Pediatric burn injuries: pattern and management outcome at Muhimbili National Hospital

Abstract

ABSTRACT Introduction: Burn is defined as an injury caused by heat (hot objects, gases, or flames), chemicals, electricity and lightning, friction, or radiation. It is the common cause of childhood injuries throughout the world with male predominance. The burden is high in low- and middle-income countries with more than 90% of the burden of burn injury. It is regarded as the second most common cause of accidental death in children less than 5 years and the most common cause of accidental death in the home. Pediatric burn injuries are reported to be a major public health problem responsible for significant morbidity and mortality within the sub Saharan region. Aim: To determine the pattern and management outcome of pediatric burn injuries in children admitted at Muhimbili National Hospital (MNH) Methodology: This was descriptive prospective study design, a hospital-based study that was conducted at MNH for a period of 12months (from April 2018 to March 2019). All children sustained burn injuries admitted at MNH with age between 2 months and 10 years were enrolled and studied. The enrolled children were followed from admission to discharge for assessment of management and outcome. Participants were interviewed direct by using a well-structured questionnaire. Data was analyzed by using SPSS Version 23.0 package. Results: A total of 111 patients were enrolled in the study, where their median age was 20 months(IQR 12-35 months).Majority were in the age group of 15-35 months contributing 83(74.8%) participants and male patients contributing 58% of the studied population. We found that provision of appropriate treatment was associated with reduction in mortality, as seen here in a logistic regression model adjusted for age, sex, first aid, type of burn, neck involvement, right leg involvement, buttocks involved, extent of burn – the odds of death were reduced by 65% as compared to those who did not receive appropriate treatment i.e., adjusted odds ratio (aOR) 0.35, 95% CI 0.05-2.36, p value 0.28. And for each one unit increase in body surface area that sustain burns, the odds of mortality increase by 12%. Burns involving buttocks had increased risk of mortality aOR 5.08, 95% CI 0.65-39.78, p value 0.12. Conclusion: In conclusion, we have established the causes and pattern of burn injuries and risk factors associated with mortality. It was observed that burns involving buttocks are associated with higher mortality among children. Our study show that increased body surface area is associated with increased risk of mortality. Key words: Burn, TBSA,