Global Disparities in Pediatric Craniofacial Burns: The Influence of Income Level, Supervision, and Access to Care

Global disparities in pediatric craniofacial burns are underexplored, yet the lasting impact and disease burden they present merit further study. This study leverages data from the WHO Global Burn Registry to evaluate differences in pediatric craniofacial burn characteristics and outcomes across income settings, and to identify structural and contextual factors contributing to disparities in care. The registry was queried for craniofacial burns in patients aged 0 to 18 years (n=1625). Patients were stratified by World Bank income classification. Descriptive statistics and multivariable regression models were used to evaluate associations between income level and outcomes, including length of stay, surgery, and discharge status. Patients in lower-income settings were older and had larger burns. They were more likely to experience delayed presentation and had significantly lower access to critical care. Higher-income settings demonstrated increased surgical intervention and longer hospital stays. Mortality was substantially higher in lower-income countries (26.14% versus 8.02%), with an 88.5% lower adjusted risk of death in higher-income settings. Increasing total body surface area was the strongest predictor of mortality. Differences in supervision and timing of injury were also observed across income levels. Outcomes in pediatric craniofacial burns are influenced not only by injury severity but also by socioeconomic context and access to care. Disparities in care capacity, supervision, and healthcare infrastructure contribute significantly to global differences in outcomes. Prevention efforts should be context-specific and address the need for improved caregiver supervision, home safety measures, and access to specialized burn care.