, household, dwelling types and services were considered using data from the 2001 census. Data of childhood burn injuries were gathered from the Red Cross Children's Hospital's register over 1999-2000 (n=923). Area features were synthesized into three main dimensions using factor analysis (principal axis method). Each dimension was split into three (exposure) levels, and the effect of each dimension on childhood burn injury was measured, compiling odds ratios with 95% confidence intervals and using the most favourable exposure level as the reference category within each dimension. RESULTS The main dimensions of contextual exposure were defined as housing conditions (five variables), child dependency (three variables) and socio-economic barriers (three variables). Each aspect had a significant impact on the risk of burn injury, with increased levels of exposure leading to increased risk of burns. For housing conditions (Factor 1) and socio-economic barriers (Factor 3), a graded relationship was observed with noteably increased odds for increased levels of exposure. CONCLUSIONS The occurrence of child burn injury is highly influenced by various features of the local environment. These features may be essential targets for sustainable childhood burn injury control and prevention programmes.
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Affiliation(s)
- A Van Niekerk
- Division of Social Medicine, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
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Özbek S, Özcan M, Kahveci R, Akin S, Özgenel Y, Ercan İ, Karaca K. A retrospective epidemiological study of 385 burn patients hospitalized during 6 years in Bursa. EUROPEAN JOURNAL OF PLASTIC SURGERY 2005. [DOI: 10.1007/s00238-005-0755-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Burd A, Yuen C. A global study of hospitalized paediatric burn patients. Burns 2005; 31:432-8. [PMID: 15896504 DOI: 10.1016/j.burns.2005.02.016] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2004] [Accepted: 02/18/2005] [Indexed: 11/20/2022]
Abstract
The global incidence of hospitalized paediatric burn patients is unknown. In order to determine a working estimate of the size of the problem, one approach is to extrapolate from relevant published studies. A literature search of the Medline database was performed to identify epidemiological papers published since 1990, which addressed paediatric burn admissions. Extrapolation from population-based studies allowed global figures to be estimated. The highest incidence of hospitalized paediatric burns patients is in Africa, the lowest in the Americas. Europe, the Middle East and Asia share similar figures, but the considerably larger population of Asia indicates that it bears over half of the world's paediatric burn population. It is unfortunate that despite many published studies describing burn admission, few meet criteria that allow for comparative epidemiological data. More attention needs to be focused on uniformity in data collection and presentation to enhance the value of the data available.
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Affiliation(s)
- Andrew Burd
- Division of Plastic and Reconstructive Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
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Abstract
As the global culture moves forward into the 21st century with increasing interaction of populations through direct contact and electronic interchange, those citizens of our planet who have not benefited from the material gains that have been realized in the "mature economy" countries will increasingly seek equity on all levels, beginning with the most fundamental aspect of health care. There is a need to develop a capacity for treatment of urgent and emergent health conditions globally, a need that will only increase with advancing global economic development.
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Affiliation(s)
- L Kristian Arnold
- Occupational Health Service, Boston Police Department, One City Hall Plaza, Boston, MA 02201, USA.
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