Epidemiology of childhood burn: Yield of largest community based injury survey in Bangladesh

Abstract

In terms of mortality, morbidity and disability, burns are emerging as a major child health problem in Bangladesh. This trend is similar to many other developing countries. To develop effective burn prevention programmes, information on its magnitude and determinants is necessary. The purpose of this study was to document the magnitude and determinant of childhood burns in Bangladesh, based on a population-based survey which was conducted between January and December 2003. Nationally representative data was collected from 171,366 rural and urban households, comprising of a total population of 819,429. To facilitate data collection, face-to-face interviews were conducted.

The rate of non-fatal burn among children under 18 years of age was calculated as 288.1 per 100,000 children-year. The highest incidence (782.1/100,000 children-year) was found among the 1–4 years age group. About 46% of non-fatal burn injuries occurred between 9 a.m. and 3 p.m. The incidence of childhood burn was found to be more than four times higher in rural children than urban children. Ninety percent (90%) of the childhood burns occurred at homes and the kitchen was the most common place. The rate of disability due to burn was 5.7 per 100,000 children per year. The rate of fatal burn was 0.6 per 100,000 per year among all children. The study findings confirmed that childhood burn was a major childhood illness in Bangladesh. An urgent and appropriate prevention programme is required to prevent these unwanted morbidities, disabilities and deaths due to burn.

Introduction

In terms of functional, social and psychological impairment burns have been identified as one of the most devastating causes of child injury [1], [2], [3], [4]. Burns have aroused widespread public health concern and constitute a global public health problem [5]. In 1998, fire related burns ranked ninth among the leading causes of global burden of diseases (based on death and disability) among children aged 5–14 years [6]. The number of global deaths due to fire was recorded as 238,000 in 2000, the majority (95%) of which occurred in low- and middle-income countries [7]. Even in developed countries, injuries from burns represent the leading cause of unintentional injury death and morbidity [8], [9], [10], [11].

In developing countries, burns have been found as a major cause of injury morbidities, disabilities and deaths. In Africa and many of the South-Asian countries, including India, Pakistan, Nepal, Sri Lanka and Afghanistan, childhood burns have emerged as a major public health issue [12], [13], [14], [15], [16], [17], [18], [19]. In Bangladesh, although there are few studies where causes of deaths are directly comparable, most public health experts noted a gradual shift in the cause of child death from largely infectious disease to largely non-communicable disease and injury [20]. However, the magnitudes of burns have not been studied and documented in Bangladesh. This population-based survey, provided evidence on the magnitude and risk factors for burn among children under 18 years of age in Bangladesh, and provides a basis for burn prevention programmes in the country.