Geospatial analysis of burn incidence in central Malawi

Low- and middle-income countries carry the highest burden of burn injury, especially in sub-Saharan Africa. This study sought to identify high burn incidence areas in the central region of Malawi using Geospatial mapping.

We performed a retrospective geospatial analysis of burn patients admitted to Kamuzu Central Hospital in Lilongwe from 2013 to 2022. We divided the patients into 2 cohorts: Cohort 1 (2013-2017) and Cohort 2 (2018-2022). Spatial analysis software was used to map burn incidence by district areas. Spatial cluster analyses were then conducted for Central Malawi using Global Moran's I.

We analyzed 2755 patients from the central district of Malawi (2013-2022; mean age 10.7 years). Overall mortality was 17.7%. Most burns were scalds (61%), followed by flame burns (34%). The incidence of burns, as measured by Global Moran's I, was randomly distributed throughout the Central Region, indicating no significant clustering. There was no statistically significant change in burn mortality distribution between Cohort 1 (Moran's I = -0.21) and Cohort 2 (Moran's I = -0.41). However, Lilongwe showed significant spatial dispersion in burn incidence (High-Low, p = 0.05) and experienced a statistically significant reduction in burn incidence from 2013 to 2022, along with greater spatial dispersion.

The incidence of burns was randomly distributed in central Malawi. Lilongwe, the capital city, had the highest burn injury risk but also showed a statistically significant reduction in burn incidence over time. Geospatial analysis of burns is a valuable tool for informing burn prevention interventions.