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Simon MH, Ujjal MUR, Botman M, van Hövell Tot Westerflier C, Ahmed MS, Vries AMD. Burn injuries and acute burn management in the rural areas in northern Bangladesh - A household survey. Burns 2024; 50:1480-1486. [PMID: 38704315 DOI: 10.1016/j.burns.2024.03.030] [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: 10/20/2023] [Revised: 03/07/2024] [Accepted: 03/31/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Burn injuries pose a significant public health challenge, especially in low- and middle-income countries (LMICs). In Bangladesh, burn injuries are prevalent and often result in severe disability or death. However, knowledge regarding the causes of burn injuries, acute burn management, and barriers to seeking burn care in the riverine areas of northern Bangladesh is limited. METHODS We conducted a questionnaire-based study in eight subunits and five selected districts in northern Bangladesh to determine the prevalence, causes, and management of burn injuries in these areas. A total of 210 individuals from different households were interviewed, which represented a population of 1020 persons. RESULTS Among the respondents, 55% reported that at least one member of their household suffered from a burn injury in the past. The most common causes of burn injuries were open fire (41%) and hot fluids (30%). More than 40% of burns were not rinsed with water directly after sustaining the injury. Additionally, almost 30% of respondents did not seek medical care immediately after the injury, with financial constraints being the most commonly cited reason. DISCUSSION We found a low rate of adequate cooling and seeking medical care. The need for basic knowledge on prevention and treatment of burn injuries and improved access to affordable health care services in the region is high.
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Affiliation(s)
- M H Simon
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centre, the Netherlands; Global Surgery Amsterdam, Amsterdam, the Netherlands.
| | | | - M Botman
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centre, the Netherlands; Global Surgery Amsterdam, Amsterdam, the Netherlands
| | - C van Hövell Tot Westerflier
- Department of Plastic, Reconstructive and Hand Surgery, University Medical Centre Utrecht, the Netherlands; Global Surgery Amsterdam, Amsterdam, the Netherlands
| | | | - A Meij-de Vries
- Global Surgery Amsterdam, Amsterdam, the Netherlands; Department of Surgery/Burn Centre, Red Cross Hospital, Beverwijk, the Netherlands; Department of Paediatric Surgery, Amsterdam University Medical Centre, the Netherlands
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Balseven-Odabaşı A, Yıldırım MŞ, Akçan R, Yalçın SS, I Nce T, Tümer AR, Yorgancı K. Dark side of customs: scalding burns in childhood due to use of traditional teacup and teapot, in Turkey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:1479-1486. [PMID: 37288960 DOI: 10.1080/09603123.2023.2221644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023]
Abstract
The most common type of burn among children is scalding burn. This study aims to reveal child abuse and neglect as a specific etiological factor that specific to our country, traditional teapot- and teacup-related scalding burns. Burn cases that admitted to our Burn Center were investigated, and among these, 72 cases suffering from scalding burns were included in the study. The interview forms issued upon admission of these cases were evaluated in detail. Out of 148 scalding burn cases, 48.6% were related to the use of traditional teapots and teacups. After a detailed assessment, all cases were considered neglect-related burns. As a result of considering the role of traditional teapots and teacups in pediatric injuries in our country, parents and caregivers should be warned about these types of injuries. Also, physicians must determine the possibility of child abuse or neglect in all pediatric burn cases.
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Affiliation(s)
| | - Mahmut Şerif Yıldırım
- Department of Forensic Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ramazan Akçan
- Department of Forensic Medicine, Hacettepe University, Ankara, Turkey
| | - S Songül Yalçın
- Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Tolga I Nce
- Department of Pediatrics, Dokuz Eylül University, Izmir, Turkey
| | - Ali Rıza Tümer
- Department of Forensic Medicine, Hacettepe University, Ankara, Turkey
| | - Kaya Yorgancı
- Department of General Surgery, Hacettepe University, Ankara, Turkey
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Yao Y, Ma L, Chen L. Characteristics of injury mechanisms in children and differences between urban and rural areas in central China. Eur J Trauma Emerg Surg 2023; 49:2459-2466. [PMID: 37410133 DOI: 10.1007/s00068-023-02320-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 06/26/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Some studies lack detailed analyses of the differences and characteristics of pediatric injury mechanisms between urban and rural areas. OBJECTIVE We aim to understand the characteristics, trends, and mortality rates of injury mechanisms in children in urban and rural areas in central China. RESULTS In a study involving 15,807 pediatric trauma patients, it was observed that boys constituted the majority (65.4%) and those aged ≤ 3 years were the most prevalent (28.62%). Falls (39.8%), burns (23.2%), and traffic accidents (21.1%) were identified as the top three injury mechanisms. The head (29.0%) and limbs (35.7%) were found to be the most susceptible to injury. Additionally, children between the ages of 1-3 years exhibited a higher likelihood of sustaining burn injuries compared to other age groups. The main causes of burn injury were hydrothermal burns (90.3%), flame burns (4.9%), chemical burns (3.5%), and electronic burns (1.3%). In urban areas, the major injury mechanisms were falls (40.9%), traffic accidents (22.4%), burns (20.9%), and poison (7.1%), whereas, in rural areas, they were falls (39.5%), burns (23.8%), traffic accidents (20.8%), and penetration (7.0%). Over the past decade, the overall incidences of pediatric trauma have been decreasing. In the past year, the number of injured children was the highest in July, and the overall mortality rate due to trauma was 0.8%. CONCLUSION Our findings revealed that in different age groups, the injury mechanisms are different in urban and rural areas. Burns are the second leading cause of trauma in children. A decrease in pediatric trauma over the past 10 years indicates targeted measures and preventive intervention may effectively prevent pediatric trauma.
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Affiliation(s)
- Yuanying Yao
- Department of Medical Record Management, The First Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China
| | - Lijuan Ma
- Department of Medical Record Management, The First Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China
| | - Lei Chen
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China.
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Mehta K, Thrikutam N, Hoyte-Williams PE, Falk H, Nakarmi K, Stewart B. Epidemiology and Outcomes of Cooking- and Cookstove-Related Burn Injuries: A World Health Organization Global Burn Registry Report. J Burn Care Res 2023; 44:508-516. [PMID: 34850021 PMCID: PMC10413420 DOI: 10.1093/jbcr/irab166] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Indexed: 11/13/2022]
Abstract
Cooking- and cookstove-related burns (CSBs) comprise a large proportion of burn injuries globally, but there are limited data on cooking behavior patterns to inform prevention and advocacy. Therefore, we aimed to describe the epidemiology, risk factors, and outcomes of these injuries and highlight the potential of the World Health Organization (WHO) Global Burn Registry (GBR). Patients with cooking-related burns were identified in the WHO GBR. Patient demographics, cooking arrangement, injury characteristics, and outcomes were described and compared. Bivariate regression was performed to identify risk factors associated with CSBs. Analysis demonstrated that 25% of patients in the GBR sustained cooking-related burns (n = 1723). The cooking environment and cooking fuels used varied significantly by country income level ([electricity use: LIC 1.6 vs MIC 5.9 vs HIC 49.6%; P < .001] [kerosene use: LIC 5.7 vs MIC 10.4 vs HIC 0.0%; P < .001]). Of cooking-related burns, 22% were cookstove-related burns (CSBs; 311 burns). Patients with CSBs were more often female (65% vs 53%; P < .001). CSBs were significantly larger in TBSA size (30%, IQR 15-45 vs 15%, IQR 10-25; P < .001), had higher revised Baux scores (70, IQR 46-95 vs 28, IQR 10-25; P < .001) and more often resulted in death (41 vs 11%; P < .001) than other cooking burns. Patients with CSBs were more likely to be burned by fires (OR 4.74; 95% CI 2.99-7.54) and explosions (OR 2.91, 95% CI 2.03-4.18) than other cooking injuries. Kerosene had the highest odds of CSB compared to other cooking fuels (OR 2.37, 95% CI 1.52-3.69). In conclusion, CSBs specifically have different epidemiology than cooking-related burns. CSBs were more likely caused by structural factors (eg, explosion, fire) than behavioral factors (eg, accidental movements) when compared to other cooking burns. These differences suggest prevention interventions for CSBs may require distinctive efforts than typically deployed for cooking-related injuries, and necessarily involve cookstove design and safety regulations to prevent fires and explosions.
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Affiliation(s)
- Kajal Mehta
- Department of Surgery, University of Washington, Seattle, USA
| | | | - Paa Ekow Hoyte-Williams
- Department of Surgery, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Reconstructive Plastic Surgery and Burns Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Henry Falk
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Kiran Nakarmi
- Department of Burns, Plastic, and Reconstructive Surgery, Kirtipur Hospital, Public Health Concern Trust-Nepal,Kathmandu, Nepal
| | - Barclay Stewart
- Division of Trauma, Burn, and Critical Care Surgery, Department of Surgery, University of Washington, UW Medicine Regional Burn Center, Seattle, USA
- Harborview Injury Prevention & Research Center, Seattle, Washington, USA
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Carvalho EN, Paggiaro AO, Nicolosi JT, Gemperli R, de Carvalho VF. Retrospective Evaluation of Characteristics of Patients with Burn Injuries Treated at the Largest Reference Hospital in Brazil. PLASTIC AND AESTHETIC NURSING 2023; 43:22-28. [PMID: 36583585 DOI: 10.1097/psn.0000000000000471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Burn injuries are a significant cause of morbidity and mortality in the Brazilian population. We conducted this study in a tertiary hospital in Brazil to discover the epidemiological characteristics of patients with burn injuries. We conducted a cohort review of patients admitted to the burn unit of our institute during a 5-year period. For each patient, we collected data that included age, gender, total percentage of burned body surface area, burn location, burn mode, and burn cause. We analyzed the data using the R programming language. We included a total of 496 patients in our study. The mean age of the patients was 28 ± 14.7 years. The median length of hospital stay was 2 weeks. We found a significant correlation between the total percentage of burned body surface area and the length of hospitalization (p < .001) and the length of hospitalization in the intensive care unit (p < .001). A total of 427 patients (86%) were discharged from the hospital after successful treatment. In contrast, 43 patients (8.67%) died. The mortality rate was highest in patients who had more than 70% of their total body surface area burned. The average length of hospitalization aligned with global and national statistics presented in the literature. The main causes of the burn injuries were thermal (e.g., fire, hot liquids). We found inhalation injuries present in more than one third of the patients who were hospitalized in the intensive care unit with thermal burns.
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Affiliation(s)
- Elisangela Nunes Carvalho
- Elisangela Nunes Carvalho, MS, is a biologist at Guarulhos University, São Paulo, Brazil
- André Oliveira Paggiaro, PhD, MD, a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil, and a plastic surgeon in the Plastic Surgery Division, Faculty of Medicine, University of São Paulo, Brazil
- Júlia Teixeira Nicolosi, PhD, RN, is a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil, and at Rua Maria Leonete da Silva Nóbrega, São Paulo, Brazil
- Rolf Gemperli, PhD, MD, is a professor in the Plastic Surgery Division, Faculty of Medicine at University of São Paulo, Brazil
- Viviane Fernandes de Carvalho, PhD, RN, is a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil
| | - André Oliveira Paggiaro
- Elisangela Nunes Carvalho, MS, is a biologist at Guarulhos University, São Paulo, Brazil
- André Oliveira Paggiaro, PhD, MD, a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil, and a plastic surgeon in the Plastic Surgery Division, Faculty of Medicine, University of São Paulo, Brazil
- Júlia Teixeira Nicolosi, PhD, RN, is a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil, and at Rua Maria Leonete da Silva Nóbrega, São Paulo, Brazil
- Rolf Gemperli, PhD, MD, is a professor in the Plastic Surgery Division, Faculty of Medicine at University of São Paulo, Brazil
- Viviane Fernandes de Carvalho, PhD, RN, is a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil
| | - Júlia Teixeira Nicolosi
- Elisangela Nunes Carvalho, MS, is a biologist at Guarulhos University, São Paulo, Brazil
- André Oliveira Paggiaro, PhD, MD, a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil, and a plastic surgeon in the Plastic Surgery Division, Faculty of Medicine, University of São Paulo, Brazil
- Júlia Teixeira Nicolosi, PhD, RN, is a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil, and at Rua Maria Leonete da Silva Nóbrega, São Paulo, Brazil
- Rolf Gemperli, PhD, MD, is a professor in the Plastic Surgery Division, Faculty of Medicine at University of São Paulo, Brazil
- Viviane Fernandes de Carvalho, PhD, RN, is a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil
| | - Rolf Gemperli
- Elisangela Nunes Carvalho, MS, is a biologist at Guarulhos University, São Paulo, Brazil
- André Oliveira Paggiaro, PhD, MD, a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil, and a plastic surgeon in the Plastic Surgery Division, Faculty of Medicine, University of São Paulo, Brazil
- Júlia Teixeira Nicolosi, PhD, RN, is a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil, and at Rua Maria Leonete da Silva Nóbrega, São Paulo, Brazil
- Rolf Gemperli, PhD, MD, is a professor in the Plastic Surgery Division, Faculty of Medicine at University of São Paulo, Brazil
- Viviane Fernandes de Carvalho, PhD, RN, is a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil
| | - Viviane Fernandes de Carvalho
- Elisangela Nunes Carvalho, MS, is a biologist at Guarulhos University, São Paulo, Brazil
- André Oliveira Paggiaro, PhD, MD, a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil, and a plastic surgeon in the Plastic Surgery Division, Faculty of Medicine, University of São Paulo, Brazil
- Júlia Teixeira Nicolosi, PhD, RN, is a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil, and at Rua Maria Leonete da Silva Nóbrega, São Paulo, Brazil
- Rolf Gemperli, PhD, MD, is a professor in the Plastic Surgery Division, Faculty of Medicine at University of São Paulo, Brazil
- Viviane Fernandes de Carvalho, PhD, RN, is a professor in the nursing postgraduate program at Guarulhos University, São Paulo, Brazil
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Adane MM, Admasie A, Shibabaw T. Prevalence and risk factors of cooking-related burn injury among under-five-years old children in a resource-limited setting: a community-based cross-sectional study in Northwest Ethiopia. Int J Inj Contr Saf Promot 2022; 30:220-231. [PMID: 36137170 DOI: 10.1080/17457300.2022.2125534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Cooking-related child burn injury causes a greater health burden in low-and-middle-income countries. Therefore, a community-based cross-sectional study was conducted among 5830 under-five-years old children in a resource-limited community in Northwest Ethiopia to determine the prevalence and risk factors of this child health problem. Data were collected by trained nurses using a questionnaire and the logistic regression analysis method was applied to identify factors linked with burn injury. Injury prevalence was 6.2% (95% CI:5.5-6.8); and this burden was linked with several risk factors such as lower literacy status of caretakers [AOR = 2.21 (95% CI:1.05-4.67)], overcrowding [AOR = 2.35(95% CI:1.25-4.43], lack of separate kitchen [AOR =2.19 (95% CI:1.56-3.07)], using traditional cookstove [AOR = 2.04 (95% CI:1.23-3.36)], and lack of child supervision [AOR = 2.27 (95% CI:1.63-3.17)]. In conclusion, children experience a high burden of burn injury. Thus, stakeholders should work to reduce child burn injury by modifying the aforementioned risk factors.
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Affiliation(s)
- Mesafint Molla Adane
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amha Admasie
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tebkew Shibabaw
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Abedin M, Rahman FN, Rakhshanda S, Mashreky SR, Rahman AKMF, Hossain A. Epidemiology of non-fatal burn injuries in children: evidence from Bangladesh Health and Injury Survey 2016. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001412. [PMID: 36053615 PMCID: PMC9198699 DOI: 10.1136/bmjpo-2022-001412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/22/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Burn is a major cause of childhood injury-related morbidity and mortality. Global estimates suggest that 90% of all cases occur in low-income and middle-income countries and over half of the disability-adjusted life-years are lost from fire-related burns in children. In Bangladesh, there is a scarcity of data on childhood burn injuries. The goal of the study was to describe the epidemiology of non-fatal burns in Bangladeshi children, including incidence estimates and identify high-risk groups. METHODS Bangladesh Health and Injury Survey 2016 was a large scale cross-sectional survey. The survey was conducted among 299 216 population utilising a multistage cluster sampling method. Among the 100 842 children, there were 437 non-fatal burn cases. RESULTS Among different injury mechanisms in children, burn was ranked fifth (7.4%). The overall yearly incidence rate (IR) of burns was 866.7 per 100 000 children (95% CI 785.6 to 947.8) in Bangladesh. The incidence was highest among 1-4 years old children (IR 2028.3, 95% CI 1761.1 to 2334.7) and had a 3.5 times higher risk of burns compared with the 15-17 years age group. Females had a much higher IR of non-fatal burns than males between the ages of 10-15 years (1655.2 vs 482.2). About 70% of burns occurred in rural areas. Hot liquid (44.7%), flames (32.5%) and hot objects (20.7%) were identified as the main causes of burns. The kitchen (60.9%), yards (20.8%) and bedroom and living room (10.5%) were the three most common places for burns. According to the study, 34.8% of burn incidences occurred between the hours of 7:00 and 10:00. CONCLUSION Children in Bangladesh suffer from a high rate of non-fatal burns. The high-risk category was identified as preschool-aged boys and adolescent girls. The majority of the incidents occurred in the morning and inside the kitchen. These findings will help raise awareness and create intervention measures to reduce the high incidence of non-fatal childhood burns in Bangladesh.
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Affiliation(s)
- Minhazul Abedin
- NCD and Mental Health Division, Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
| | - Farah Naz Rahman
- NCD and Mental Health Division, Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
| | - Shagoofa Rakhshanda
- NCD and Mental Health Division, Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
| | - Saidur Rahman Mashreky
- NCD and Mental Health Division, Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh.,Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - A K M Fazlur Rahman
- Office of Executive Director, Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh.,Department of Epidemiology, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Ahmed Hossain
- Department of Public Health, North South University, Dhaka, Bangladesh.,Global Health Institute, North South University, Dhaka, Bangladesh
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Biswas A, Dalal K, Sawon RA, Mayaboti CA, Mashreky SR. Emergency management for severe burn (EMSB) course for the nurses in Bangladesh: opportunity and way forward. Heliyon 2022; 8:e09156. [PMID: 35846460 PMCID: PMC9280581 DOI: 10.1016/j.heliyon.2022.e09156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 08/03/2021] [Accepted: 03/17/2022] [Indexed: 11/26/2022] Open
Abstract
Background Methodology Results Conclusions
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Jordan KC, Di Gennaro JL, von Saint André-von Arnim A, Stewart BT. Global trends in pediatric burn injuries and care capacity from the World Health Organization Global Burn Registry. Front Pediatr 2022; 10:954995. [PMID: 35928690 PMCID: PMC9343701 DOI: 10.3389/fped.2022.954995] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 06/27/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Burn injuries are a major cause of death and disability globally. The World Health Organization (WHO) launched the Global Burn Registry (GBR) to improve understanding of burn injuries worldwide, identify prevention targets, and benchmark acute care. We aimed to describe the epidemiology, risk factors, and outcomes of children with burns to demonstrate the GBR's utility and inform needs for pediatric burn prevention and treatment. METHODS We performed descriptive analyses of children age ≤ 18 years in the WHO GBR. We also described facility-level capacity. Data were extracted in September of 2021. RESULTS There were 8,640 pediatric and adult entries from 20 countries. Of these, 3,649 (42%) were children (0-18 years old) from predominantly middle-income countries. The mean age was 5.3 years and 60% were boys. Children aged 1-5 years comprised 62% (n = 2,279) of the cohort and mainly presented with scald burns (80%), followed by flame burns (14%). Children >5 years (n = 1,219) more frequently sustained flame burns (52%) followed by scald burns (29%). More than half of pediatric patients (52%) sustained a major burn (≥15% total body surface area) and 48% received surgery for wound closure during the index hospitalization. Older children had more severe injuries and required more surgery. Despite the frequency of severe injuries, critical care capacity was reported as "limited" for 23% of pediatric patients. CONCLUSIONS Children represent a large proportion of people with burn injuries globally and often sustain major injuries that require critical and surgical intervention. However, critical care capacity is limited at contributing centers and should be a priority for healthcare system development to avert preventable death and disability. This analysis demonstrates that the GBR has the potential to highlight key epidemiological characteristics and hospital capacity for pediatric burn patients. To improve global burn care, addressing barriers to GBR participation in low- and low-middle-income countries would allow for greater representation from a diversity of countries, regions, and burn care facilities.
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Affiliation(s)
- Kelly C Jordan
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, United States
| | - Jane L Di Gennaro
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, United States
| | - Amélie von Saint André-von Arnim
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, United States.,Department of Global Health, University of Washington, Seattle, WA, United States
| | - Barclay T Stewart
- Division of Trauma, Burn, and Critical Care Surgery, Department of Surgery, University of Washington, Seattle, WA, United States
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10
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The cost of inpatient burn management in Nepal. Burns 2021; 47:1675-1682. [PMID: 33947601 DOI: 10.1016/j.burns.2021.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 12/18/2020] [Accepted: 01/22/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The management of burns is costly and complex with inpatient burns accounting for a high proportion of the costs associated with burn care. We conducted a study to estimate the cost of inpatient burn management in Nepal. Our objectives were to identify the resource and cost components of the inpatient burn care pathways and to estimate direct and overhead costs in two specialist burn units in tertiary hospitals in Nepal. METHODS We conducted fieldwork at two tertiary hospitals to identify the cost of burns management in a specialist setting. Data were collected through semi-structured in-depth interviews (IDIs) and focus group discussions (FGDs) with burn experts; unit cost data was collected from hospital finance departments, laboratories and pharmacies. The study focused on acute inpatient burn cases admitted to specialist burn centres within a hospital-setting. RESULTS Experts divided inpatient burn care pathways into three categories: superficial partial-thickness burns (SPT), mixed depth partial-thickness burns (MDPT) and full thickness burns (FT). These pathways were confirmed in the FGDs. A 'typical' burns patient was identified for each pathway. Total resource use and total direct costs along with overhead costs were estimated for acute inpatient burn patients. The average per patient pathway costs were estimated at NRs 102,194 (US$ 896.4), NRs 196,666 (US$ 1725), NRs 481,951 (US$ 4,227.6) for SPT, MDPT and FT patients respectively. The largest cost contributors were surgery, dressings and bed charges respectively. CONCLUSION This study is a first step towards a comprehensive estimate of the costs of severe burns in Nepal.
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Aydogdu HI, Kirci GS, Askay M, Bagci G, Peksen TF, Ozer E. Medicolegal evaluation of cases with burn trauma: Accident or physical abuse. Burns 2020; 47:888-893. [PMID: 33131946 DOI: 10.1016/j.burns.2020.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/01/2020] [Accepted: 10/07/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION AND OBJECTIVE Burns are thermal injuries that may have a wide variety of clinical consequences from simple injuries to mortality. There are many aspects that must be medicolegally addressed in both non-survivors and survivors from burn injuries. The objective of this study was to determine sociodemographic characteristics, injury patterns, treatment requirements and prognoses of patients with burn injuries to evaluate the findings of neglect-abuse and forensic reporting processes. This study also aimed to contribute to the medicolegal classification criteria in respect of the factors that have an effect on the prognosis in the analyses. MATERIAL AND METHOD The study was conducted by retrospective review of digital files and paper records of patients who received therapy in the Burns Unit of KTU Farabi Hospital between 1st January, 2013, and 31st December, 2017. RESULTS Evaluation was made of a total of 1225 patients, comprising 769 (62.8%) males and 456 (37.2%) females, with a mean age of 21.8 ± 23.8 years (range, 1-89 years). The mean burnt body surface area was 14.29 ± 13.74. A trauma-related psychiatric disorder was diagnosed in 60 (4.9%) patients during treatment. When the medical history and physical examination findings were evaluated together, burn injuries suggested physical abuse in 54 patients (4.4%). The doctors who evaluated the patients with burn injuries in the emergency room and those who applied treatment in the Burns Unit made a forensic notification for 379 (30.9%) patients. The mean age of non-survivors was significantly higher than that of patients who survived to discharge (56.54 ± 28.60 years for non-survivors and 19.39 ± 23.12 years for survivors; p < 0.001). CONCLUSION Burn injuries are frequently encountered, and they require precautionary measures. Burn injuries due to abuse are more frequently observed in the elderly and especially in children. Thus, the findings must be correctly interpreted, and more effort should be made to improve the knowledge of healthcare professionals about forensic reporting. Moreover, regulations should be implemented in respect of the medicolegal classification of trauma.
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Affiliation(s)
| | - Guven Seckin Kirci
- Karadeniz Technical University, Faculty of Medicine, Department of Forensic Medicine, Trabzon, Turkey
| | - Mehmet Askay
- Karadeniz Technical University, Faculty of Medicine, Department of Forensic Medicine, Trabzon, Turkey
| | - Gozde Bagci
- Karadeniz Technical University, Faculty of Medicine, Department of Forensic Medicine, Trabzon, Turkey
| | - Tevfik Furkan Peksen
- Karadeniz Technical University, Faculty of Medicine, Department of Forensic Medicine, Trabzon, Turkey
| | - Erdal Ozer
- Karadeniz Technical University, Faculty of Medicine, Department of Forensic Medicine, Trabzon, Turkey
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Padalko A, Cristall N, Gawaziuk JP, Logsetty S. Social Complexity and Risk for Pediatric Burn Injury: A Systematic Review. J Burn Care Res 2020; 40:478-499. [PMID: 30918946 DOI: 10.1093/jbcr/irz059] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Social complexity in health outcomes has been attributed to greater risk of injury, adverse health consequences, and early death in a variety of populations. To determine what social complexity factors associated with burn injury in children, a systematic review of the literature was performed. Two different databases (PubMed and SCOPUS) were searched for articles related to environmental and social determinants of burn injury. Selected literature examined social complexity factors to establish the strength of evidence in relation to incidence of burn injury in children. The extent of factors and the most common social complexities were reviewed. The 641 manuscripts found in PubMed and 327 from SCOPUS were initially reviewed for duplication and English language. Subsequently, manuscripts were selected for relevance based on titles followed by abstracts. Forty-seven manuscripts were reviewed in their entirety. The literature supports a relationship between an increased incidence of pediatric burns in lower income families, children with behavioral disorders, fewer years of parental education and children residing in a rural setting. The majority of reports came from Europe followed by Australia, and scattered information from other countries. Social complexity factors in the environment of the child are associated with an increased risk of burn injury in children. The literature supports the influence of lower income, lower parental education, behavioral disorders and living rurally with an increased incidence of injury. By identifying children at increased risk, it is possible to develop targeted burn prevention and education programs to mitigate burn injury.
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Affiliation(s)
- Adam Padalko
- BSc Med Research Program, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Nora Cristall
- Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Canada
| | | | - Sarvesh Logsetty
- Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Canada.,Department of Surgery, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.,Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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14
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Keshavarz M, Javanmardi F, Mohammdi AA. A Decade Epidemiological Study of Pediatric Burns in South West of Iran. World J Plast Surg 2020; 9:67-72. [PMID: 32190595 PMCID: PMC7068181 DOI: 10.29252/wjps.9.1.67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Burn is one of the most traumatic injuries and life-threatening states which expose children at a higher risk. The aim of this study was evaluating the epidemiology of pediatric burns in age less than eighteen years old during the last decade. METHODS This cross-sectional study was carried out during 2008-2017 in Amir-al Momenin Burn Center, affiliated by Shiraz University of Medical Sciences, Shiraz, Iran. The subjects consisted of burn victims under 18 years old who were registered as outpatients and inpatients. RESULTS During the study period, 1893 and 12431 patient were registered as inpatients and outpatients of the hospital. The burn victims were males. Children under 5 years old were prone to scald injuries more than children in any other age. More than 90% of inpatients children burned accidentally, while 116 (6.12%) burn injuries were suicidal; which was mostly seen in girls (75%, 87 out of 116). CONCLUSION Most burns involved scalds from hot liquids especially in children age less than 5 years. Different strategies can be executed by means of broadcast flashes in mass media and educational programs through schools to show risk situation and statements calling attention to prevent childhood burn injuries.
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Affiliation(s)
- Mohammad Keshavarz
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Javanmardi
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Akbar Mohammdi
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Division of Plastic and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
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Alemayehu S, Afera B, Kidanu K, Belete T. Management Outcome of Burn Injury and Associated Factors among Hospitalized Children at Ayder Referral Hospital, Tigray, Ethiopia. Int J Pediatr 2020; 2020:9136256. [PMID: 32148527 PMCID: PMC7049818 DOI: 10.1155/2020/9136256] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 01/10/2020] [Accepted: 02/03/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Burn injuries are a global public health problem, accounting for an estimated 265,000 deaths. Globally, over half of the disability-adjusted life years lost from fire-related burns which occurred between the ages of 0 and 14 years. The rate of child deaths from burns is currently over 7 times higher in low- and middle-income countries than in high-income countries. In Ethiopia, burn was the second leading cause of death among children from the unintentional injuries. So far, no research had been conducted in terms of assessing the outcome of burn injury in children in Ethiopia and particularly in Tigray region. The aim of this study was to assess the outcome of burn injury and associated factors among hospitalized children of under 18 years at Ayder Referral Hospital in Mekelle, Ethiopia. METHOD A retrospective document review was used to assess the outcome of burn injury and associated factors in Ayder Referral Hospital. A total of 382 hospitalized children's chart from 2011 to 2015 were reviewed using a structured check list. To select the patients' chart, a simple random sampling technique was used and a sampling frame was prepared based on a registration book. Data was entered, cleaned, and analyzed using SPSS version 20. RESULT Almost 70% of the burns were caused by scald, and 45.3% of the burns were confined to the upper extremities. Eighty-two percent of the patients were discharged without complication. Lack of fluid resuscitation within 24 hours (AOR = 2.767; 95% CI (1.276-5.999)) and a burn patient with malnutrition (AOR = 0.252; 95% CI (0.069-0.923)) were statically significant with the outcome of burn injury. CONCLUSION Majority of the pediatric burn patients were discharged without complication. The most causative agent of these accidents was scald; upper extremities also were the most affected area. The factors associated with the outcome of burn injury according to this study were lack of fluid resuscitation and malnourishment of burn patients.
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Affiliation(s)
- Sielu Alemayehu
- Mekelle University, School of Nursing, Mekelle, Tigray, Ethiopia
| | - Bhafta Afera
- Mekelle University, School of Nursing, Mekelle, Tigray, Ethiopia
| | - Kalayou Kidanu
- Mekelle University, School of Nursing, Mekelle, Tigray, Ethiopia
| | - Tilahun Belete
- Mekelle University, School of Nursing, Mekelle, Tigray, Ethiopia
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Exploration of gaps and challenges in managing burn injury at district and sub-district government health care facilities in Bangladesh. BURNS OPEN 2020. [DOI: 10.1016/j.burnso.2019.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Naik A, Lewis CJ, Allison KP. Temperature dissociation of liquids in reusable thermoplastic containers-An eco-friendly scald risk? Burns 2019; 45:1621-1624. [PMID: 31371231 DOI: 10.1016/j.burns.2019.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/14/2019] [Accepted: 07/10/2019] [Indexed: 01/14/2023]
Abstract
Recent global concern regarding the impact of plastic waste on the environment has resulted in efforts to utilise reusable drink containers. Research is lacking regarding temperature dissociation of drinks in reusable thermoplastic cups. This study aimed to compare the cooling time of two common hot drinks sold at a UK retailer, in the three vessels they are sold; ceramic, disposable paper (with and without lid) and reusable thermoplastic cups (with and without lid). All temperatures were collated from 250 ml volumes of black Americano coffee or café latte in the three different containers. The cooling time was measured every sixty seconds using a standardised digital thermocouple thermometer until a threshold liquid temperature of 43 °C was reached. All experiments were performed in triplicate and temperatures converted to a dimensionless logarithmic scale prior to statistical analysis. Cooling time was significantly slower for lidded cups irrespective of material. Unlidded thermoplastic cups significantly slowed cooling times for both black Americano coffee and café latte compared to ceramic and unlidded disposable paper cups. The growing trend in reusable cups does not in itself pose an increased risk of scald injury. However, we consider that the potentially increased ambulatory behaviour associated with using a lidded rather than unlidded cup may increase scald risk. We propose that further consumer guidance should be disseminated regarding the use of any lidded takeaway container to prevent scalds in both adults and children.
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Affiliation(s)
- A Naik
- Department of Plastic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
| | - C J Lewis
- Department of Plastic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom.
| | - K P Allison
- Department of Plastic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
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Characterization of burn wound healing gel prepared from human amniotic membrane and Aloe vera extract. Altern Ther Health Med 2019; 19:115. [PMID: 31159783 PMCID: PMC6547555 DOI: 10.1186/s12906-019-2525-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 05/17/2019] [Indexed: 01/25/2023]
Abstract
Background Skin burn wound is a notable medical burden worldwide. Rapid and effective treatment of burnt skin is vital to fasten wound closure and healing properly. Amniotic graft and Aloe vera are widely used as wound managing biomaterials. Sophisticated processing, high cost, availability, and the requirement of medics for transplantation limit the application of amnion grafts. We aim to prepare a novel gel from amnion combined with the Aloe vera extract for burn wound healing which overcome the limitations of graft. Methods Two percent human amniotic membrane (AM), Aloe vera (AV) and AM+AV gels were prepared. In vitro cytotoxicity, biocompatibility, cell attachment, proliferation, wound healing scratch assays were performed in presence of the distinct gels. After skin irritation study, second-degree burns were induced on dorsal region of Wistar rats; and gels were applied to observe the healing potential in vivo. Besides, macroscopical measurement of wound contraction and re-epithelialization; gel treated skin was histologically investigated by Hematoxylin and eosin (H&E) staining. Finally, quantitative assessment of angiogenesis, inflammation, and epithelialization was done. Results The gels were tested to be non-cytotoxic to nauplii and compatible with human blood and skin cells. Media containing 500 μg/mL AM+AV gel were observed to promote HaCaT and HFF1 cells attachment and proliferation. In vitro scratch assay demonstrated that AM+AV significantly accelerated wound closure through migration of HaCaT cells. No erythema and edema were observed in skin irritation experiments confirming the applicability of the gels. AV and AM+AV groups showed significantly accelerated wound closure through re-epithelialization and wound contraction with P < 0.01. Macroscopically, AM and AM+AV treated wound recovery rates were 87 and 90% respectively with P < 0.05. Histology analysis revealed significant epitheliazation and angiogenesis in AM+AV treated rats compared to control (P < 0.05). AM+AV treated wounds had thicker regenerated epidermis, increased number of blood vessels, and greater number of proliferating keratinocytes within the epidermis. Conclusion We demonstrated that a gel consisting of a combination of amnion and Aloe vera extract has high efficacy as a burn wound healing product. Amniotic membrane combined with the carrier Aloe vera in gel format is easy to produce and to apply.
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Santos JV, Viana J, Oliveira A, Ramalho A, Sousa-Teixeira J, Duke J, Amarante J, Freitas A. Hospitalisations with burns in children younger than five years in Portugal, 2011-2015. Burns 2019; 45:1223-1230. [PMID: 30686698 DOI: 10.1016/j.burns.2019.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 12/21/2018] [Accepted: 01/01/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Paediatric population still represents a high burden of hospitalisations among burns inpatients. Children under five years old have a distinct aetiology distribution comparing to other age groups, representing in Portugal a fifth of all hospitalisations with burns. We aimed to describe the demographic and clinical burden of burns requiring hospitalization, as well as hospitalization charges, among this age group in Portugal. METHODS We performed a retrospective study including inpatients younger than five years-old and discharged between 2011 and 2015 in a public Portuguese hospital with a main or secondary diagnosis of burns (ICD-9-CM: 940.xx-949.xx). Clinical and demographics characteristics were assessed, as well as hospital reimbursement charges. RESULTS A total of 1217 hospitalisations with burns were found, with a hospitalization rate of 54.6 hospitalisations/100,000 inhabitants/year, higher among boys. Ninety percent of them were due to hot liquid or objects. There were three in-hospital deaths. There was a median length of stay of 9days and a mean hospitalization reimbursed charge of 3073 Euros (4918 I$). Non-rural: rural hospitalization rate ratio was of 0.42:1. Évora and Bragança were the districts with higher hospitalization rate with 116 and 107, respectively. DISCUSSION This Portuguese nation-wide study on hospitalisations with burns highlights that 90% of all burns were due to hot liquid or object and a major impact of patients younger than 2years old in this age group. Urban vs rural difference in hospitalization rate should also be considered for further health inequalities' studies. As conclusion, ongoing attention needs to be dedicated to paediatric burn prevention and safety cost-effective strategies, particularly in relation to scalds, to further reduce the incidence of burn hospitalisations in children and the associated hospital costs.
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Affiliation(s)
- João Vasco Santos
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Portugal; Public Health Unit, ACES Grande Porto VIII - Espinho/Gaia, ARS Norte, Portugal.
| | - João Viana
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Portugal
| | - Andreia Oliveira
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal
| | - André Ramalho
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Portugal; FGV Management (Getúlio Vargas Foundation), São Paulo, Brazil
| | - Joana Sousa-Teixeira
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal
| | - Janine Duke
- Burn Injury Research Unit, Faculty of Health and Medical Sciences, The University of Western Australia, Australia
| | - José Amarante
- Department of Surgery, Faculty of Medicine, University of Porto, Portugal
| | - Alberto Freitas
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Portugal
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Bailey ME, Sagiraju HKR, Mashreky SR, Alamgir H. Epidemiology and outcomes of burn injuries at a tertiary burn care center in Bangladesh. Burns 2019; 45:957-963. [PMID: 30612889 DOI: 10.1016/j.burns.2018.12.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 11/15/2018] [Accepted: 12/13/2018] [Indexed: 10/27/2022]
Abstract
Globally, burns are among some of the most devastating injuries and account for more than 265,000 deaths worldwide. In Bangladesh alone, nearly 3000 people die annually from burn-related injuries. This study was conducted at the National Institute of Burn and Plastic Surgery in Dhaka, Bangladesh in June of 2016. Data included conducting surveys of hospitalized burn patients (N=66) and a chart review of deceased burn patients (N=88). In addition to reporting on the demographic profile of patients, information was also obtained on clinical measures during hospitalization. For non-fatal burns, high risk groups included young adult males (early 30s) of lower socioeconomic status. Among children, the most vulnerable group was found to be children less than eight years old. The most common non-fatal types of burn injuries were flame (35%), electrical (31%) and scald (24%). Discharged patients had an average hospital stay of around 30days with half of all patients requiring surgical intervention, thus indicating the severity of those cases and the need for resource-intensive care. Among the discharged patient population, factors significantly associated with a longer duration of hospital stay included severity of injury, not having received prior treatment before admission and whether or not patients required surgery during hospitalization. Among the mortality cases, the high-risk groups also included young adult males and children of around eight years of age. The average total body surface area (TBSA) sustained in these cases was 46.4%, with 65% of deaths attributable to complications from flame burns. These findings highlight the frequency and severity of burn injuries, identify vulnerable population groups and list common causes of burns in this large developing country of 160 million people. Furthermore, these findings may be applicable to the epidemiology and outcome of burns in similar low and middle income countries.
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Affiliation(s)
- M E Bailey
- School of Medicine, University of Texas Health Science Center San Antonio, 7733 Louis Pasture San Antonio, TX 78229, USA; The University of Texas School of Public Health, 7411 John Smith Dr, #1100 San Antonio, TX 78229, USA.
| | - H K R Sagiraju
- The University of Texas School of Public Health, 7411 John Smith Dr, #1100 San Antonio, TX 78229, USA
| | - S R Mashreky
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), House # B-162, Road # 23, New DOHS, Mohakhali, Dhaka, 1206, Bangladesh
| | - H Alamgir
- New York Medical College, 40 Sunshine Cottage Rd, Valhalla, NY 10595, USA
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Sinha S, Nuñez Martinez CM, Hartley RL, Quintana Alvarez RJ, Yoon G, Biernaskie JA, Nickerson D, Gabriel VA. Epidemiological analysis of pediatric burns in the Dominican Republic reveals a demographic profile at significant risk for electrical burns. Burns 2018; 45:471-478. [PMID: 30573295 DOI: 10.1016/j.burns.2018.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 03/23/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Pediatric burns are preventable with legislative and infrastructural changes. Although retrospective audits of many low- and middle-income countries have aided preventative efforts, the epidemiological status of burns in the Caribbean is not known. This study characterizes pediatric burns in the Dominican Republic (DR) and compares these to age-matched North American records captured by the National Burn Repository. METHODS A retrospective audit of 1600 patients admitted to the Unidad de Niños Quemados Dra. Thelma Rosario Hospital, the island's only major pediatric burn center, between January 2010 to March 2017 was performed. Epidemiological variables analyzed included age, gender, burn mechanism, year, month, city, admission duration, nationality, mortality, and %TBSA. RESULTS Pediatric burn patients in the DR sustained larger burns (8.2% vs. 6.5% TBSA) and spent more days in the hospital (10 vs. 6 days). Females were overrepresented (M:F=1:1.5) and mortality amongst admitted patients was 4-fold higher (2.8% vs. 0.7%). Electrical burns were significantly overrepresented in DR (21%) compared to age-matched North American patients (2%). Although electrical burns were smaller (4% TBSA), compared to scald (14% TBSA), and flame (19% TBSA), these burns preferred hands and had a high mortality rate (3%). No significant seasonality in burn mechanisms were observed. Finally, we report geographical and age group differences in the distribution of burn mechanisms and highlight particularly vulnerable subpopulations. CONCLUSION This investigation identifies a demographical profile where electrical burns account for a significant percentage of the burn population. This provides a basis for concentrating preventative efforts in vulnerable populations.
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Affiliation(s)
- Sarthak Sinha
- Division of Physical Medicine and Rehabilitation, Departments of Clinical Neurosciences, Pediatrics and Surgery, Faculty of Medicine, University of Calgary, Canada; Department of Comparative Biology & Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Canada.
| | | | - Rebecca L Hartley
- Section of Plastic Surgery, Department of Surgery, University of Calgary, Canada.
| | | | - Grace Yoon
- Department of Comparative Biology & Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Canada.
| | - Jeff A Biernaskie
- Department of Comparative Biology & Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Canada.
| | - Duncan Nickerson
- Section of Plastic Surgery, Department of Surgery, University of Calgary, Canada; Calgary Firefighters' Burn Treatment Centre, Canada.
| | - Vincent A Gabriel
- Division of Physical Medicine and Rehabilitation, Departments of Clinical Neurosciences, Pediatrics and Surgery, Faculty of Medicine, University of Calgary, Canada; Calgary Firefighters' Burn Treatment Centre, Canada.
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Das M, Elsey H, Shawon RA, Hicks J, Ferdoush J, Huque R, Fieroze F, Nasreen S, Wallace H, Mashreky SR. Protocol to develop sustainable day care for children aged 1-4 years in disadvantaged urban communities in Dhaka, Bangladesh. BMJ Open 2018; 8:e024101. [PMID: 30068626 PMCID: PMC6074616 DOI: 10.1136/bmjopen-2018-024101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Lack of safe, stimulating and health-promoting environments for children under-5 hinders their physical, social and cognitive development, known as early childhood development (ECD). Improving ECD impacts on children, and can improve educational attainment for girls, who often care for younger siblings, and employment prospects for mothers. Developing and evaluating the impacts of ECD programmes within childcare needs to assess a range of social, health, educational and economic impacts, including women's empowerment.Children living in slums are at high risk of poor early development and holistic, sustainable interventions are needed to address ECD in these contexts. This study will be undertaken in Dhaka, Bangladesh, a city where over 8.5 million inhabitants live in slums. In collaboration with government, non-governmental organisations and communities, we are developing and testing a sustainable day-care model for low-income communities in Dhaka. METHODOLOGY AND ANALYSIS A sequential mixed methods approach is being used in the study, with qualitative work exploring quantitative findings. Two hundred households with children under-5 will be surveyed to determine day-care needs and to assess ECD (parent-reported and direct assessment). The feasibility of four ECD measuring tools Caregiver-Reported Early Development Index, Measuring Early Learning Quality and Outcomes, The Early Human Capability Index and International Development and Early Learning Assessment will be assessed quantitatively and qualitatively. Qualitative methods will help understand demand and perceptions of day care while mothers work. Participatory action research will be used to develop a locally appropriate and potentially sustainable model of day care for under-5 children. A ward in the south of Dhaka has been selected for the study as this typifies communities with slum and non-slum households living next to each other, allowing us to explore potential for better-off household to subsidise day care for poorer households. ETHICS AND DISSEMINATION Findings will be published and inform decision makers at the national, regional and the local actors in order to embed the study into the policy and practice on childcare and ECD. Ethical approvals for this study were obtained from the School of Medicine Research Ethics Committee at the Faculty of Medicine and Health at the University of Leeds (ref: MREC16-106) and the Bangladesh Medical Research Council (ref: BMRCAIREC/20 I 6-20 I 9 I 250).
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Affiliation(s)
- Mahua Das
- Nuffield Institute for International Health and Development, Leeds University, Leeds, UK
| | - Helen Elsey
- Nuffield Institute for International Health and Development, Leeds University, Leeds, UK
| | - Riffat Ara Shawon
- Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
| | - Joseph Hicks
- Nuffield Institute for International Health and Development, Leeds University, Leeds, UK
| | - J Ferdoush
- Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
| | | | | | | | - Hilary Wallace
- School of Medicine, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Saidur R Mashreky
- Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
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Biswas A, Abdullah ASM, Dalal K, Deave T, Rahman F, Mashreky SR. Exploring perceptions of common practices immediately following burn injuries in rural communities of Bangladesh. BMC Health Serv Res 2018; 18:467. [PMID: 29914495 PMCID: PMC6006944 DOI: 10.1186/s12913-018-3287-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 06/11/2018] [Indexed: 11/16/2022] Open
Abstract
Background Burns can be the most devastating injuries in the world, they constitute a global public health problem and cause widespread public health concern. Every year in Bangladesh more than 365,000 people are injured by electrical, thermal and other causes of burn injuries. Among them 27,000 need hospital admission and over 5600 people die. Immediate treatment and medication has been found to be significant in the success of recovering from a burn. However, common practices used in the treatment of burn injuries in the community is not well documented in Bangladesh. This study was designed to explore the perception of local communities in Bangladesh the common practices used and health-seeking behaviors sought immediately after a burn injury has occurred. Methods A qualitative study was conducted using Focus Group Discussions (FGD) as the data collection method. Six unions of three districts in rural Bangladesh were randomly selected and FGDs were conducted in these districts with six burn survivors and their relatives and neighbours. Data were analyzed manually, codes were identified and the grouped into themes. Results The participants stated that burn injuries are common during the winter in Bangladesh. Inhabitants in the rural areas said that it was common practice, and correct, to apply the following to the injured area immediately after a burn: egg albumin, salty water, toothpaste, kerosene, coconut oil, cow dung or soil. Some also believed that applying water is harmful to a burn injury. Most participants did not know about any referral system for burn patients. They expressed their dissatisfaction about the lack of available health service facilities at the recommended health care centers at both the district level and above. Conclusions In rural Bangladesh, the current first-aid practices for burn injuries are incorrect; there is a widely held belief that using water on burns is harmful.
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Affiliation(s)
- Animesh Biswas
- Reproductive and Child Health Department, Centre for Injury Prevention and Research, Bangladesh (CIPRB), House B 162, Road 23, New DOHS, Mohakhali, Dhaka, 1206, Bangladesh.
| | - Abu Sayeed Md Abdullah
- Reproductive and Child Health Department, Centre for Injury Prevention and Research, Bangladesh (CIPRB), House B 162, Road 23, New DOHS, Mohakhali, Dhaka, 1206, Bangladesh
| | - Koustuv Dalal
- Department of Public Health Science, School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Toity Deave
- Centre for Child & Adolescent Health, Faculty of Health & Applied Sciences, University of the West of England, Bristol, UK
| | - Fazlur Rahman
- Reproductive and Child Health Department, Centre for Injury Prevention and Research, Bangladesh (CIPRB), House B 162, Road 23, New DOHS, Mohakhali, Dhaka, 1206, Bangladesh.,Bangladesh University of Health sciences (BUHS), Dhaka, Bangladesh
| | - Saidur Rahman Mashreky
- Reproductive and Child Health Department, Centre for Injury Prevention and Research, Bangladesh (CIPRB), House B 162, Road 23, New DOHS, Mohakhali, Dhaka, 1206, Bangladesh.,Bangladesh University of Health sciences (BUHS), Dhaka, Bangladesh
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Davé DR, Nagarjan N, Canner JK, Kushner AL, Stewart BT. Rethinking burns for low & middle-income countries: Differing patterns of burn epidemiology, care seeking behavior, and outcomes across four countries. Burns 2018; 44:1228-1234. [PMID: 29475744 DOI: 10.1016/j.burns.2018.01.015] [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: 06/12/2017] [Revised: 11/27/2017] [Accepted: 01/18/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE Low-and middle-income (LMIC) countries account for 90% of all reported burns, nevertheless there is a paucity of providers to treat burns. Current studies on burns in LMICs have not evaluated the gap between care seeking and receiving. This study explores this gap across socioeconomically similar populations in a multi-country population based assessment to inform burn care strategies. METHODS The Surgeons OverSeas Assessment of Surgical Need (SOSAS) instrument is a cross sectional national, cluster random sampling survey administered in Nepal, Rwanda, Sierra Leone, and Uganda from 2011 to 2014. The survey identifies burn etiology, demographics, timing, disability, and barriers to receiving care. RESULTS Among 13,763 individuals surveyed, 896 burns were identified. Rwanda had the highest proportion of individuals seeking and receiving care (91.6% vs 88.5%) while Sierra Leone reported the fewest (79.3% vs 70.3%). Rwanda reported the largest disability while Nepal reported the highest proportion with no disability (47.5% vs 76.2%). Lack of money, healthcare providers, and rural living reduce the odds of receiving care by 68% and 85% respectively. CONCLUSIONS Despite similar country socioeconomic characteristics there was significant variability in burn demographics, timing, and disability. Nevertheless, being geographically and economically disadvantaged predict lack of access to burn care.
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Affiliation(s)
- Dattesh R Davé
- Department of Surgery, University of California San Diego, San Diego, CA, USA.
| | - Neeraja Nagarjan
- Department of General Surgery, Brigham and Women's Boston Hospital and Medical Center, Boston, MA, USA
| | - Joseph K Canner
- Surgery Center for Outcomes Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Adam L Kushner
- Surgeons OverSeas, New York, NY, USA; Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Doza S, Jabeen Rahman M, Islam MA, Kwong LH, Unicomb L, Ercumen A, Pickering AJ, Parvez SM, Naser AM, Ashraf S, Das KK, Luby SP. Prevalence and Association of Escherichia coli and Diarrheagenic Escherichia coli in Stored Foods for Young Children and Flies Caught in the Same Households in Rural Bangladesh. Am J Trop Med Hyg 2018; 98:1031-1038. [PMID: 29436348 PMCID: PMC5928814 DOI: 10.4269/ajtmh.17-0408] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Consumption of contaminated stored food can cause childhood diarrhea. Flies carry enteropathogens, although their contribution to food contamination remains unclear. We investigated the role of flies in contaminating stored food by collecting food and flies from the same households in rural Bangladesh. We selected 182 households with children ≤ 24 months old that had stored foods for later feeding at room temperature for ≥ 3 hours. We collected food samples and captured flies with fly tapes hung by the kitchen. We used the IDEXX Quanti-Tray System (Colilert-18 media; IDEXX Laboratories, Inc., Westbrook, ME) to enumerate Escherichia coli with the most probable number (MPN) method. Escherichia coli–positive IDEXX wells were analyzed by polymerase chain reaction for pathogenic E. coli genes (eae, ial, bfp, ipaH, st, lt, aat, aaiC, stx1, and stx2). Escherichia coli was detected in 61% (111/182) of food samples, with a mean of 1.1 log10 MPN/dry g. Fifteen samples (8%) contained pathogenic E. coli; seven (4%) had enteropathogenic E. coli (EPEC) genes (eae and/or bfp); and 10 (5%) had enteroaggregative E. coli genes (aat and/or aaiC). Of flies captured in 68 (37%) households, E. coli was detected in 41 (60%, mean 2.9 log10 MPN/fly), and one fly (1%) had an EPEC gene (eae). For paired fly-food samples, each log10 MPN E. coli increase in flies was associated with a 0.31 log10 MPN E. coli increase in stored food (95% confidence interval: 0.07, 0.55). In rural Bangladesh, flies possibly a likely route for fecal contamination of stored food. Controlling fly populations may reduce contamination of food stored for young children.
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Affiliation(s)
- Solaiman Doza
- International Center for Diarrheal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | | | | | | | - Leanne Unicomb
- International Center for Diarrheal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Ayse Ercumen
- University of California, Berkeley, Berkeley, California
| | | | - Sarker Masud Parvez
- International Center for Diarrheal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Abu Mohd Naser
- Department of Environmental Health Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Sania Ashraf
- Johns Hopkins Bloomberg School of Public Health University, Baltimore, Maryland.,International Center for Diarrheal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Kishor Kumar Das
- International Center for Diarrheal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Stephen P Luby
- Stanford University, Stanford, California.,International Center for Diarrheal Diseases Research, Bangladesh, Dhaka, Bangladesh
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Burgess J, Kimble R, Watt K, Cameron C. Hot tea and tiny tots don’t mix: A cross-sectional survey on hot beverage scalds. Burns 2017; 43:1809-1816. [DOI: 10.1016/j.burns.2017.05.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/05/2017] [Accepted: 05/08/2017] [Indexed: 10/19/2022]
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Pattern of Road Traffic Injuries in Rural Bangladesh: Burden Estimates and Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111354. [PMID: 29112145 PMCID: PMC5707993 DOI: 10.3390/ijerph14111354] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/01/2017] [Accepted: 11/02/2017] [Indexed: 11/16/2022]
Abstract
Globally, road traffic injury (RTI) causes 1.3 million deaths annually. Almost 90% of all RTI deaths occur in low- and middle-income countries. RTI is one of the leading causes of death in Bangladesh; the World Health Organization estimated that it kills over 21,000 people in the country annually. This study describes the current magnitude and risk factors of RTI for different age groups in rural Bangladesh. A household census was carried out in 51 unions of seven sub-districts situated in the north and central part of Bangladesh between June and November 2013, covering 1.2 million individuals. Trained data collectors collected information on fatal and nonfatal RTI events through face-to-face interviews using a set of structured pre-tested questionnaires. The recall periods for fatal and non-fatal RTI were one year and six months, respectively. The mortality and morbidity rates due to RTI were 6.8/100,000 population/year and 889/100,000 populations/six months, respectively. RTI mortality and morbidity rates were significantly higher among males compared to females. Deaths and morbidities due to RTI were highest among those in the 25–64 years age group. A higher proportion of morbidity occurred among vehicle passengers (34%) and pedestrians (18%), and more than one-third of the RTI mortality occurred among pedestrians. Twenty percent of all nonfatal RTIs were classified as severe injuries. RTI is a major public health issue in rural Bangladesh. Immediate attention is needed to reduce preventable deaths and morbidities in rural Bangladesh.
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He S, Alonge O, Agrawal P, Sharmin S, Islam I, Mashreky SR, Arifeen SE. Epidemiology of Burns in Rural Bangladesh: An Update. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040381. [PMID: 28379160 PMCID: PMC5409582 DOI: 10.3390/ijerph14040381] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/29/2017] [Accepted: 03/31/2017] [Indexed: 12/23/2022]
Abstract
Each year, approximately 265,000 deaths occur due to burns on a global scale. In Bangladesh, around 173,000 children under 18 sustain a burn injury. Since most epidemiological studies on burn injuries in low and middle-income countries are based on small-scale surveys or hospital records, this study aims to derive burn mortality and morbidity measures and risk factors at a population level in Bangladesh. A household survey was conducted in seven rural sub-districts of Bangladesh in 2013 to assess injury outcomes. Burn injuries were one of the external causes of injury. Epidemiological characteristics and risk factors were described using descriptive as well as univariate and multivariate logistic regression analyses. The overall mortality and morbidity rates were 2 deaths and 528 injuries per 100,000 populations. Females had a higher burn rate. More than 50% of injuries were seen in adults 25 to 64 years of age. Most injuries occurred in the kitchen while preparing food. 88% of all burns occurred due to flame. Children 1 to 4 years of age were four times more likely to sustain burn injuries as compared to infants. Age-targeted interventions, awareness of first aid protocols, and improvement of acute care management would be potential leads to curb death and disability due to burn injuries.
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Affiliation(s)
- Siran He
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Olakunle Alonge
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Priyanka Agrawal
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Shumona Sharmin
- International Center for Diarrheal Disease Research, GPO Box 128, Dhaka 1000, Bangladesh.
| | - Irteja Islam
- International Center for Diarrheal Disease Research, GPO Box 128, Dhaka 1000, Bangladesh.
| | - Saidur Rahman Mashreky
- Center for Injury Prevention and Research, House # B-162, Road # 23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh.
| | - Shams El Arifeen
- International Center for Diarrheal Disease Research, GPO Box 128, Dhaka 1000, Bangladesh.
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Tripathee S, Basnet SJ. Epidemiology of burn injuries in Nepal: a systemic review. BURNS & TRAUMA 2017; 5:10. [PMID: 28413803 PMCID: PMC5389177 DOI: 10.1186/s41038-017-0075-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 03/08/2017] [Indexed: 11/30/2022]
Abstract
Burn is a global public health problem associated with significant morbidity and mortality, mostly in low- and middle-income countries. Southeast-Asian countries share a big burden of burn injuries, and Nepal is not an exception. We performed a systemic review to examine the epidemiological characteristics of burn injures in Nepal. Relevant epidemiological studies were identified through systemic search in PubMed, EMBASE, and Google Scholar. Reference lists from relevant review articles were also searched. Studies were included if they meet our selection criteria. Eight studies were included in our systemic review. Most of the burn victims belong to the working age group between 15–60 years old. Flame burns were found to be the most common cause of burn injury followed by scald burns, whereas scald burns were the most common cause of burn injury among the pediatric population. Most patients sustained less severe burn injuries, with home being the most common place of burn injury. The average hospital stay among the burn victims ranged from 13 to 60 days. Mortality among the burn victims ranged from 4.5 to 23.5%, with highest mortality among the flame burn patients. Developed nations have significantly reduced the burn incidence through effective intervention program. Although, burn injuries are the leading cause of morbidity and mortality in Nepal, effective intervention programs are lacking due to the limited epidemiological data related to burn injuries. Further large scale research is imperative to investigate the problem and assess the effectiveness of an intervention program.
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Inbaraj LR, Rose A, George K, Bose A. Incidence and Impact of Unintentional Childhood Injuries: A Community Based Study in Rural South India. Indian J Pediatr 2017; 84:206-210. [PMID: 27864749 DOI: 10.1007/s12098-016-2260-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 10/31/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To estimate the incidence of unintentional childhood injuries and to assess the impact of injury during childhood. METHODS This is a cross sectional study, conducted in 13 clusters of a rural block in Vellore. Children were screened by two-stage cluster sampling method by two weeks and three months recall method. The primary caregivers of injured children were administered a questionnaire to assess the impact of the injury. RESULTS Childhood injury related morbidity was 292.5 per 1000 y. Children between 10 and 14 y (4.6%) and boys (4.5%) had a higher rate of injury. Fall (43.1 %) was the most common cause of injury followed by RTIs (Road Traffic Incidents- 27.6%). Work absenteeism for primary caregivers ranged from 1 to 60 (IQR 2-7) days. Sickness absenteeism ranged from 1 to 45 d with a mean of 7.64 (IQR 2-7) days. Half of the children missed school after an injury. The days spent with temporary disability ranged from 1 to 60 d with a mean of 11.79 (IQR 2-7) d and 7.73% had permanent disability. CONCLUSIONS Unintentional childhood injury is a neglected public health problem which leads to sickness absenteeism and disability. Boys and older children are the most common victims of injury. There is a need for establishing state or nationwide injury registries to help understand accurate estimates of disability-adjusted life year (DALY) and loss of productivity.
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Affiliation(s)
- Leeberk Raja Inbaraj
- Department of Community Health, Bangalore Baptist Hospital, Bangalore, Karnataka, 560024, India.
| | - Anuradha Rose
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Kuryan George
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anuratha Bose
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
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Abdalla S, Abdel Aziz M, Basheir I. Association of sociodemographic and household characteristics with non-fatal burns among children under the age of 10 years in Sudan: an exploratory secondary analysis of the Sudan Household Health Survey 2010. Inj Prev 2017; 23:377-382. [DOI: 10.1136/injuryprev-2016-042208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 12/06/2016] [Accepted: 01/18/2017] [Indexed: 11/04/2022]
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Dhopte A, Tiwari VK, Patel P, Bamal R. Epidemiology of pediatric burns and future prevention strategies-a study of 475 patients from a high-volume burn center in North India. BURNS & TRAUMA 2017; 5:1. [PMID: 28164140 PMCID: PMC5286678 DOI: 10.1186/s41038-016-0067-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/13/2016] [Indexed: 11/26/2022]
Abstract
Background Pediatric burns have a long-term social impact. This is more apparent in a developing country such as India, where their incidence and morbidity are high. The aim of this study was to provide recent prospective epidemiological data on pediatric burns in India and to suggest future preventive strategies. Methods Children up to 18 years old admitted to the Department of Burns, Plastic & Maxillofacial Surgery, VMMC & Safdarjung Hospital, New Delhi, between January and December 2014 were included in the study. Data regarding age, sex, etiology, total body surface area (TBSA), circumstances of injury, and clinical assessment were collected. The Mann-Whitney test or Kruskal-Wallis test or ANOVA was used to compare involved TBSA among various cohort groups accordingly. Univariate and multivariate linear regression analyses were used to determine the predictors of TBSA. Results There were a total of 475 patients involved in the study, including seven suicidal burns, all of whom were females with a mean age greater than the cohort average. Age, type of burns, mode of injury, presence or absence of inhalation injury, gender, and time of year (quarter) for admission were found to independently affect the TBSA involved. Electrical burns also formed an important number of presenting burn patients, mainly involving teenagers. Several societal issues have come forth, e.g., child marriage, child labor, and likely psychological problems among female children as suggested by a high incidence of suicidal burns. Conclusions This study also highlights several issues such as overcrowding, lack of awareness, dangerous cooking practices, and improper use of kerosene oil. There is an emergent need to recognize the problems, formulate strategies, spread awareness, and ban or replace hazardous substances responsible for most burn accidents.
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Affiliation(s)
- Amol Dhopte
- Department of Burns, Plastic & Maxillofacial Surgery, VMMC & Safdarjung Hospital, New Delhi, India
| | - V K Tiwari
- Department of Burns, Plastic & Maxillofacial Surgery, VMMC & Safdarjung Hospital, New Delhi, India ; Present Address: Department of Burns & Plastic Surgery, PGIMER & RML Hospital, New Delhi, India
| | - Pankaj Patel
- Department of Burns, Plastic & Maxillofacial Surgery, VMMC & Safdarjung Hospital, New Delhi, India
| | - Rahul Bamal
- Department of Burns, Plastic & Maxillofacial Surgery, VMMC & Safdarjung Hospital, New Delhi, India
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Biswas A, Dalal K, Hossain J, Ul Baset K, Rahman F, Rahman Mashreky S. Lightning Injury is a disaster in Bangladesh? - Exploring its magnitude and public health needs. F1000Res 2016; 5:2931. [PMID: 28184286 PMCID: PMC5288675 DOI: 10.12688/f1000research.9537.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/23/2016] [Indexed: 11/20/2022] Open
Abstract
Background: Lightning injury is a global public health issue. Low and middle-income countries in the tropical and subtropical regions of the world are most affected by lightning. Bangladesh is one of the countries at particular risk, with a high number of devastating lightning injuries in the past years, causing high mortality and morbidity. The exact magnitude of the problem is still unknown and therefore this study investigates the epidemiology of lightning injuries in Bangladesh, using a national representative sample. Methods: A mixed method was used. The study is based on results from a nationwide cross-sectional survey performed in 2003 in twelve randomly selected districts. In the survey, a total of 819,429 respondents from 171,336 households were interviewed using face-to-face interviews. In addition, qualitative information was obtained by reviewing national and international newspaper reports of lightning injuries sustained in Bangladesh between 13 and 15 May 2016. Results: The annual mortality rate was 3.661 (95% CI 0.9313–9.964) per 1,000,000 people. The overall incidence of lightning injury was 19.89/100,000 people. Among the victims, 60.12% (n=98) were males and 39.87% (n=65) were females. Males were particularly vulnerable, with a 1.46 times increased risk compared with females (RR 1.46, 95% CI 1.06–1.99). Rural populations were more vulnerable, with a 8.73 times higher risk, than urban populations (RR 8.73, 95% CI 5.13–14.86). About 43% of injuries occurred between 12 noon and 6 pm. The newspapers reported 81 deaths during 2 days of electric storms in 2016. Lightning has been declared a natural disaster in Bangladesh. Conclusions: The current study indicates that lightning injuries are a public health problem in Bangladesh. The study recommends further investigations to develop interventions to reduce lightning injuries, mortality and related burden in Bangladesh.
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Affiliation(s)
- Animesh Biswas
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Koustuv Dalal
- School of Health Sciences, Örebro University, Örebro, Sweden
| | - Jahangir Hossain
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Kamran Ul Baset
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Fazlur Rahman
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
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Epidemiology of a decade of Pediatric fatal burns in Colombia, South America. Burns 2015; 41:1587-92. [DOI: 10.1016/j.burns.2015.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 04/30/2015] [Accepted: 05/06/2015] [Indexed: 11/24/2022]
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Deeba F, Rapee RM. Prevalence of traumatic events and risk for psychological symptoms among community and at-risk children and adolescents from Bangladesh. Child Adolesc Ment Health 2015; 20:218-224. [PMID: 32680344 DOI: 10.1111/camh.12093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Children from developing countries are more vulnerable to traumatic experiences and more likely to suffer a range of psychological problems than children from developed countries. METHOD The current paper describes a survey of 1360 children and adolescents from Bangladesh who were selected either from the general community or through a range of social service organizations. Children completed a checklist of traumatic events and questionnaires to assess symptoms of PTSD, anxiety and depression. RESULTS Children from both samples reported high levels of exposure to traumatic events, both via direct experience and indirectly. Direct experiences with intentional, man-made events were more frequently reported by children from support services while trauma from natural disasters was more common among community children. Psychological symptoms were significantly higher within children from social support services. The strongest predictors of psychological symptoms were age, gender, sample source and exposure to man-made direct traumas. CONCLUSION The results point to the common occurrence of traumatic events and their emotional consequences among children and adolescents from Bangladesh and indicate the need to develop effective and accessible mental health services for Bangladeshi children and adolescents.
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Affiliation(s)
- Farah Deeba
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, C3A 721, Macquarie University, Sydney, New South Wales, 2109, Australia
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Abstract
BACKGROUND The elderly population is more likely to be affected by accidents, such as burns, compared to younger populations because of their diminished host defense. There is limited data about the outcomes of elderly burn patients requiring hospitalization. METHODS In this retrospective study, we assessed the epidemiology and outcomes of burn injuries in elderly patients (>60 years old) admitted to a burn unit of a tertiary medical center based on patient characteristics, type and extent of burns, treatment, hospital stay and mortality rates. RESULTS Forty-eight elderly burn patients among 870 burn patients during the study period were evaluated. Fire was the most common cause of burns (77.1%). Most of the burns involved more than 20% of total body surface area. Twenty-six (54.2%) patients died during hospitalization. Although burn surface area slightly and non-significantly increased in patients over 75 years, there was a significantly increased mortality rate in these patients. Multivariate linear regression analysis revealed burn area and age as independent associates of mortality. CONCLUSION Our data show a high mortality rate in elderly burn patients. Extensive burns and increased age seem to increase the mortality risk.
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Affiliation(s)
- Muhammed Eren Simsek
- Plastic, Reconstructive and Aesthetic Surgery Department, Bursa Çekirge State Hospital , Bursa , Turkey
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Sharma NP, Duke JM, Lama BB, Thapa B, Dahal P, Bariya ND, Marston W, Wallace HJ. Descriptive Epidemiology of Unintentional Burn Injuries Admitted to a Tertiary-Level Government Hospital in Nepal. Asia Pac J Public Health 2015; 27:551-60. [DOI: 10.1177/1010539515585386] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study describes the epidemiology of unintentional adult burn injury admissions in a tertiary hospital in Nepal, from 2002 to 2013, focusing on gender-specific patterns. Chi-square tests and Wilcoxon Rank Sum tests were performed. There were 819 unintentional burn admissions: 52% were male and 58% younger than 35 years. The median percentage total body surface area burned (interquartile range) was greater in females than in males ( P < .001): 28% (17-40) versus 20% (12-35), and female mortality was higher (32% vs 11%). A higher proportion females were illiterate than males (48% vs 17%). Burns occurred at home (67%), work (28%), and public places (5%); gender-specific patterns were observed. Flame burns accounted for 77%, electricity 13%, and scalds 8%. Kerosene (31%) and biomass (27%) were the major fuels. Cooking, heating, and lighting were the main activities associated with burn injury. Results support interventions to reduce the use of open fires and kerosene and to promote electrical safety.
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Affiliation(s)
| | - Janine M. Duke
- The University of Western Australia, Crawley, Western Australia, Australia
| | | | | | | | | | | | - Hilary J. Wallace
- The University of Western Australia, Crawley, Western Australia, Australia
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Kataoka E, Griffin M, Durham J. The characteristics of, and risk factors for, child injuries in Andhra Pradesh, India: the Young Lives project. Int Health 2015; 7:447-54. [PMID: 25908716 DOI: 10.1093/inthealth/ihv022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 12/29/2014] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Injuries are an emerging public health issue among children worldwide, and one of the leading causes of disability-adjusted life years lost for children aged 0-14 years. Few studies, particularly in low- and middle-income countries, have analysed characteristics and risk factors for these injuries. METHODS This study examined the occurrence and risk factors of serious non-fatal injuries in children aged 7-9 years (n=1820) from Andhra Pradesh, India. Logistic regression models were used to explore potential risk factors for these injuries. RESULTS Based on a 3-year recall period, 336 (18.5%) children reported serious non-fatal injuries. Incidence was higher among males (209/971; 21.5%) compared to females (127/849; 15.0%). Of the most serious non-fatal injuries reported, falls (n=186, 55.4%) were the major cause of injuries, followed by road traffic injuries (50, 14.9%), and assaults/blows/hits (26, 7.7%). Twenty children (6.0%) did not fully recover from their injuries, and 14 (4.2%) had long-term health problems as a result of their injuries. The logistic regression analyses indicated that being male (AOR 1.59; 95% CI: 1.25-2.05), in poor health (AOR 2.50; 95% CI: 1.88-3.31), and having a caregiver with low education (AOR 1.53; 95% CI: 1.15-2.05) were associated with an increased risk of non-fatal injury. CONCLUSIONS Urgent attention is needed to reduce child injuries and address risk factors according to local context.
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Affiliation(s)
- Erika Kataoka
- School of Population Health, The University of Queensland, 4006 Brisbane, QLD, Australia
| | - Mark Griffin
- Australian Development Agency for Statistics and Information Systems, 4109 Brisbane, Australia
| | - Jo Durham
- School of Population Health, The University of Queensland, 4006 Brisbane, QLD, Australia
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Childhood burns in Sulaimaniyah province, Iraqi Kurdistan: A prospective study of admissions and outpatients. Burns 2015; 41:394-400. [DOI: 10.1016/j.burns.2014.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 05/16/2014] [Accepted: 07/08/2014] [Indexed: 11/15/2022]
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Burns in Nepal: A population based national assessment. Burns 2014; 41:1126-32. [PMID: 25523087 DOI: 10.1016/j.burns.2014.11.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 11/18/2014] [Accepted: 11/19/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND Burns are ranked in the top 15 leading causes of the burden of disease globally, with an estimated 265,000 deaths annually and a significant morbidity from non-fatal burns, the majority located in low and middle-income countries. Given that previous estimates are based on hospital data, the purpose of this study was to explore the prevalence of burns at a population level in Nepal, a low income South Asian country. METHODS A cluster randomized, cross sectional countrywide survey was administered in Nepal using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) from May 25th to June 12th, 2014. Fifteen of the 75 districts of Nepal were randomly chosen proportional to population. In each district, three clusters, two rural and one urban, were randomly selected. The SOSAS survey has two portions: the first collects demographic data about the household's access to healthcare and recent deaths in the household; the second is structured anatomically and designed around a representative spectrum of surgical conditions, including burns. RESULTS In total, 1350 households were surveyed with 2695 individuals with a response rate of 97%. Fifty-five burns were present in 54 individuals (2.0%, 95% CI 1.5-2.6%), mean age 30.6. The largest proportion of burns was in the age group 25-54 (2.22%), with those aged 0-14 having the second largest proportion (2.08%). The upper extremity was the most common anatomic location affected with 36.4% of burns. Causes of burns included 60.4% due to hot liquid and/or hot objects, and 39.6% due to an open fire or explosion. Eleven individuals with a burn had an unmet surgical need (20%, 95% CI 10.43-32.97%). Barriers to care included facility/personnel not available (8), fear/no trust (1) and no money for healthcare (2). CONCLUSION Burns in Nepal appear to be primarily a disease of adults due to scalds, rather than the previously held belief that burns occur mainly in children (0-14) and women and are due to open flames. This data suggest that the demographics and etiology of burns at a population level vary significantly from hospital level data. To tackle the burden of burns, interventions from all the public health domains including education, prevention, healthcare capacity and access to care, need to be addressed, particularly at a community level. Increased efforts in all spheres would likely lead to a significant reduction of burn-related death and disability.
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Zhou B, Zhou X, Ouyang LZ, Huang XY, Zhang PH, Zhang MH, Ren LC, Liang PF. An epidemiological analysis of paediatric burns in urban and rural areas in south central China. Burns 2014; 40:150-6. [DOI: 10.1016/j.burns.2013.04.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 03/27/2013] [Accepted: 04/30/2013] [Indexed: 10/26/2022]
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Wong JM, Nyachieo DO, Benzekri NA, Cosmas L, Ondari D, Yekta S, Montgomery JM, Williamson JM, Breiman RF. Sustained high incidence of injuries from burns in a densely populated urban slum in Kenya: an emerging public health priority. Burns 2014; 40:1194-200. [PMID: 24461306 DOI: 10.1016/j.burns.2013.12.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 12/12/2013] [Accepted: 12/13/2013] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Ninety-five percent of burn deaths occur in low- and middle-income countries (LMICs); however, longitudinal household-level studies have not been done in urban slum settings, where overcrowding and unsafe cook stoves may increase likelihood of injury. METHODS Using a prospective, population-based disease surveillance system in the urban slum of Kibera in Kenya, we examined the incidence of household-level burns of all severities from 2006-2011. RESULTS Of approximately 28,500 enrolled individuals (6000 households), we identified 3072 burns. The overall incidence was 27.9/1000 person-years-of-observation. Children <5 years old sustained burns at 3.8-fold greater rate compared to (p<0.001) those ≥5 years old. Females ≥5 years old sustained burns at a rate that was 1.35-fold (p<0.001) greater than males within the same age distribution. Hospitalizations were uncommon (0.65% of all burns). CONCLUSIONS The incidence of burns, 10-fold greater than in most published reports from Africa and Asia, suggests that such injuries may contribute more significantly than previously thought to morbidity in LMICs, and may be increased by urbanization. As migration from rural areas into urban slums rapidly increases in many African countries, characterizing and addressing the rising burden of burns is likely to become a public health priority.
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Affiliation(s)
- Joshua M Wong
- Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Nairobi, Kenya and the Kenya Medical Research Institute (KEMRI)-CDC Research Collaboration
| | - Dhillon O Nyachieo
- Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Nairobi, Kenya and the Kenya Medical Research Institute (KEMRI)-CDC Research Collaboration
| | - Noelle A Benzekri
- Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Nairobi, Kenya and the Kenya Medical Research Institute (KEMRI)-CDC Research Collaboration
| | - Leonard Cosmas
- Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Nairobi, Kenya and the Kenya Medical Research Institute (KEMRI)-CDC Research Collaboration
| | - Daniel Ondari
- Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Nairobi, Kenya and the Kenya Medical Research Institute (KEMRI)-CDC Research Collaboration
| | - Shahla Yekta
- Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, ON, Canada
| | - Joel M Montgomery
- Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Nairobi, Kenya and the Kenya Medical Research Institute (KEMRI)-CDC Research Collaboration
| | - John M Williamson
- Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Nairobi, Kenya and the Kenya Medical Research Institute (KEMRI)-CDC Research Collaboration
| | - Robert F Breiman
- Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Nairobi, Kenya and the Kenya Medical Research Institute (KEMRI)-CDC Research Collaboration.
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He S, Lunnen JC, Puvanachandra P, Amar-Singh, Zia N, Hyder AA. Global childhood unintentional injury study: multisite surveillance data. Am J Public Health 2014; 104:e79-84. [PMID: 24432924 DOI: 10.2105/ajph.2013.301607] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We aimed to analyze the epidemiology of childhood unintentional injuries presenting to hospitals in 5 select sites in low- and middle-income countries (LMICs) (Bangladesh, Colombia, Egypt, Malaysia, and Pakistan). METHODS We collected standardized data from children ages 0 to 12 years at participating emergency departments (EDs) in 2007. Statistical analyses were conducted to compare the characteristics of these injuries and to explore the determinants of injury outcomes. RESULTS Among 2686 injured children, falls (50.4%) and road traffic injuries (16.4%) were the most common, affecting boys more often (64.7%). Home injuries were more common among younger children (average 5.41 vs 7.06 years) and girls (38.2% vs 31.7%). Following an ED visit, 24% of injured children were admitted to the hospital, and 6 died. Injury outcomes were associated with risk factors, such as age and sex, to varying extents. CONCLUSIONS Standardized ED surveillance revealed unintentional injuries are a threat to child health. The majority of events took place inside the home, challenging traditional concepts of children's safety and underscoring the need for intensified context-appropriate injury prevention.
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Affiliation(s)
- Siran He
- Siran He, Jeffrey C. Lunnen, Prasanthi Puvanachandra, Nukhba Zia, and Adnan A. Hyder are with Johns Hopkins International Injury Research Unit, Bloomberg School of Public Health, Baltimore, MD. Amar Singh is with the Paediatric Department, Ipoh General Hospital, Perak, Malaysia
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Agbenorku P. Early childhood severe scalds in a developing country: A 3-year retrospective study. BURNS & TRAUMA 2013; 1:122-7. [PMID: 27574634 PMCID: PMC4978099 DOI: 10.4103/2321-3868.123073] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The burns intensive care unit (BICU) staff observed an increasing number of pediatric scald burn admissions as a result of increase injuries associated with the scald burns. A retrospective study was conducted to identify scalds demographics, etiologies, and mortality risk factors. This descriptive study comprised a total of 166 patients aged 0-5 years, who were admitted to the BICU of the Reconstructive Plastic Surgery and Burns Unit (RPSBU) through the Accident and Emergency (A and E) Centre of the Komfo Anokye Teaching Hospital (KATH)from May 1(st) 2009 to April 30(th) 2012. Source of information was the BICU Computerized Database System. Data extracted included demographics as well as treatment methods and outcomes. The study population was 166; 92 (55.4%) males and 74 (44.6%) females. Scalds admissions were 141 (84.9%); 13 (9.2%) of them died, 83 (58.9%) discharged, and 45 (31.9%) transferred-out to another burn ward and pediatric surgery ward in the hospital. Scald patients' demographics included 78 males (55.3%) and 63 females (44.7%); mean age was 2.18 years. Mortality risk factors identified were age <3 years (P = 0.044); scalds from hot water (P = 0.033), total burns surface area >30% (P = 0.017), and multiple body parts affected (P = 0.049). The current study showed age, hot water, and Total Burns Surface Area (TBSA) as risk factors of early childhood scalds. Education on scalds prevention targeting mothers/caregivers is needed to create awareness of the frequency, severity, and danger associated with pediatric scalds.
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Affiliation(s)
- Pius Agbenorku
- Reconstructive Plastic Surgery and Burns Unit, Department of Surgery, Komfo Anokye Teaching Hospital, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Wesson HKH, Bachani AM, Mtambeka P, Schulman D, Mavengere C, Stevens KA, Millar AJW, Hyder AA, van As AB. Pediatric burn injuries in South Africa: a 15-year analysis of hospital data. Injury 2013; 44:1477-82. [PMID: 23415388 DOI: 10.1016/j.injury.2012.12.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 12/10/2012] [Accepted: 12/16/2012] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Burns are a significant burden of pediatric injuries, particularly in low and middle-income countries, were more than 90% of burn-related pediatric deaths occur. This study explores pediatric burn-related injuries over a fifteen year time period in South Africa through an analysis of a pediatric trauma surveillance system. METHODS This retrospective observational study used data collected by Childsafe South Africa from the Red Cross War Memorial Children's Hospital (RCH) trauma registry in Cape Town, South Africa between 1995 and 2009 for children less than 13 years of age who presented with burn injuries to the hospital's casualty department. Demographic data and Abbreviated Injury Scores (AISs) were first assessed, followed by an analysis of time trends using Poisson regression. Logistic regression models were used to analyse factors related to hospital admissions. RESULTS Between 1995 and 2009, 9438 children with burn-related injuries presented to RCH, of which nearly three-quarters resulted from scalds (73%; n=7024). The mean age of the injured children was 3.1 ± 2.9 years 58% were male. 11 deaths occurred in the hospital's casualty department. 39% of injuries were minor, 56% were moderate, and 5% were severe. During the 15-year study period, moderate burn injuries increased by 3%, while minor injuries decreased by 10% (p<0.05). 49% of all children were admitted to the hospital. Hospital admissions increased by 3% (p<0.05) during the study period. CONCLUSIONS Pediatric burn injuries are a significant contributor to the burden of child diseases in developing county hospitals. Pediatric surveillance systems, such as Childsafe South Africa's, are important to study epidemiologic changes in burn injuries. Findings suggest the need for targeted interventions to address the prevention of specific burn-related injuries.
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Affiliation(s)
- Hadley K H Wesson
- International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
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Pant PR, Towner E, Pilkington P, Ellis M. Epidemiology of unintentional child injuries in the South-East Asia Region: a systematic review. Int J Inj Contr Saf Promot 2013; 22:24-32. [PMID: 24111572 DOI: 10.1080/17457300.2013.842594] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
All the 11 members of the South-East Asia Region (SEAR) of the World Health Organization are categorised as low- and middle-income countries. This region has over a quarter of the world's total population but comprises about one-third of the world's unintentional injury-related deaths. There is a paucity of good-quality mortality and morbidity data from most of these countries. This is the first systematic review of community-based surveys on child injuries that summarises evidence from child injury studies from the SEAR countries. The included papers reported varying estimates of overall non-fatal unintentional injury rates across the countries, from 15/1000 children in Thailand to as high as 342/1000 children in India. The fatal injury rates were also found to be varying. This review revealed a need for strengthening child injury research using standard methodologies across the region and for promoting the dissemination of the results.
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Affiliation(s)
- Puspa Raj Pant
- a Faculty of Health and Life Sciences , University of the West of England , Bristol , United Kingdom
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Ravindran V, Rempel GR, Ogilvie L. Embracing survival: A grounded theory study of parenting children who have sustained burns. Burns 2013; 39:589-98. [DOI: 10.1016/j.burns.2012.12.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 12/09/2012] [Accepted: 12/18/2012] [Indexed: 10/27/2022]
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