1
|
Hamza Hermis A, Tehrany PM, Hosseini SJ, Firooz M, Hosseini SR, Jamshidbeigi A, Zaboli Mahdiabadi M, Ghorbani Vajargah P, Mollaei A, Karkhah S, Takasi P, Alizadeh Otaghvar H, Farzan R. Prevalence of non-accidental burns and related factors in children: A systematic review and meta-analysis. Int Wound J 2023; 20:3855-3870. [PMID: 37224877 PMCID: PMC10588353 DOI: 10.1111/iwj.14236] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/26/2023] Open
Abstract
Non-accidental burns (NABs) in children had some adverse effects, such as severe burns, requiring skin grafting, and mortality. Previous studies reported NABs in the form of neglect, suspected abuse, and child abuse. Also, different statistics were estimated for the prevalence of NABs in children. Therefore, the current study aimed to comprehensively review and summarise the literature on the prevalence of NABs in children. Also, factors related to NABs as a secondary aim were considered in this review. Keywords combined using Boolean operators and searches were performed in international electronic databases, such as Scopus, PubMed, and Web of Science. Only studies in English were considered from the earliest to 1 March 2023. The analysis was performed using STATA software version 14. Finally, 29 articles were retrieved for the quantitative analysis. Results found that the prevalence of child abuse, suspected abuse, neglect, 'child abuse or suspect abused', and 'abuse, suspect abused, or neglect' was 6% (ES: 0.06, 95% confidence interval [CI]: 0.05-0.07), 12% (ES: 0.12, 95% CI: 0.09-0.15), 21% (ES: 0.21, 95% CI: 0.07-0.35), 8% (ES: 0.08, 95% CI: 0.07-0.09), and 15% (ES: 0.15, 95% CI: 0.13-0.16) among burns victims, respectively. Also, factors related to NABs are categorised into age and gender, agent and area of burns, and family features. Considering the results of the current study, planning for rapid diagnosis and designing a process to manage NABs in children is necessary.
Collapse
Affiliation(s)
| | - Pooya M. Tehrany
- Department of Orthopaedic Surgery, Faculty of MedicineNational University of MalaysiaBaniMalaysia
| | - Seyed Javad Hosseini
- Department of Pediatric Nursing, School of Nursing and MidwiferyMashhad University of Medical SciencesMashhadIran
- Department of NursingEsfarayen Faculty of Medical SciencesEsfarayenIran
| | - Mahbobeh Firooz
- Department of NursingEsfarayen Faculty of Medical SciencesEsfarayenIran
- School of Nursing and MidwiferyGolestan University of Medical SciencesGorganIran
| | - Seyed Reza Hosseini
- Student Research Committee, Faculty of Nursing and MidwiferyMashhad University of Medical SciencesMashhadIran
| | - Amirreza Jamshidbeigi
- Student Research Committee, Faculty of Nursing and MidwiferyMashhad University of Medical SciencesMashhadIran
| | | | - Pooyan Ghorbani Vajargah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Amirabbas Mollaei
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Samad Karkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Poorya Takasi
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Hamidreza Alizadeh Otaghvar
- Department of Plastic Surgery, Trauma and Injury Research CenterIran University of Medical SciencesTehranIran
| | - Ramyar Farzan
- Department of Plastic & Reconstructive Surgery, School of MedicineGuilan University of Medical SciencesRashtIran
| |
Collapse
|
2
|
Amado V, Trott S, Möller J, Couto MT, Wallis L, Laflamme L. Changing patterns in the burden of paediatric injuries during the COVID-19 pandemic: a study in Mozambique's central hospitals. BMC Health Serv Res 2023; 23:1071. [PMID: 37803444 PMCID: PMC10559493 DOI: 10.1186/s12913-023-10073-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: 11/21/2022] [Accepted: 09/26/2023] [Indexed: 10/08/2023] Open
Abstract
INTRODUCTION There is a substantial body of knowledge on the effects of the COVID-19 pandemic on injuries showing frequent but inconsistent reductions in both volume and pattern. Yet, studies specifically addressing children are less common, not least from low- and middle-income countries. This study investigated whether changes in the pattern and outcome of paediatric injury admissions to Mozambique's four regional referral hospitals during 2020. METHODS Clinical charts of paediatric patients presenting to the targeted hospitals with acute injuries were reviewed using a set of child, injury, and outcome characteristics during each of two consecutive restriction periods in 2020 using as a comparator the same periods in 2019, the year before the pandemic. Differences between 2020 and 2019 proportions for any characteristic were examined using the t-test (significance level 0.05). RESULTS During both restriction periods, compared with the previous year, reductions in the number of injuries were noticed in nearly all aspects investigated, albeit more remarkably during the first restriction period, in particular, greater proportions of injuries in the home setting and from burns (7.2% and 11.5% respectively) and a reduced one of discharged patients (by 2.5%). CONCLUSION During the restrictions implemented to contend the pandemic in Mozambique in 2020, although each restriction period saw a drop in the volume of injury admissions at central hospitals, the pattern of child, injury and outcome characteristics did not change much, except for an excess of home and burn injuries in the first, more restrictive period. Whether this reflects the nature of the restrictions only or, rather, other mechanisms that came into play, individual or health systems related, remains to be determined.
Collapse
Affiliation(s)
- Vanda Amado
- Department of Global Public Health, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
- Maputo Central Hospital, Maputo, Mozambique.
| | - Sebastien Trott
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Maria Tereza Couto
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Medical Council Maputo, Maputo, Mozambique
| | - Lee Wallis
- Division of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lucie Laflamme
- Department of Global Public Health, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
- Institute for Social and Health Sciences, University of South Africa, Pretoria, South Africa
| |
Collapse
|
3
|
Lindert J, Bbaale D, Mohr C, Chamania S, Bandyopadhyay S, Boettcher J, Katabogama JB, Alliance BW, Elrod J. State of burns management in Africa: Challenges and solutions. Burns 2023; 49:1028-1038. [PMID: 36759220 DOI: 10.1016/j.burns.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Understand the availability of human resources, infrastructure and medical equipment and perceived improvement helps to address interventions to improve burn care. METHODS Online survey covering human resources, infrastructure, and medical equipment of burn centers as well as perceived challenges and points for improvement. The survey was distributed in English and French via snowball method. Descriptive statistics and AI-based technique random forest analysis was applied to identify determinants for a reduction of the reported mortality rate. RESULTS 271 questionnaires from 237 cities in 40 African countries were analyzed. 222 (81.9 %) from countries with a very low Human Development Index (HDI) (4th quartile). The majority (154, 56.8 %) of all responses were from tertiary health care facilities. In only 18.8 % (n = 51) therapy was free of charge for the patients. The majority (n = 131, 48.3 %) had between 1 and 3 specialist doctors (n = 131, 48.3 %), 1 to 3 general doctors (n = 138, 50.9 %) and more than 4 nurses (n = 175, 64.6 %). A separate burn ward was available in 94 (34.7 %) centers. Regular skin grafting was performed in 165 (39.1 %) centers. Random forest-based analysis revealed a significant association between HDI (feature importance: 0.38) and mortality. The most important reason for poor outcome was perceived late presentation (212 institutions, 78.2 %). The greatest perceived potential for improvement was introduction of intensive care units (229 institutions, 84.5 %), and prevention or education (227 institutions, 83.7 %). INTERPRETATION A variety of factors, including a low HDI, delayed hospital presentation e.g. due to prior care by non-physicians and lack of equipment seem to worsen the outcome. Introduction of an intensive care unit and communal education are perceived to be important steps in improving health care in burns.
Collapse
Affiliation(s)
- Judith Lindert
- Department of Pediatric Surgery, University Hospital Rostock, Ernst-Heydemann Str 8, 18057 Rostock, Germany; German Society of Global and Tropical Surgery e.V., Germany
| | - Dorothy Bbaale
- Department of Surgery, International Hospital Kampala, Plot 4686 Barnabas Rd, Kampala, Uganda; CURE International, 70 Ionia Ave SW, Suite 200, Grand Rapids, MI 49503, United States
| | - Christoph Mohr
- Department of Pediatric Surgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Shobha Chamania
- Choithram Hospital and Research Centre, 14, Manik Bagh Rd, Indore, India
| | - Soham Bandyopadhyay
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, John Radcliffe Hospital, Headington, Oxford OX3 9DU, United Kingdom
| | - Johannes Boettcher
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | | | - Bisimwa Wani Alliance
- Provincial General Reference Hospital of Bukavu, 02, avenue Michombero/Commune de Kadutu, Bukavu, Democratic Republic of the Congo
| | - Julia Elrod
- Department of Pediatric Surgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
| |
Collapse
|
4
|
Assessment and Management of Pain in Patients Sustaining Burns at Emergency Department Kenyatta National Hospital, Kenya: A Descriptive Study. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Poorly managed burn pain affects the victim by delayed healing, psychological disturbances, and chronic pain. Burn injuries are the fourth leading cause of injuries worldwide. The incidence of thermal burns in Kenya is 3%. Pain assessment and control are integral parts of management that a burn victim should be offered. We lack data on pain management in burn patients during setup. Methods: A descriptive study was carried out at the emergency department (ED) of Kenyatta National Hospital. We enrolled patients who sustained thermal burns until a sample 138 patients was reached. Enrollment of patients was done from February to August 2015. The pain level was assessed using a visual analogue scale, and the Lund and Browder chart was used to record the depth and extent of the burn. Data on the type of analgesia prescribed and its route of administration was collected. Data was analyzed using STATA v.11. Results: The median age of the sample was 28 years with a male to female ratio 1.8:1. The majority of the victims (38%) sustained flame burns. The median total body surface area was 19.5%. Pain assessment was done in 2% with a visual analogue scale and face pain recognition scale. Mean Visual Analogue score was 7. Analgesia was offered to 96% of participants, and it was unimodal in the majority, 76.7%, and the preferred drug of choice was morphine. The majority of all burn patients had sustained moderate to major burns. The tools used to assess pain in this hospital were Face Pain Recognition Scale and Visual Analogue Scale; however, pain assessment was done on a meagre 2% of the sample. Conclusions: A minority of the patients had any sort of pain assessment done at the emergency department. As a result, burn pain was inappropriately managed. There is a need to improve the assessment of burn pain and improve its management by encouraging training of ED burn care providers by burn surgeons and pain therapists.
Collapse
|
5
|
Tiruneh CM, Belachew A, Mulatu S, Emiru TD, Tibebu NS, Abate MW, Nigat AB, Belete A, Walle BG. Magnitude of mortality and its associated factors among Burn victim children admitted to South Gondar zone government hospitals, Ethiopia, from 2015 to 2019. Ital J Pediatr 2022; 48:12. [PMID: 35063000 PMCID: PMC8780362 DOI: 10.1186/s13052-022-01204-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/27/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Burn is one of the leading causes of preventable death and disability every year in low and middle-income countries, which mainly affects those aged less than 15 years. Death from burn injuries carries the most significant losses, which often have grave consequences for the countries. Even though data from different settings are necessary to tackle it, pieces of evidence in this area are limited. Thus, this study was aimed to answer the question, what is the Magnitude of Mortality? And what are the factors associated with mortality among burn victim children admitted to South Gondar Zone Government Hospitals, Ethiopia, from 2015 to 2019? METHODS Institutional-based cross-sectional study design was used to study 348 hospitalized burn victim pediatrics', from 2015 to 2019. A simple random sampling method was used. Data were exported from Epidata to SPSS version 23 for analysis. Significant of the variables were declared when a p-value is < 0.05. RESULT The mortality rate of burn victim children in this study was 8.5% (95% CI = 5.5-11.4). Medical insurance none users burn victim children were more likely (AOR 3.700; 95% CI =1.2-11.5) to die as compared with medical insurance users, burn victim children with malnutrition were more risk (AOR 3.9; 95% CI = 1.3-12.2) of mortality as compared with well-nourished child. Moreover, electrical (AOR 7.7; 95% CI = 1.8-32.5.2) and flame burn (AOR 3.3; 95% CI = 1.2-9.0), total body surface area greater than 20% of burn were more likely (AOR 4.6; 95% CI 1.8-11.8) to die compared to less than 20% burn area and burn victim children admitted with poor clinical condition at admission were four times (AOR 4.1, 95% CI = 1.3-12.0) of mortality compared to a good clinical condition. CONCLUSION The mortality among burn victim children was higher than most of the studies conducted all over the world. Medical insurance none users, being malnourished, burned by electrical and flame burn, having total body surface area burnt greater than 20%, and having poor clinical condition at addition were significantly associated with mortality of burn victim pediatrics. Therefore, timely identification and monitoring of burn injury should be necessary to prevent mortality of burn victim pediatrics.
Collapse
Affiliation(s)
- Chalie Marew Tiruneh
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amare Belachew
- Department of Pediatrics and Child Health Nursing, School Of Health Sciences, College Of Medicine and Health Sciences, P.O. Box 79, Bahir Dar, Ethiopia
| | - Sileshi Mulatu
- Department of Pediatrics and Child Health Nursing, School Of Health Sciences, College Of Medicine and Health Sciences, P.O. Box 79, Bahir Dar, Ethiopia
| | - Tigabu Desie Emiru
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Nigusie Selomon Tibebu
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Moges Wubneh Abate
- Department of Adult health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Adane Birhanu Nigat
- Department of Adult health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amsalu Belete
- Department of Psychiatry, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Belete Gelaw Walle
- Department of Pediatrics and Child Health Nursing, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| |
Collapse
|
6
|
Nakarmi KK, Pathak BD, Shrestha D, Budhathoki P, Rai SM. Comparison of accidental pediatric scald burns in a tertiary care center: hot cauldron burns versus accidental spill burns. F1000Res 2021; 10:1086. [PMID: 35083037 PMCID: PMC8758969 DOI: 10.12688/f1000research.73840.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Scald burns result from exposure to high-temperature fluids and are more common in the pediatric age group. They occur mainly by two mechanisms: (i) spill and (ii) immersion (hot cauldron) burns. These two patterns differ in clinical characteristics and outcomes. Scalds cause significant morbidity and mortality in children. The objective of this study was to compare accidental spill burns and hot cauldron burns in a hospital setting. Methods: An analytical cross-sectional study was conducted by reviewing the secondary data of scald cases admitted during the years 2019 and 2020 in a burn-dedicated tertiary care center. Total population sampling was adopted. Data analysis was done partly using SPSS, version-23, and Stata-15. Mann Whitney U-test and Chi-square/Fisher's exact test were done appropriately to find associations between different variables. Binary regression analysis was performed taking mortality events as the outcome of interest. Results: Out of 108 scald cases, 43 (39.8%) had hot cauldron burns and 65 (60.2%) had accidental spill burns. Overall mortality was 16 (14.8%), out of which hot cauldron burns and accidental spill burns comprised 12 (75.0%) and 4 (25.0%), respectively. Binary logistic regression analysis showed the type of scald, age, and Baux score found to be associated with mortality. Every one-year increment in age had a 29% lower odds of occurrence of mortality event (adjusted odds ratio [OR], 0.71; 95% confidence interval [CI], 0.50-0.99, p=0.042). Likewise, every one-point increment in Baux score was associated with 19% higher odds of mortality (adjusted OR, 1.190; 95% CI, 1.08-1.32; p<0.001). Conclusions: Accidental spill burn was more common but mortality was significantly higher for hot cauldron burns. The risk of mortality was significantly higher in burn events occurring outside the house, and burns involving back, buttocks, perineum, and lower extremities.
Collapse
Affiliation(s)
- Kiran Kishor Nakarmi
- Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital, phect-NEPAL, Kathmandu, Bagmati Province, 44600, Nepal
| | - Bishnu Deep Pathak
- Department of Internal Medicine, Nepalese Army Institute of Health Sciences, College of Medicine, Kathmandu, Bagmati Province, 44600, Nepal
| | - Dhan Shrestha
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, Illinois, USA
| | - Pravash Budhathoki
- Department of Internal Medicine, Bronx-Lebanon Hospital, Bronxville, New York, USA
| | - Shankar Man Rai
- Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital, phect-NEPAL, Kathmandu, Bagmati Province, 44600, Nepal
| |
Collapse
|
7
|
Nakarmi KK, Pathak BD, Shrestha D, Budhathoki P, Rai SM. Comparison of accidental pediatric scald burns in a tertiary care center: hot cauldron burns versus accidental spill burns. F1000Res 2021; 10:1086. [PMID: 35083037 PMCID: PMC8758969 DOI: 10.12688/f1000research.73840.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 04/06/2024] Open
Abstract
Background: Scald burns result from exposure to high-temperature fluids and are more common in the pediatric age group. They occur mainly by two mechanisms: (i) spill and (ii) immersion (hot cauldron) burns. These two patterns differ in clinical characteristics and outcomes. Scalds cause significant morbidity and mortality in children. The objective of this study was to compare accidental spill burns and hot cauldron burns in a hospital setting. Methods: An analytical cross-sectional study was conducted by reviewing the secondary data of scald cases admitted during the years 2019 and 2020 in a burn-dedicated tertiary care center. Total population sampling was adopted. Data analysis was done partly using SPSS, version-23, and Stata-15. Mann Whitney U-test and Chi-square/Fisher's exact test were done appropriately to find associations between different variables. Regression analysis was performed taking mortality events as the outcome of interest. Results: Out of 108 scald cases, 43 (39.8%) had hot cauldron burns and 65 (60.2%) had accidental spill burns. Overall mortality was 16 (14.8%), out of which hot cauldron burns and accidental spill burns comprised 12 (75.0%) and 4 (25.0%), respectively. Multinomial logistic regression analysis showed the type of scald, age, and Baux score found to be associated with mortality. Every one-year increment in age had a 29% lower odds of occurrence of mortality event (adjusted odds ratio [OR], 0.71; 95% confidence interval [CI], 0.50-0.99, p=0.042). Likewise, every one-point increment in Baux score was associated with 19% higher odds of mortality (adjusted OR, 1.190; 95% CI, 1.08-1.32; p<0.001). Conclusions: Accidental spill burns were more common but mortality was significantly higher for hot cauldron burns. The majority of burn injuries occurred inside the kitchen emphasizing appropriate parental precautions. The risk of mortality was significantly higher in burn events occurring outside the house, and burns involving back, buttocks, perineum, and lower extremities.
Collapse
Affiliation(s)
- Kiran Kishor Nakarmi
- Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital, phect-NEPAL, Kathmandu, Bagmati Province, 44600, Nepal
| | - Bishnu Deep Pathak
- Department of Internal Medicine, Nepalese Army Institute of Health Sciences, College of Medicine, Kathmandu, Bagmati Province, 44600, Nepal
| | - Dhan Shrestha
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, Illinois, USA
| | - Pravash Budhathoki
- Department of Internal Medicine, Bronx-Lebanon Hospital, Bronxville, New York, USA
| | - Shankar Man Rai
- Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital, phect-NEPAL, Kathmandu, Bagmati Province, 44600, Nepal
| |
Collapse
|
8
|
Moshiro R, Furia FF, Massawe A, Mmbaga EJ. Pattern and risk factors for childhood injuries in Dar es Salaam, Tanzania. Afr Health Sci 2021; 21:817-825. [PMID: 34795740 PMCID: PMC8568247 DOI: 10.4314/ahs.v21i2.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Injuries contribute to morbidity and mortality in children. This study was carried out to describe the pattern of childhood injuries and associated risk factors in Dar es Salaam, Tanzania. Methods This case control study was conducted in six selected health facilities in Dar es Salaam, Tanzania. Data were collected using a structured questionnaire. Cases and controls were children below 18 years who had suffered injuries and those without injury associated condition respectively. Results A total of 492 cases and 492 controls were included in the study, falls (32%), burns (26%), Road Traffic Injuries (14%) and cuts (10%) were the major types of injuries identified. Younger parents/guardians {Adjusted odds ratio (AOR)= 1.4; 95% CI: 1.4 -3.6}, more than six people in the same house (AOR= 1.8; 95% CI: 1.3–2.6), more than three children in the house {AOR= 1.4; 95% CI (1.0–2.0)}, absence of parent/guardian at time of injury occurrence (AOR= 1.6; 95% CI: 1.1–2.3), middle socio-economic (AOR=1.6; 95%CI: 1.1–2.4) and low socio-economic status (AOR= 1.5; 95% CI: 1.0–2.1) were independent risk factors for childhood injury. Conclusion Falls, burns and road traffic injuries were the main injury types in this study. Inadequate supervision, overcrowding, lower socio-economic status and low maternal age were significant risk factors for childhood injuries.
Collapse
Affiliation(s)
- Robert Moshiro
- Department of Paediatrics, Muhimbili National Hospital, Dar es Salaam, Tanzania
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Francis F Furia
- Department of Paediatrics, Muhimbili National Hospital, Dar es Salaam, Tanzania
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Augustine Massawe
- Department of Paediatrics, Muhimbili National Hospital, Dar es Salaam, Tanzania
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Elia John Mmbaga
- Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| |
Collapse
|
9
|
What is Known About Burns in East Africa? A Scoping Review. J Surg Res 2021; 266:113-124. [PMID: 33989890 DOI: 10.1016/j.jss.2021.03.055] [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: 12/18/2020] [Revised: 02/27/2021] [Accepted: 03/31/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Burns are a global public health concern, with the majority of the disease burden affecting low- and middle-income countries. Yet, as suggested by previous publications, there is a widespread belief that literature about burns in low- and middle-income countries is lacking. Therefore, we aimed to assess with a scoping review, the extent of the literature output on burns in East Africa, and to investigate patient demographics, injury characteristics, treatment and outcomes, as reported from the existing publications. METHODS Studies discussing burns in East Africa were identified by searching PubMed / Medline (National Library of Medicine), EMBASE (Elsevier), Global Health Database (EBSCO), and Global Index Medicus on December 12, 2019. Controlled vocabulary terms (i.e., MeSH, EMTREE, Global Health thesaurus terms) were included when available and appropriate. No year restrictions were applied. RESULTS A total of 1,044 records were retrieved from the database searches, from which 40 articles from 6 countries published between 1993 and 2019 were included in the final review. No studies were found from five East African countries with the lowest GDP. Most papers focused on pediatric trauma patients or tertiary hospital settings. The total number of burn patients recorded was 44,369, of which the mean proportion of males was 56%. The most common cause of injury was scalds (61%), followed by open flame (17%). Mortality rate ranged from 0-67%. The mean length of stay in hospital was between 9-60 d. CONCLUSIONS Burn data is limited in the East African region, with socio-economically weak countries being particularly underrepresented. This scoping review has identified the largest set of literature on burns in East Africa to date, indicating the importance of reviewing data at a regional or local level, as "global" studies tend to be dominated by high-income country data. Data collection in specific registries is needed to better characterize the exact burden of burn injuries in East Africa.
Collapse
|
10
|
Mohammed M, Mekonen Y, Berhe H. Clinical Profile of Pediatric Burn Patients in Burn Care Unit of Halibet Hospital in 2018: Asmara, Eritrea. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2021; 12:13-21. [PMID: 33447128 PMCID: PMC7803088 DOI: 10.2147/phmt.s288154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/23/2020] [Indexed: 11/23/2022]
Abstract
Background Pediatric burn injuries result in severe and long-term complications in the developing world, especially in sub-Saharan Africa. Accurate data on burn injuries are either unavailable or incomplete in Eritrea. Objective The objective of this study was to define the clinical characteristics of pediatric burn injuries in the Burn Care Unit of Halibet hospital in 2018 in Asmara, Eritrea. Methods The study design was a retrospective cross-sectional descriptive study. The medical records of pediatric patients aged 15 years and below admitted to the Burn Care Unit of Halibet hospital between January 2018 and December 2018 were assessed. Results In the study period, 524 children with burn injuries were admitted to the Unit. The mean age of the study group was 4.2±3.7 years. Nearly 75% of the patients were in the age group 1–5 years. In 95.3% of the patients, scalds were the most common type of burn with burn injury occurring mostly indoor in 98.1% of cases. The average length of hospital stay was 4.6±8.4 days with a median of 1 day. In 94.8% of the patients, the body surface area involved was 1–10%, and the most body part involved was the extremity in 80.7% of the cases. Patients with body surface involvement >10% and who came from rural areas stayed longer in hospital and those with scald burns have a shorter hospital stay. Patients with body surface area involvement >10% and who came from rural areas also have more complications. Conclusion The most affected age group were 1–5 years old children with scalds being the most common type of burns with injury occurring mostly indoors in this population. Teaching parents about household safety, seeking early medical attention, and raising public awareness could decrease the incidence of burn injury in children.
Collapse
Affiliation(s)
- Mahmud Mohammed
- Department of Pediatrics and Child Health, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
| | | | | |
Collapse
|
11
|
Holden MR, Watson MC, Clifford MJ. Parents' perceptions of unintentional paediatric burn injuries - A qualitative study. Burns 2020; 46:1179-1192. [PMID: 32192866 DOI: 10.1016/j.burns.2019.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/07/2019] [Accepted: 12/15/2019] [Indexed: 11/27/2022]
Abstract
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.
Collapse
Affiliation(s)
- Maria Ruth Holden
- School of Health Sciences/Faculty of Engineering, University of Nottingham, NG7 2UH, UK.
| | | | - Mike J Clifford
- Faculty of Engineering, University of Nottingham, NG7 2RD, UK.
| |
Collapse
|
12
|
Outwater AH, Van Braekel T. Prehospital care of burn injuries in Africa: A review, 1990-2018. Burns 2019; 46:1737-1745. [PMID: 31785926 DOI: 10.1016/j.burns.2019.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 07/21/2019] [Accepted: 08/14/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Administration of appropriate first aid immediately after a burn injury is crucial to averting further harm to the victim, physically and psychologically. The aim of this review is to enable the design of better interventions by describing what is known about prehospital care of burn victims in Africa. RESULTS This review is based on 17 articles from 5 countries. For the purposes of the review, first responders are defined as those nearest the victim when a burn occurs. First responders include nonclinicians, most typically the mother of a young burn victim. Forty-five different substances, sometimes used in combination, are reported to have been applied to burn injuries: water, 15 food items (especially oils and egg), 14 pharmaceutical products, 9 traditional treatments, 5 minerals (petroleum products being the most common), and charcoal. Appropriate treatment, defined as the application of cool water for 10 min, was achieved about 0.5% of the time, most frequently in Cape Town, South Africa. Most victims do not have their wounds covered while they are transported to a health-care facility. Treatment delays are common. Pain management is hardly addressed. CONCLUSIONS Appropriate prehospital care for burn injury generally is not practiced in Africa. Yet best practices for prehospital care are affordable, available, and easily understood. The greatest risk factor for poor care is first responders' lack of knowledge. Awareness and education campaigns focusing on the lay public, as well as educational institutions for health workers, are urgently needed throughout the continent.
Collapse
Affiliation(s)
- Anne H Outwater
- Muhimbili University of Health and Allied Sciences, School of Nursing, PO Box 105211, Dar es Salaam, Tanzania.
| | | |
Collapse
|
13
|
Atwell K, Bartley C, Cairns B, Charles A. The Effect of Pre-existing Seizure Disorders on Mortality and Hospital Length of Stay Following Burn Injury. J Burn Care Res 2019; 40:979-982. [PMID: 31420660 PMCID: PMC6939827 DOI: 10.1093/jbcr/irz141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Patients with a seizure disorder have a higher incidence of burn injury; however, there are limited studies that examine the association between pre-existing seizure disorders (PSD) and burn outcomes. This is a retrospective study of admitted burn patients. Variables analyzed include patient demographics, clinical characteristics, associated PSD, hospital length of stay (LOS), and mortality. Multivariate logistic regression was performed to analyze the impact of PSD on burn mortality and LOS. Seven thousand six hundred and forty patients met the inclusion criteria and 1.31% (n = 100) patients had a PSD. There was no difference in mortality rate between patients with or without PSD (odds ratio [OR] = 2.28, 95% confidence interval [CI] = 0.87 to 5.93). Multivariate logistic regression showed that patients with PSD had significantly increased odds of longer hospital LOS (OR = 2.85, 95% CI = 1.73 to 4.67). Seizure disorder management is mandatory in reducing burn injury and decreasing the costs associated with increased hospital LOS.
Collapse
Affiliation(s)
- Kenisha Atwell
- Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center
| | - Colleen Bartley
- Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center
| | - Bruce Cairns
- Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center
| | - Anthony Charles
- Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center
| |
Collapse
|
14
|
Benkhalifa A, Ayadi M. Causes of nonfatal occupational injury in the private sector in Tunisia. Toxicol Ind Health 2019; 35:558-566. [DOI: 10.1177/0748233719869509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The absence of studies that investigate the causes and risk factors of nonfatal occupational injury in Tunisia inhibits the development of effective preventive strategies. The objective of this study was to identify the causes and risk factors of nonfatal occupational injury in the private sector in Tunisia. We used retrospective data derived from the occupational injury reporting forms submitted to the Caisse Nationale d’Assurance Maladie. A sample of 42,293 workers in the private sector for 2014 contains information on sociodemographic variables. Multivariable Poisson regression was used to investigate the association of cause-specific injury with demographic variables. The leading causes of nonfatal occupational injury were “falls” (employee fall and falling objects; 36%) and “struck by objects” (23%). Male employees were at higher risk of “exposure to extreme temperatures” (PR = 12 [7–45]), “asphyxia and poisoning” (PR = 4 [2.4–12]), “transport and handling” (PR = 2.4 [1.9–5]), “falling objects” (PR = 2.3 [1.4–3.7]), and “employee fall” (PR = 1.2 [1.1–1.5]). Although, rural areas were at higher risk to “asphyxia and poisoning” (PR = 3.6 [1.1–11.4]), “transport and handling” (PR = 2.5 [1.3–5.4]), and “burns” (PR = 1.3 [1.1–3]). It is important that effective interventions be developed to minimize the impact of falls and “struck by objects.” The most vulnerable categories to occupational injury are less educated men, rural residents aged between 15 years and 24 years, and elderly employees (55 years and over). Thus, our findings can contribute to the planning of prevention intervention programs that should expand to the most vulnerable categories.
Collapse
Affiliation(s)
- Abdelaziz Benkhalifa
- Ecole Supérieure des Sciences Economiques et Commerciales de Tunis, Université de Tunis, Tunis, Tunisia
| | - Mohamed Ayadi
- Institut Supérieur de Gestion, Université de Tunis, Tunis, Tunisia
| |
Collapse
|
15
|
Outwater AH, Thobias A, Shirima PM, Nyamle N, Mtavangu G, Ismail M, Bujile L, Justin-Temu M. Prehospital treatment of burns in Tanzania: a mini-meta-analysis. INTERNATIONAL JOURNAL OF BURNS AND TRAUMA 2018; 8:68-76. [PMID: 30042866 PMCID: PMC6055078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 06/12/2018] [Indexed: 06/08/2023]
Abstract
The present study describes initial burn injury care in Tanzania-materials applied, sources of information, reasons for applying the materials, and time to a health centre-in order to suggest ways to optimize initial care. Eight small studies were conducted in which burn-injured patients were interviewed who had been admitted to referral hospitals in four regions in Tanzania. Most burn injuries in Tanzania occur in the home cooking area, and it was found that the first responders were family members, friends, and neighbours. A total of 710 burn victims were interviewed. Twenty-four different materials were applied to the patients' wounds. The most common application was honey. Only 14.3% of the victims received the recommended form of care: application of cool water. It was also found that nothing was applied to the wounds of 17.5% of these patients by first responders. Sources of information on burn treatment were family, friends and neighbours, and, less often, health workers or the media. Most of the burn victims' households had enough water to enable administration of recommended initial care. The main impediment to the provision of appropriate initial treatment of a burn appears to be lack of correct and useful knowledge about what to do immediately after the injury. A two-pronged educational approach should be used to improve care. A national mass media campaign should start immediately to inform ordinary citizens about proper initial treatment of burns. In addition, curricula of all schools that train health workers need to be reviewed for accuracy, and appropriate knowledge about initial care of burn victims should be added if necessary. Measures to improve burn first aid, are relatively easy, even in a low-income country such as Tanzania.
Collapse
Affiliation(s)
- Anne H Outwater
- School of Nursing, Muhimbili University of Health and Allied SciencesDar es Salaam 65004, Tanzania
| | - Abel Thobias
- Nursing Services, Bugando Medical CentreMwanza, Tanzania
| | - Peter M Shirima
- Nursing Services, Muhimbili Academic Medical CentreDar es Salaam, Tanzania
| | - Notikela Nyamle
- School of Nursing, Muhimbili University of Health and Allied SciencesDar es Salaam 65004, Tanzania
| | - Greyson Mtavangu
- Nursing Services, Muhimbili Academic Medical CentreDar es Salaam, Tanzania
| | - Mwanahawa Ismail
- Ministry of Health, Community Development, Gender, Elderly and Children, Mafia District HospitalMafia, Tanzania
| | - Lusajo Bujile
- School of Nursing, Muhimbili University of Health and Allied SciencesDar es Salaam 65004, Tanzania
| | - Mary Justin-Temu
- School of Pharmacy, Muhimbili University of Health and Allied SciencesDar es Salaam, Tanzania
| |
Collapse
|
16
|
Zvizdic Z, Bećirović K, Salihagić S, Milisic E, Jonuzi A, Karamustafic A. Epidemiology and clinical pattern of paediatric burns requiring hospitalization in sarajevo canton, bosnia and herzegovina, 2012-2016. ANNALS OF BURNS AND FIRE DISASTERS 2017; 30:250-255. [PMID: 29983675 PMCID: PMC6033473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 11/06/2017] [Indexed: 06/08/2023]
Abstract
We first aimed to investigate the epidemiological characteristics and clinical pattern of hospitalized paediatric burn patients in Sarajevo Canton. Second, we aimed to determine the targets for the paediatric burn prevention program. This descriptive retrospective study was carried out to analyse the demographic, etiologic and clinical data of 73 hospitalized paediatric burn patients in Sarajevo Canton over a 5-year period from January 1, 2012 to December 31, 2016. The differences between various groups were evaluated using the chisquare test. During the course of the study, 73 paediatric burns (37 boys and 36 girls; ratio 1:0.97) were hospitalized. The overall mean age was 3.0 ± 2.9 years (range: 3 months to 12.5 years). The mean total body surface area burned was 8.4 ± 8.3%. The most common causes of burns in children were scald injuries (84.9%) followed by contact with a hot object (9.6%). No children were found to have burns caused by chemicals or electricity. A total of 97.3% of paediatric burn injuries occurred at home (p<0.001), and almost all were preventable. Although the most burns were recorded in the spring months (35.6%), there was no significant seasonal variation in burns (p = 0.199). Average length of hospital stay (LOS) was 16.32 ± 12 days (range: 1 to 65 days). The findings of the current study revealed that the main cause of paediatric burns was scald occurring at home. These data can contribute to the development of a prevention program to protect the paediatric population from burns.
Collapse
Affiliation(s)
- Z. Zvizdic
- Clinic of Paediatric Surgery, University Clinical Centre Sarajevo, Sarajevo, Bosnia and Herzegovina
- Medical Faculty, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - K. Bećirović
- Medical Faculty, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - S. Salihagić
- Medical Faculty, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
- Clinic for Plastic and Reconstructive Surgery, University Clinical Centre Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - E. Milisic
- Clinic of Paediatric Surgery, University Clinical Centre Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - A. Jonuzi
- Clinic of Paediatric Surgery, University Clinical Centre Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - A. Karamustafic
- Clinic of Paediatric Surgery, University Clinical Centre Sarajevo, Sarajevo, Bosnia and Herzegovina
| |
Collapse
|
17
|
Rybarczyk MM, Schafer JM, Elm CM, Sarvepalli S, Vaswani PA, Balhara KS, Carlson LC, Jacquet GA. A systematic review of burn injuries in low- and middle-income countries: Epidemiology in the WHO-defined African Region. Afr J Emerg Med 2017; 7:30-37. [PMID: 30456103 PMCID: PMC6234151 DOI: 10.1016/j.afjem.2017.01.006] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/03/2016] [Accepted: 01/10/2017] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION According to the World Health Organization (WHO), burns result in the loss of approximately 18 million disability adjusted life years (DALYs) and more than 250,000 deaths each year, more than 90% of which are in low- and middle-income countries (LMICs). The epidemiology of these injuries, especially in the WHO-defined African Region, has yet to be adequately defined. METHODS We performed a systematic review of the literature regarding the epidemiology of thermal, chemical, and electrical burns in the WHO-defined African Region. All articles indexed in PubMed, EMBASE, Web of Science, Global Health, and the Cochrane Library databases as of October 2015 were included. RESULTS The search resulted in 12,568 potential abstracts. Through multiple rounds of screening using criteria determined a priori, 81 manuscripts with hospital-based epidemiology as well as eleven manuscripts that included population-based epidemiology were identified. Although the studies varied in methodology, several trends were noted: young children appear to be at most risk; most individuals were burned at home; and hot liquids and flame are the most common aetiologies. DISCUSSION While more population-based research is essential to identifying specific risk factors for targeted prevention strategies, our review identifies consistent trends for initial efforts at eliminating these often devastating and avoidable injuries.
Collapse
Affiliation(s)
- Megan M. Rybarczyk
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, United States
| | - Jesse M. Schafer
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Courtney M. Elm
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, United States
| | - Shashank Sarvepalli
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, United States
| | - Pavan A. Vaswani
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States
| | - Kamna S. Balhara
- Department of Emergency Medicine, The Johns Hopkins Hospital, Baltimore, MD, United States
| | - Lucas C. Carlson
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, United States
| | - Gabrielle A. Jacquet
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, United States
- Boston University School of Medicine, Boston, MA, United States
- Boston University Center for Global Health and Development, Boston, MA, United States
| |
Collapse
|
18
|
Blom L, Klingberg A, Laflamme L, Wallis L, Hasselberg M. Gender differences in burns: A study from emergency centres in the Western Cape, South Africa. Burns 2016; 42:1600-1608. [PMID: 27262931 DOI: 10.1016/j.burns.2016.05.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 05/04/2016] [Accepted: 05/07/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Little is known about gender differences in aetiology and management of acute burns in resource-constrained settings in South Africa. METHOD This cross-sectional study is based on burn case reports (n=1915) from eight emergency centres in Western Cape, South Africa (June 2012-May 2013). Male/female rate ratios by age group and age-specific incidence rates were compiled for urban and rural areas along with gender differences in proportions between children and adults for injury aetiology, burn severity, length of stay and patient disposition. RESULTS Children 0-4 years in urban areas had the highest burn incidence but only among adults did male rates surpass females, with fire burns more common among men 20-39 years and hot liquid burns among men 55+ years. Men had a higher proportion of burns during weekends, from interpersonal violence and suspected use of alcohol/other substances, with more pronounced differences for hot liquid burns. Despite similar Abbreviated Injury Scale (AIS) scores, men were more often transferred to higher levels of care and women more often treated and discharged. CONCLUSION Burns were far more common among children although gender differences arose only among adults. Men sustained more injuries of somewhat different aetiology and were referred to higher levels of care more often for comparable wound severity. The results suggest different disposition between men and women despite similar AIS scores. However, further studies with more comprehensive information on severity level and other care- and patient-related factors are needed to explore these results further.
Collapse
Affiliation(s)
- Lisa Blom
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Anders Klingberg
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Lucie Laflamme
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; University of South Africa, Pretoria, South Africa
| | - Lee Wallis
- Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Bellville, South Africa
| | - Marie Hasselberg
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
19
|
Nthumba PM. Burns in sub-Saharan Africa: A review. Burns 2015; 42:258-66. [PMID: 25981292 DOI: 10.1016/j.burns.2015.04.006] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 02/25/2015] [Accepted: 04/17/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Burns are important preventable causes of morbidity and mortality, with a disproportionate incidence in sub-Saharan Africa. The management of these injuries in sub-Saharan Africa is a challenge because of multiple other competing problems such as infectious diseases (HIV/AIDS, tuberculosis and malaria), terrorist acts and political instability. There is little investment in preventive measures, pre-hospital, in-hospital and post-discharge care of burns, resulting in high numbers of burns, high morbidity and mortality. Lack of data that can be used in legislation and policy formulation is a major hindrance in highlighting the problem of burns in this sub-region. METHODS An online search of publications on burns from sub-Saharan countries was performed. RESULTS A total of 54 publications with 32,862 patients from 14 countries qualified for inclusion in the study. The average age was 15.3 years. Children aged 10 years and below represented over 80% of the burn patient population. Males constituted 55% of those who suffered burns. Scalds were the commonest cause of thermal injuries, accounting for 59% of all burns, while flame burns accounted for 33%. The burn mortality averaged 17%, or the death of one of every five burn victims. CONCLUSIONS These statistics indicate the need for an urgent review of burn policies and related legislation across the sub-Saharan region to help reduce burns, and provide a safe environment for children.
Collapse
|
20
|
Al-Zacko S, Zubeer H, Mohammad A. Pediatric burns in Mosul: an epidemiological study. ANNALS OF BURNS AND FIRE DISASTERS 2014; 27:70-5. [PMID: 26170779 PMCID: PMC4396798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Indexed: 06/04/2023]
Abstract
A cross-sectional study was conducted to determine the characteristics and case fatality rate of pediatric burns in Mosul, Iraq. The study group was burn patients aged 14 years and under who were admitted to the Burns Unit in Al-Jamhoori Teaching Hospital from the 1(st) of March 2011 to the 1(st) of March 2012. Of the 459 emergency burn admissions, 209 (45.53%) were pediatric patients up to 14 years of age, with a mean age of 4.73±3.61 years. Scald was the most common type of burn and occurred mainly in domestic settings. The mean total body surface area (TBSA) burned was 19.73±17.15%. Thirty-five patients died during the study period, giving a case fatality rate of 16.75%. The maximum number of deaths occurred in the 2-4 years age group. The case fatality rate was high in patients having more than 40% TBSA involvement. Flame burns were significantly more fatal than scalds, with a fatality rate of 35.35% and 12.05% respectively; (p=0.0001). In conclusion, given that most pediatric burn accidents occur at home, burn prevention should be focused on improving living conditions and on providing an educational program for parents.
Collapse
Affiliation(s)
- S.M. Al-Zacko
- Department of Surgery, College of Medicine, University of Mosul, Iraq
| | - H.G. Zubeer
- Department of Community Medicine, College of Medicine, University of Mosul, Iraq
| | - A.S. Mohammad
- Department of Plastic Surgery, Ninevah College of Medicine, University of Mosul, Iraq
| |
Collapse
|
21
|
Behavior disturbance and psychiatric morbidity in a sample of abused Egyptian children. MIDDLE EAST CURRENT PSYCHIATRY 2014. [DOI: 10.1097/01.xme.0000438390.90764.9e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
22
|
Abdalla S. Patterns of vulnerability to non-fatal injuries in Sudan: initial evidence from a national cross-sectional survey. Inj Prev 2013; 20:310-6. [DOI: 10.1136/injuryprev-2013-040884] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
23
|
Agbenorku P, Agbenorku M, Fiifi-Yankson PK. Pediatric burns mortality risk factors in a developing country's tertiary burns intensive care unit. INTERNATIONAL JOURNAL OF BURNS AND TRAUMA 2013; 3:151-8. [PMID: 23875121 PMCID: PMC3712406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 06/11/2013] [Indexed: 06/02/2023]
Abstract
AIM This study aimed at identifying risk factors related to pediatric burns mortality in a middle income country such as Ghana. METHODS The data for the three years retrospective study (May 2009 - April 2012) was obtained from the pediatric burn admissions records and patients' folders of the Reconstructive Plastic Surgery & Burns Unit (RPSBU), Komfo Anokye Teaching Hospital (KATH), Ghana. Data retrieved included: Demographic features, Total Burned Surface Area (TBSA) incurred; Aetiology of burns; Duration of the admission; Outcome of admission; Part of the body affected and Cost incurred. Ethical approval for this study was obtained from the KNUST-SMS/KATH Committee on Human Research, Publications and Ethics. Data analyses were performed with SPSS 17.0 version. RESULTS Information on 197 patients was completely retrieved for the study. Burns mortality rate for the study was identified to be 21.3% (N=42). The mean age of the 42 dead patients was 3.7±0.3 years, ranging from 0-13 years, while, males (54.8%, N= 23) outnumbered females (45.2%, N=19). The TBSA burned interquartile range was 48%. In terms of etiology of burns Scald (73.8%, N=31) was the commonest cause of injury. Mortality risk factors identified were Age <6 years (P=0.028); Scald especially hot water and soup (P=0.016); TBSA >36% (P=0.028) and Inhalation injury (P=0.040). CONCLUSION Age, scald, TBSA and Inhalation Injury were identified as pediatric burns mortality risk factors in a developing country such as Ghana's RPSBU. These identified factors will serve as a guideline for plastic surgeons and other health professionals practicing in countries such as Ghana.
Collapse
Affiliation(s)
- Pius Agbenorku
- Reconstructive Plastic Surgery and Burns Unit, Kwame Nkrumah University of Science & TechnologyKumasi, Ghana
- Department of Surgery, Kwame Nkrumah University of Science & TechnologyKumasi, Ghana
- Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science & TechnologyKumasi, Ghana
- School of Medical Sciences, Kwame Nkrumah University of Science & TechnologyKumasi, Ghana
- Kwame Nkrumah University of Science & TechnologyKumasi, Ghana
| | - Manolo Agbenorku
- Reconstructive Plastic Surgery and Burns Unit, Kwame Nkrumah University of Science & TechnologyKumasi, Ghana
- Department of Surgery, Kwame Nkrumah University of Science & TechnologyKumasi, Ghana
- Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science & TechnologyKumasi, Ghana
| | - Papa Kwesi Fiifi-Yankson
- Reconstructive Plastic Surgery and Burns Unit, Kwame Nkrumah University of Science & TechnologyKumasi, Ghana
- Department of Surgery, Kwame Nkrumah University of Science & TechnologyKumasi, Ghana
- Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science & TechnologyKumasi, Ghana
| |
Collapse
|
24
|
Outwater AH, Ismail H, Mgalilwa L, Justin Temu M, Mbembati NA. Burns in Tanzania: morbidity and mortality, causes and risk factors: a review. INTERNATIONAL JOURNAL OF BURNS AND TRAUMA 2013; 3:18-29. [PMID: 23386982 PMCID: PMC3560491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Accepted: 01/12/2013] [Indexed: 06/01/2023]
Abstract
Burn injuries in low and middle income countries still remain a significant health problem, even though numbers of burn injuries in high income countries have decreased showing that such events are not "accidents" but are usually preventable. WHO states that the vast majority (over 95%) of fire-related burns occur in low and middle income countries. Burn injuries are a major cause of prolonged hospital stays, disfigurement, disability, and death in Africa Region. Evidence shows that prevention strategies can work. However prevention strategies need to be tailored to the specific environment taking into account local risk factors and available resources. An examination of the patterns and causes of burns should allow site specific recommendations for interventions. This literature review, specific to the United Republic of Tanzania, was conducted by researching PubMed, SafetyLit, and African Journals on Line data bases for primary sources using key words plus . Two sets of student data collected as part of Bachelor's degree final dissertations at Muhimbili University of Health and Allied Sciences were used. In all, twenty two primary sources were found. Risk factors for burn morbidity in Tanzania are: 1/ a young age, especially years 1-3, 2/ home environment, especially around cooking fires, 3/ epilepsy, during seizures, and 4/ perceived inevitability of the incident. It was expected that ground level cooking fires would be found to be a risk factor, but several studies have shown non-significant results about raised cooking fires, types of fuel used, and cooking appliances. Risk factors for burn mortality are: being male, between 20-30 years of age, and being punished for alleged thieving by community mobs. An important factor in reducing burn morbidity, especially in children, is to educate people that burns are preventable in most cases and that most burns occur in the home around cooking fires. Children need to be kept away from fires. Epileptics should be monitored for medication and kept away from cooking fires as well. Community members need to be encouraged to bring wrong doers to the police.
Collapse
Affiliation(s)
- Anne H Outwater
- School of Nursing, Muhimbili University of Health SciencesDar es Salaam, Tanzania
| | | | | | - Mary Justin Temu
- School of Pharmacy, Muhimbili University of Health SciencesDar es Salaam, Tanzania
| | - Naboth A Mbembati
- School of Medicine, Muhimbili University of Health SciencesDar es Salaam, Tanzania
| |
Collapse
|
25
|
Ae-Ngibise KA, Masanja H, Kellerman R, Owusu-Agyei S. Risk factors for injury mortality in rural Tanzania: a secondary data analysis. BMJ Open 2012; 2:bmjopen-2012-001721. [PMID: 23166132 PMCID: PMC3533022 DOI: 10.1136/bmjopen-2012-001721] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Injuries rank high among the leading causes of death and disability annually, injuring over 50 million and killing over 5 million people globally. Approximately 90% of these deaths occur in developing countries. OBJECTIVES To estimate and identify the risk factors for injury mortality in the Rufiji Health and Demographic Surveillance System (RHDSS) in Tanzania. METHODS Secondary data from the RHDSS covering the period 2002 and 2007 was examined. Verbal autopsy data was used to determine the causes of death based on the 10th revision of the International Classification of Diseases (ICD-10). Trend and Poisson regression tests were used to investigate the associations between risk factors and injury mortality. RESULTS The overall crude injury death rate was 33.4/100 000 population. Injuries accounted for 4% of total deaths. Men were three times more likely to die from injuries compared with women (adjusted IRR (incidence risk ratios)=3.04, p=0.001, 95% CI (2.22 to 4.17)). The elderly (defined as 65+) were 2.8 times more likely to die from injuries compared with children under 15 years of age (adjusted IRR=2.83, p=0.048, 95% CI (1.01 to 7.93)). The highest frequency of deaths resulted from road traffic crashes. CONCLUSIONS Injury is becoming an important cause of mortality in the Rufiji district. Injury mortality varied by age and gender in this area. Most injuries are preventable, policy makers need to institute measures to address the issue.
Collapse
|