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Burns at KCMC: epidemiology, presentation, management and treatment outcome
1Kilimanjaro Christian Medical University College, P.O. BOX 224O, Moshi, Tanzania.
Insights
Young children in Tanzania face a high burn injury burden, with most incidents occurring at home. Inadequate burn care leads to significant mortality and complications in this low-resource setting.
Area of Science:
- Global Health
- Trauma Surgery
- Pediatric Burns
Background:
- Burns disproportionately affect low and middle-income countries, with high pediatric mortality in Africa.
- Tanzania lacks specialized burn centers, leading to management in general surgical wards.
- Kilimanjaro Christian Medical Centre serves as a tertiary referral hospital in Tanzania.
Purpose of the Study:
- To review the epidemiology, presentation, management, and outcomes of burn patients in Tanzania.
- To understand the challenges of burn care in a resource-limited environment.
Main Methods:
- A prospective, cross-sectional study was conducted from October 2011 to April 2012.
- Involved a cohort of 41 burn patients treated at Kilimanjaro Christian Medical Centre.
Main Results:
- The majority of patients were male (65.9%) and under five years old (36.6%).
- Open flame was the primary cause (over 50%), with most burns occurring at home (73.2%).
- High rates of wound sepsis (53.7%) and contractures (24.4%) were observed, alongside a significant mortality rate (26.8%).
Conclusions:
- Children under five are the most vulnerable population to burn injuries.
- Burn wound management, both pre-hospital and in-hospital, was often inappropriate, contributing to poor outcomes.
- High mortality and complication rates underscore the need for improved burn care strategies in Tanzania.
Background:
About 90% of the global burden of burns occurs in the low and middle income countries. In Africa it is estimated that between 17,000 and 30,000 children under five die each year due to burns. In Tanzania there are no specialized burn centers. Burn patients are often managed in the general surgical wards in most hospitals. Kilimanjaro Christian Medical Centre is one of the four tertiary referral hospitals in Tanzania.
Rationale:
This study aimed to review the epidemiology presentation management and outcome of burn patients in this challenging environment.
Patients And Methods:
A cross-sectional prospective study involving 41 patients was undertaken from October 2011 to April 2012.
Results:
65.9% were males. The largest age group was below 5 years (36.6%). 19.5% were epileptic. More than half of the burns were due to open flame. 80.5% had second degree burns. 56.1% had a BSA of 15% or less and 56.1% had an APACHE score of 10 or less. It was found that 73.2% of burns occurred at home. The commonest prehospital first aid applied was honey. Only 41.5% arrived in hospital within the first 24h after burn. Among the 14.6% who had skin grafting, none had early excision of burn wound. 53.7% developed wound sepsis while 24.4% developed contractures. The mortality rate was 26.8%.
Conclusion:
Children under five are the worst affected by burns. Most patients had second degree burn wounds. Inappropriate management of the burn wound started just after injury and continued even in hospital. Mortality and complication rates are high.
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