Disparities in Burns Research Authorship in Burn-Specific Journals: Evidence from Low- and Middle-Income Countries

Low- and middle-income countries (LMICs) bear a disproportionate burden of burn injuries compared to high-income countries (HICs), making LMIC representation and leadership in burn-related literature critical. This study analyzed authorship patterns and temporal trends in LMIC participation across burn-specific journals. We analyzed 18,275 burn journal publications from 1982 to 2025 using the PubMed Entrez API, with metadata enriched using OpenAlex country affiliations. Country income classification followed World Bank 2025 definitions. LMIC involvement was defined as the presence of at least one LMIC-affiliated author on a publication. We assessed LMIC representation overall, by authorship position, collaboration type, and temporal period. Chi-square tests were used for temporal comparisons. Country affiliation data were identifiable for 8,348 publications (45.7%) representing 75 countries. Among publications, 26.2% (n=2,185; 95% CI: 25.2-27.1%) included at least one LMIC-affiliated author. LMIC researchers held first authorship in 25.7% and last authorship in 25.3% of publications, with identifiable country affiliation. However, this likely reflects LMIC-only publications rather than parity in HIC-LMIC collaborations. Notably, mixed HIC-LMIC collaborations comprised 3.5% of publications, with the majority being either HIC-only (73.8%) or LMIC-only (22.7%). LMIC representation increased significantly over time, from 13.5% pre-2000 to 31.7% between 2020-2025 (p<0.001). China (n=527), Iran (n=370), and India (n=247) were the leading LMIC contributors, representing 54% of LMIC publications. Representation from the African continent remained low at 3%. LMIC participation in burns research has increased over four decades, though HIC-LMIC collaboration remains limited. Initiatives to foster HIC-LMIC partnerships and empower LMIC authors to lead burns research may maximize collaborative efforts.