Sanyang Edrisa, Peek-Asa Corinne, Young Tracy, Fuortes Laurence
Injury Prevention and Research Center, College of Public Health, University of Iowa, Iowa City, IA 52240, USA.
Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, University of The Gambia, Brikama, PO Box 3530 Serrekunda, The Gambia.
Int J Environ Res Public Health. 2017 Jul 30;14(8):856. doi: 10.3390/ijerph14080856.
Burn-related injuries are a significant burden in children, particularly in low- and middle-income countries (LMICs), where more than 90% of burn-related pediatric deaths occur. Lack of adult supervision of children is a major risk for pediatric burn injuries. The goal of this paper was to examine the general characteristics of burns and identify burn injury outcomes among adult-supervised children compared to those who were not supervised. The study examined burn injury and clinical characteristics among all burn patients admitted to two trauma hospitals in The Gambia, West Africa. At intake in the emergency room, the treating physician or nurse determined the need for admission based on body surface area burned (BSAB), depth of burn, and other clinical considerations such as co-occurring injuries and co-morbidities. During the study period of 1 April 2014 through 31 October 2016, 105 burn patients were admitted and data were collected by the treating physician for all of them. Information about supervision was only asked for children aged five years or less. More than half (51%) of the burn patients were children under 18 years, and 22% were under 5 years. Among children under five, most (86.4%) were supervised by an adult at the time of burn event. Of the 19 supervised children, 16 (84.2%) had body area surface burned (BSAB) of less than 20%. Two of the three children without adult supervision at the time of burn event had BSAB ≥ 20%. Overall, 59% of the patients had 20% + BSAB. Females (aOR = 1.25; 95% CI = 0.43-3.62), those burned in rural towns and villages (aOR = 2.29; 95% CI = 0.69-7.57), or burned by fire or flames (aOR = 1.47; 95% CI = 0.51-4.23) had increased odds of having a BSAB ≥ 20%, although these differences were not statistically significant. Children 0-5 years or 5-18 years (aOR = 0.04, 95% CI = 0.01-0.17; aOR = 0.07, 95% CI = 0.02-0.23, respectively) were less likely to have BSAB ≥ 20% than adults. Those burned in a rural location (aOR = 9.23, 95% CI = 2.30-37.12) or by fire or flames (aOR = 6.09, 95% CI = 1.55-23.97) were more likely to die. Children 0-5 years or 5-18 years (aOR = 0.2, 95% CI = 0.03-1.18; aOR = 0.38; 95% CI = 0.11-1.570, respectively) were less likely to die. Children constitute a significant proportion of admitted burn patients, and most of them were supervised at the time of the burn event. Supervised children (compared to unsupervised children) had less severe burns. Programs that focus on burn prevention at all levels including child supervision could increase awareness and reduce burns or their severity. Programs need to be designed and evaluated with focus on the child development stage and the leading causes of burns by age group.
烧伤相关伤害给儿童带来了沉重负担，在低收入和中等收入国家（LMICs）尤为如此，超过90%的烧伤相关儿童死亡发生在这些国家。缺乏成人对儿童的监管是儿童烧伤的主要风险因素。本文的目的是研究烧伤的一般特征，并确定与未受监管儿童相比，受成人监管儿童的烧伤结局。该研究调查了西非冈比亚两家创伤医院收治的所有烧伤患者的烧伤情况和临床特征。在急诊室接收患者时，主治医生或护士根据烧伤体表面积（BSAB）、烧伤深度以及其他临床因素（如并发损伤和合并症）来确定是否需要住院治疗。在2014年4月1日至2016年10月31日的研究期间，共收治了105名烧伤患者，主治医生为他们收集了相关数据。仅询问了5岁及以下儿童的监管信息。超过一半（51%）的烧伤患者为18岁以下儿童，其中22%为5岁以下儿童。在5岁以下儿童中，大多数（86.4%）在烧伤发生时受到成人监管。在19名受监管儿童中，16名（84.2%）的烧伤体表面积（BSAB）小于20%。在烧伤发生时未受成人监管的3名儿童中，有两名的BSAB≥20%。总体而言，59%的患者BSAB≥20%。女性（调整后比值比[aOR]=1.25；95%置信区间[CI]=0.43 - 3.62）、在农村城镇和村庄烧伤的患者（aOR = 2.29；95% CI = 0.69 - 7.57）或因火灾或火焰烧伤的患者（aOR = 1.47；95% CI = 0.51 - 4.23），其BSAB≥20%的几率增加，尽管这些差异无统计学意义。0 - 5岁或5 - 18岁的儿童（aOR分别为0.04，95% CI = 0.01 - 0.17；aOR = 0.07，95% CI = 0.02 - 0.23）的BSAB≥20%的可能性低于成年人。在农村地区烧伤的患者（aOR = 9.23，95% CI = 2.30 - 37.12）或因火灾或火焰烧伤的患者（aOR = 6.09，95% CI = 1.55 - 23.97）死亡的可能性更大。0 - 5岁或5 - 18岁的儿童（aOR分别为0.2，95% CI = 0.03 -
