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      The design and evaluation of a system for improved surveillance and prevention programmes in resource-limited settings using a hospital-based burn injury questionnaire

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          Abstract

          Background

          Limited and fragmented data collection systems exist for burn injury. A global registry may lead to better injury estimates and identify risk factors. A collaborative effort involving the WHO, the Global Alliance for Clean Cookstoves, the CDC and the International Society for Burn Injuries was undertaken to simplify and standardise inpatient burn data collection. An expert panel of epidemiologists and burn care practitioners advised on the development of a new Global Burn Registry (GBR) form and online data entry system that can be expected to be used in resource-abundant or resource-limited settings.

          Methods

          International burn organisations, the CDC and the WHO solicited burn centre participation to pilot test the GBR system. The WHO and the CDC led a webinar tutorial for system implementation.

          Results

          During an 8-month period, 52 hospitals in 30 countries enrolled in the pilot and were provided the GBR instrument, guidance and a data visualisation tool. Evaluations were received from 29 hospitals (56%).

          Key findings

          Median time to upload completed forms was <10 min; physicians most commonly entered data (64%), followed by nurses (25%); layout, clarity, accuracy and relevance were all rated high; and a vast majority (85%) considered the GBR ‘highly valuable’ for prioritising, developing and monitoring burn prevention programmes.

          Conclusions

          The GBR was shown to be simple, flexible and acceptable to users. Enhanced regional and global understanding of burn epidemiology may help prioritise the selection, development and testing of primary prevention interventions for burns in resource-limited settings.

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          Most cited references7

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          Epidemiology of burns throughout the World. Part II: intentional burns in adults.

          Michael Peck (2012)
          A significant number of burns and deaths from fire are intentionally wrought. Rates of intentional burns are unevenly distributed throughout the world; India has a particularly high rate in young women whereas in Europe rates are higher in men in mid-life. Data from hospitalized burn patients worldwide reveal incidence rates for assault by fire and scalds ranging from 3% to 10%. The average proportion of the body surface area burned in an assault by fire or scalds is approximately 20%. In different parts of the world, attempted burning of others or oneself can be attributed to different motives. Circumstances under which assaults occur fall largely into the categories of interpersonal conflict, including spousal abuse, elder abuse, or interactions over contentious business transactions. Contributing social factors to assaults by burning include drug and alcohol abuse, non-constructive use of leisure time, non-participation in religious and community activities, unstable relationships, and extramarital affairs. Although the incidence of self-mutilation and suicide attempts by burning are relatively low, deliberate self-harm carries a significant risk of death, with an overall mortality rate of 65% worldwide. In those who resort to self-immolation, circumstantial themes reflect domestic discord, family dysfunction, and the social ramifications of unemployment. Preventing injurious burn-related violence requires a multifaceted approach, including legislation and enforcement, education, and advocacy. Better standardized assessment tools are needed to screen for risks of abuse and for psychiatric disorders in perpetrators. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.
          Article 0 comments Cited 46 times – based on 0 reviews     Review now
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            Epidemiology of burn injuries: highlighting cultural and socio-demographic aspects.

            Sharmila Dissanaike, Maham Rahimi (2009)
            Burns are devastating injuries that disproportionately affect people in developing countries, including children. In addition to a high mortality rate, survivors are burdened with life-long physical and emotional scars. The etiology and nature of burn injuries varies significantly by country, and this chapter explores the predominant causes and patterns of burn injury in both the developing and industrialized worlds. Gender differences play a significant role in the risk of burn injuries, across a spectrum with a predominance of women injured in fires from cooking and heating fuels in the developing world and industrial accidents primarily affecting men in developed nations. Children are particularly vulnerable to burn injuries, accounting for almost 50% of all burn patients in some studies. A majority of pediatric burns are scald injuries usually affecting very young children below the age of 5 years, and we discuss the behavioral patterns underlying this finding. Finally, the elderly form a rapidly increasing proportion of the population in many countries, and are often burdened with comorbidities that are likely to pose significant challenges in burn care.
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              Fire-related deaths in India in 2001: a retrospective analysis of data.

              Prachi Sanghavi, Kavi Bhalla, Veena Das (2009)
              Hospital-based studies have suggested that fire-related deaths might be a neglected public-health issue in India. However, no national estimates of these deaths exist and the only numbers reported in published literature come from the Indian police. We combined multiple health datasets to assess the extent of the problem. We computed age-sex-specific fire-related mortality fractions nationally using a death registration system based on medically certified causes of death in urban areas and a verbal autopsy based sample survey for rural populations. We combined these data with all-cause mortality estimates based on the sample registration system and the population census. We adjusted for ill-defined injury categories that might contain misclassified fire-related deaths, and estimated the proportion of suicides due to self-immolation when deaths were reported by external causes. We estimated over 163 000 fire-related deaths in 2001 in India, which is about 2% of all deaths. This number was six times that reported by police. About 106 000 of these deaths occurred in women, mostly between 15 and 34 years of age. This age-sex pattern was consistent across multiple local studies, and the average ratio of fire-related deaths of young women to young men was 3:1. The high frequency of fire-related deaths in young women suggests that these deaths share common causes, including kitchen accidents, self-immolation, and different forms of domestic violence. Identification of populations at risk and description of structural determinants from existing data sources are urgently needed so that interventions can be rapidly implemented.
              Article 0 comments Cited 23 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Inj Prev
                Journal ID (iso-abbrev): Inj. Prev
                Journal ID (hwp): injuryprev
                Journal ID (publisher-id): ip
                Title: Injury Prevention
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Print): 1353-8047
                ISSN (Electronic): 1475-5785
                Publication date (Print): April 2016
                Volume: 22
                Issue: Suppl 1 , Injury Surveillance: Next Generation
                Pages: i56-i62
                Affiliations
                [1 ]Division of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona Health Sciences Center , Tucson, Arizona, USA
                [2 ]Office of Noncommunicable Disease, Injury, and Environmental Health, Centers for Disease Control and Prevention , Atlanta, Georgia, USA
                [3 ]Department of Noncommunicable Diseases, World Health Organization , Geneva, Switzerland
                [4 ]Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention , Atlanta, Georgia, USA
                [5 ]Director of Programs, Global Alliance for Clean Cookstoves , Washington DC, USA
                [6 ]The Public Health Institute , Oakland, California, USA
                Author notes
                [Correspondence to ] Dr Michael Peck, Arizona Burn Center, 2601 East Roosevelt Street, Phoenix, AZ 85008, USA; mpeck47@ 123456hotmail.com
                Article
                Publisher ID: injuryprev-2015-041815
                DOI: 10.1136/injuryprev-2015-041815
                PMC ID: 4853523
                PubMed ID: 27044496
                SO-VID: fa9a8b5a-4a93-49f9-905d-dae988f96ef1
                Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
                License:

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                Date received : 8 September 2015
                Date revision received : 23 February 2016
                Date accepted : 25 February 2016
                Categories
                Subject: 1506
                Subject: Original Article
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                ScienceOpen disciplines: Medicine
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                ScienceOpen disciplines: Medicine

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