Chalya Phillipo L, Mabula Joseph B, Dass Ramesh M, Giiti Geofrey, Chandika Alphonce B, Kanumba Emmanuel S, Gilyoma Japhet M
Department of Surgery, Weill-Bugando University College of Health Sciences, Mwanza, Tanzania.
BMC Res Notes. 2011 Nov 9;4:485. doi: 10.1186/1756-0500-4-485.
Burn injuries constitute a major public health problem and are the leading cause of childhood morbidity and mortality worldwide. There is paucity of published data on childhood burn injuries in Tanzania, particularly the study area. This study was conducted to describe the pattern of childhood burn injuries in our local setting and to evaluate their management outcome.
A cross sectional study was conducted at Bugando Medical Centre (in Northwestern Tanzania) over a 3-year period from January 2008 to December 2010. Data was collected using a pre-tested coded questionnaire and statistical analyses performed using SPSS software version 15.0.
A total of 342 burned children were studied. Males were mainly affected. Children aged = 2 were the majority accounting for 45.9% of cases. Intentional burn injuries due to child abuse were reported in 2.9% of cases. Scald was the most common type of burns (56.1%). The trunk was the most commonly involved body region (57.3%). Majority of patients (48.0%) sustained superficial burns. Eight (2.3%) patients were HIV positive. Most patients (89.8%) presented to the hospital later than 24 h. The rate of burn wound infection on admission and on 10th day were 32.4% and 39.8% respectively.Staphylococcus aureus were more common on admission wound swabs, with Pseudomonas aeruginosa becoming more evident after 10th day. MRSA was detected in 19.2% of Staphylococcus aureus. Conservative treatment was performed in 87.1% of cases. Surgical treatment mainly skin grafting (65.9%) was performed in 44 (12.9%) of patients. The overall average of the length of hospital stay (LOS) was 22.12 ± 16.62 days. Mortality rate was 11.7%. Using multivariate logistic regression analysis; age of the patient, type of burn, delayed presentation, clothing ignition, %TBSA and severity of burn were found to be significantly associated with LOS (P < 0.001), whereas mortality rate was found to be independently and significantly related to the age of the patient, type of burn, HIV positive with stigmata of AIDS, CD4 count, inhalation injury, %TBSA and severity of burn (P < 0.001).
Childhood burn injuries still remain a menace in our environment with virtually unacceptable high morbidity and mortality. There is need for critical appraisal of the preventive measures and management principles currently being practiced.
烧伤是一个重大的公共卫生问题，是全球儿童发病和死亡的主要原因。关于坦桑尼亚儿童烧伤的数据，尤其是研究区域内的数据，发表的资料很少。本研究旨在描述我们当地环境中儿童烧伤的模式，并评估其治疗效果。
2008年1月至2010年12月的3年期间，在布甘多医疗中心（位于坦桑尼亚西北部）进行了一项横断面研究。使用预先测试的编码问卷收集数据，并使用SPSS软件15.0版进行统计分析。
共研究了342名烧伤儿童。主要为男性受影响。2岁及以上儿童占大多数，占病例的45.9%。2.9%的病例报告为因虐待儿童导致的故意烧伤。烫伤是最常见的烧伤类型（56.1%）。躯干是最常受累的身体部位（57.3%）。大多数患者（48.0%）为浅度烧伤。8名（2.3%）患者HIV呈阳性。大多数患者（89.8%）在24小时后才到医院就诊。入院时和第10天时烧伤创面感染率分别为32.4%和39.8%。入院时伤口拭子中金黄色葡萄球菌更常见，第10天后铜绿假单胞菌更明显。在19.2%的金黄色葡萄球菌中检测到耐甲氧西林金黄色葡萄球菌。87.1%的病例采用保守治疗。44名（12.9%）患者进行了手术治疗，主要是皮肤移植（65.9%）。住院时间（LOS）的总体平均值为22.12±16.62天。死亡率为11.7%。使用多因素逻辑回归分析；发现患者年龄、烧伤类型、延迟就诊、衣物着火、烧伤总面积（%TBSA）和烧伤严重程度与住院时间显著相关（P<0.001），而死亡率与患者年龄、烧伤类型、伴有艾滋病体征的HIV阳性、CD4计数、吸入性损伤、烧伤总面积和烧伤严重程度独立且显著相关（P<0.001）。
儿童烧伤在我们的环境中仍然是一个威胁，发病率和死亡率高得几乎令人无法接受。需要对目前正在实施的预防措施和治疗原则进行严格评估。
