Burn Prevention in Zambia: A Targeted Epidemiological Approach

The Effect of Education on Primary School Students' Knowledge Regarding Burn Prevention Measures and Actions to Take

Burns injuries are a global concern. Many health specialists develop prevention programs, especially for high-risk groups such as children. This study was designed to investigate the effect of education on knowledge of primary school students about burn prevention and initial actions to take in dealing with burns. This is a quasi-experimental study conducted on primary school students. The sampling was done by cluster method in six boys' and girls' public schools (fourth to sixth grade) in three different regions of Tehran. The collected data included a demographic section and 17 questions for assessing students' awareness about prevention and initial actions in dealing with burns. The training was conducted by two experts who were familiar with the children's education in the schools. The level of the students' knowledge was evaluated by the questionnaire before the intervention, immediately after, and 3 months follow-up. The results showed that the knowledge score in both domains of prevention and initial actions significantly increased immediately and 3 months after training (P < .05). Also, there was a significant relationship between knowledge score in both domains with sex, educational level, and education area after intervention. Education is effective on raising students' knowledge about prevention and initial actions to take after a burn injury. Therefore, it is suggested to repeat educational programs, educate parents and students simultaneously, and use media to change beliefs and attitudes that are rooted in the culture of a society, especially in lower socioeconomic classes.

Parents' perceptions of unintentional paediatric burn injuries - A qualitative study

BACKGROUND

Burn injuries disproportionally affect the world's poorest populations. However, there has been a lack of research that has investigated the social, cultural or contextual factors associated with this injury mechanism in these areas. As a result, there is a scarcity of information from which to develop culturally appropriate and targeted burn prevention initiatives.

METHODS

A community survey was used to identify households to take part in this qualitative study. Semi-structured interviews were conducted with 32 parents from four different villages in Malawi to discuss their experiences of burn injuries sustained by children in the household as well as any existing preventative strategies used. In addition, 29 of the study households took part in an observation exercise to identify and discuss burn hazards present around the home environment. Transcripts and observations were recorded and transcribed verbatim. A thematic approach was used to analyse the data.

RESULTS

The final themes could be categorised into three key areas: parental perception of hazards around the home; socio-cultural and developmental factors associated with burn injuries; and parental perception of burns prevention. Factors associated with unintentional burn injuries, as perceived by parents, included: increased exposure to hazards, children's play and development activities, increased fire use during the morning hours and the children's household roles and responsibilities. Although some parents identified possible burns prevention strategies numerous barriers to prevention were highlighted including: poverty, poor housing infrastructure and restrictions, knowledge deficit, inability to provide adequate supervision and the child's behaviour.

CONCLUSIONS

Parents recognise that there are a number of burn hazards and risks present around the home however factors that prevented them acting included: a lack of knowledge about injury prevention, a lack of household safety equipment, a lack of control to make alternations to their housing and an inability to adequately supervise their children. In the future it is crucial that the local context and community are consulted in the development of any future burn injury prevention strategies to ensure that they are appropriate, accepted and effective.

First aid management of paediatric burn and scald injuries in Southern Malawi: A mixed methods study

BACKGROUND

In sub-Saharan Africa, burn and scald injuries occur more commonly in children aged less than five years, than in any other age group, and carry a high lifetime morbidity. The optimal first aid at the time of injury includes the use of cool running water, which can reduce pain, scarring, and skin grafting. Data on the types of first aid used in Malawi is lacking, as is an in-depth understanding of the underlying factors which may influence this health behaviour. This study sought to: (a) document the types of first aid after paediatric burn and scald injuries in Southern Malawi; and (b) explore factors affecting the choice of first aid used.

METHODS ANDFINDINGS

We conducted a sequential explanatory mixed methods study. Quantitative analysis of a prospectively collected database of all patients aged less than 17 years admitted to the only burn unit in Southern Malawi was followed by thematic analysis of semi-structured interviews with 15 adults who had witnessed a paediatric burn or scald injury. 1326 patients aged less than 17 years were admitted to the Queen Elizabeth Central Hospital between July 2009 and December 2016. Median age was 3.0 years (IQR 1.9-5.0) and male to female ratio 1:0.9. The commonest cause of injury was hot liquid (45%), followed by open fire (31%) and porridge (12%). First aid was applied in 829 patients (69%), the commonest applications used were water (31%) and egg (21%). There was a statistically significant association between the type of first aid and secondary education of the father (p = 0.009) or mother (p = 0.036); however, the type of first aid used was more likely to be egg rather than water. Analysis of qualitative interviews identified four main themes: perceived roles and responsibilities within the community, drivers of individual behaviours, availability, and trust. Participants reported using eggs as a first aid treatment, as these were readily available and were seen to reduce the occurrence of blisters and prevent peeling of the skin. By comparison, there was a strong underlying fear of using water on burn injuries due to its association with peeling of the skin. Intergenerational learning appeared to play a strong role in influencing what is used at the time of injury, and mothers were the key source of this information.

CONCLUSIONS

This study provides the largest description of first aid use in sub-Saharan Africa, strengthening the evidence that remedies aside from water are commonly used and that higher parental education levels do not translate to increased use of water, but rather use of alternative treatments. Our qualitative findings allow improved understanding of how first aid for paediatric burns is perceived in rural Malawi communities, providing insight as to why certain first aid choices are made and the possible barriers and facilitators to the adoption of water as a first aid treatment.