Abstract:
Background: Burn injuries result in severe and often life-changing medical, social and
psychological problems, along with a severe economic loss to individuals and their
family. Ninety-percent of burns are preventable. However, even within one country, burn
injuries' location and causative factors differ substantially between communities and
regions. This prospective descriptive study describes the added benefit of using the
geospatial techniques in mapping the burns prevalence in Dar es Salaam. The geospatial
technique could be helpful in formulating the preventive measures in highly populated
cities with similar context.
Study objective: To determine the geographical location of burn patients and
circumstances of burn among patients with burn injuries presenting to Muhimbili
National Hospital in Dar Es Salaam, Tanzania
Materials and methods: Patients presenting with burns were identified from patients
at the emergency department and enrolled in the study after signing the informed
consent. The patient’s residency Geographical Information System (GIS) coordinates
were mapped over a base map of Dar es Salaam provided by ArcGisPro and entered
into a kernel density analysis to identify areas of high burn prevalence including a map
on statistical spatial clustering. The study used a questionnaire to interview the patients
with burns on the causes, circumstances of the burn. The analysis included the
magnitude of burn, etiologies and the circumstances.
Results: Among 144 participants enrolled, (56.3% (81/144) were male. The median
age was 3 years (interquartile range, 2 – 9 years). Using the coordinates, most burns
came from the convergence of Ilala, Temeke and Kinondoni district in Dar es Salaam,
with almost two-thirds of participants coming from Ilala District alone. The majority
(84.7%) were referrals from other facilities. On arrival, the majority were stable. Most,
86.8%, had superficial partial burn (wet-pink), multiple (65.3%). Nearly half of the
participants had a total burn surface area of 15% or more; involving mainly the upper
limbs and anterior trunk. Regarding the causative agent, 86.1% were due to scald.
Over 90% of burns happened at home and in the kitchen, 88.9%. Almost half of them
received first aid at home, which included the application of honey/powder. Only 43%
applied cold water. Following the management at the emergency department, 11.1%
were discharged home and 84.7% were admitted to the burn ward
Conclusion: Geospatial technique has enabled the researchers to establish not precisely
where the burn took place in the city but also a clustering of burns in the city and using
the coordinates, most burns came from the convergence of Ilala, Temeke and
Kinondoni district in Dar es Salaam, with almost two-thirds of participants coming from
Ilala District alone. The knowledge of initial burn management before the survivors are
referred to the health facilities is poor. Strengthening burn management capabilities,
both in knowledge, skills and equipment, of the regional hospitals, could decongest the
national hospital.