Review of childhood burn injuries in sub-Saharan Africa : a forgotten public health challenge : literature review

Abstract

lbrglIgIntroduction:l/Ig Burn injuries constitute a substantial proportion of the total burden of injuries among children in low- and middle-income countries, yet research into causes and potential interventions in such settings is scarce. Children under five years of age represent the highest risk category for burn injury. This paper reviews the published literature to estimate the incidence and mortality due to burns and to develop an epidemiological profile of burn injuries among children 0-4 years of age in sub-Saharan Africa. lbrglIgMethods:l/Ig English-language articles published between 1980 and 2003 relating to burn injuries in Africa were identified through PubMed. Studies that provided data on burn injuries in children below five years of age were reviewed. Individual study results were averaged to estimate incidence and mortality, case-fatality ratio, and proportion of hospital admissions due to burns. lbrglIgResults:l/Ig Forty-three studies met the inclusion criteria. Approximately 56 percent of paediatric burn injuries occurred in the 0-4 year age group, and burns represented up to 18 percent of total hospital admissions. The incidence of burns among children 0-4 years ranged 0.28 to 16.3 percent per year. The mean and weighted mean case-fatality ratios were 17.3 and 11 percent, respectively. lbrglIg Discussion:l/Ig The range of reported incidence rates suggest 300,257 to 17,479,262 burn cases annually among African children under five years of age. Assuming a mean case-fatality ratio of 6-10 percent this suggests at least 18,000 to 30,000 burn deaths annually. Economic, environmental, and behavioural factors are important risk determinants, and effective medical services remain inaccessible to victims.