Acid burns from personal assault in Uganda

Acid burns from assault represent a substantial and neglected proportion of burn injuries in the developing world. A retrospective chart review was conducted to assess the frequency of acid burns in relation to total burns requiring admission in Kampala, Uganda. Seventeen percent of the adult burns admitted at New Mulago hospital over an 18-month period resulted from acid assault. Patients had a mean age of 33.1 years, with a male to female ratio of 1.1:1. The average extent of injury was 14.1% total body surface area (TBSA), commonly involving the face (86.7%), head and neck (66.7%), upper limbs (60.0%) and chest (53.3%). Thirty-three percent of patients suffered partial or complete blindness. Mean length of stay in hospital was 49.5 days and all patients survived. Patterns of assault followed two common trends: attacks during robberies (46.7%), and attacks associated with domestic disputes (33.3%). The Ugandan pattern is contrasted with patterns reported from Bangladesh, Cambodia and Jamaica with a view to understanding the social context underlying such assaults. Prevention of these hideous injuries will require further understanding of their underlying social and cultural determinants. Serious questions remain whether public education programs will reduce the incidence of acid assault or increase it by giving potential assailants an idea they did not have before.