Burns Care in Sub‑Saharan Africa

Experience from a Trauma Registry in Nigeria – An Observational Study

Authors

  • Sydney E. Ibeanusi University of Port Harcourt Author
  • B. Kejeh University of Port Harcourt Author

Keywords:

Burns care, epidemiology of burns, Nigeria, outcome, sub‑Saharan Africa

Abstract

Background: Burns is quite common and often associated with deleterious consequences. The incidence, mortality and morbidity from burns are decreasing in most developed countries over the years, but in the developing countries, the burden of burn injuries continue to pose a significant challenge. Various factors have been attributed to this persisting trend. This study aim is to highlight the pattern of presentation, care and outcome of injuries from burns from a regional trauma registry in Nigeria. Methods: Retrospective evaluation of data from a regional trauma registry in Port Harcourt Nigeria prospectively collected over a seven-year period (from January 2007 to December 2013). Descriptive and inferential statistics of the results are presented. Results: The result showed that 601 cases of burns were recorded during the period under observation. Males between the age group (20-29) years were the most involved (n = 223 {37.1%}) and flame burns (n = 380 {63.2%}) arising mainly from explosions of petroleum products (n = 333 {55.4%}) was the most commonly seen. The overall mortality recorded was 34%, but the median lethal burn surface area at which 50% of the victims died was about 40%. Most of the deaths occurred in the first week following burns. The common early complications were fluid and electrolyte derangement (n = 280 {46.6%}), while burn scarring was a common complication among survivors. Conclusion: Burns remains a significant contributor to high trauma mortality and morbidity in the region. Inadequate infrastructure, human and material resources and some persisting cultural beliefs and practises contribute to the poor outcome of burns.

Author Biographies

  • Sydney E. Ibeanusi, University of Port Harcourt

    Department of Surgery, University of Port Harcourt, Port Harcourt, Nigeria

  • B. Kejeh, University of Port Harcourt

    Department of Surgery, University of Port Harcourt, Port Harcourt, Nigeria

References

1. Olaitan PB, Olaitan JO. Burns and scalds – Epidemiology and preventionin a developing country. Niger J Med 2005;14:9‑16.

2. Kalayi GD. Mortality from burns in Zaria: An experience in a developingeconomy. East Afr Med J 2006;83:461‑5.

3. Haik J, Liran A, Tessone A, Givon A, Orenstein A, Peleg K, et al. Burnsin Israel: Demographic, etiologic and clinical trends, 1997‑2003. IsrMed Assoc J 2007;9:659‑62.

4. Brigham PA, McLoughlin E. Burn incidence and medical care use in theUnited States: Estimates, trends, and data sources. J Burn Care Rehabil1996;17:95‑107.

5. Heimbach D. Burn patients, then and now. Burns 1999;25:1‑2.

6. Vehmeyer‑Heeman M, Van Holder C, Nieman F, Van den Kerckhove E,Boeckx W. Predictors of mortality: A comparison between two burnwound treatment policies. Burns 2007;33:167‑72.

7. Herndon DN, Gore D, Cole M, Desai MH, Linares H, Abston S, et al. Determinants of mortality in pediatric patients with greater than 70%full‑thickness total body surface area thermal injury treated by earlytotal excision and grafting. J Trauma 1987;27:208‑12.

8. Lawton G, Dheansa B. The management of major burns – A surgicalperspective. Curr Anaesth Crit Care 2008;30:1‑7.

9. Datubo‑Brown DD, Kejeh BM. Burn injuries in port Harcourt, Nigeria.Burns 1989;15:152‑4.

10. Oladele AO, Olabanji JK. Burns in Nigeria: A review. Ann Burns FireDisasters 2010;23:120‑7.

11. Kalayi GD. Mortality from burns in Zaria: An experience in a developingeconomy. East Afr Med J 2006;83:461‑4.

12. Olaitan PB, Jiburum BC. Analysis of burn mortality in a burns centre. Ann Burns Fire Disasters 2006;19:59‑62.

13. Opaluwa AS, Orkar SK. Emphasise burns prevention in developingcountries. BMJ 2004;329:801.

14. Agbenorku P. Morbidity and mortality data‑Kumasi: 1st GhanaBurn Conference 2008/Launch of Ghana Burn Association. Theme:Prevention and Management of Burns in Ghana: Are we Doing it Right?Accra, Ghana: Ghana College of Physicians and Surgeons; July, 2008.

15. Agbenorku P, Akpaloo J, Farhat BF, Hoyte‑Williams PE, Yorke J,Agbenorku M, et al. Burn disasters in the middle belt of Ghana from2007 to 2008 and their consequences. Burns 2010;36:1309‑15.

16. Okoro PE, Igwe PO, Ukachukwu AK. Childhood burns in South EasternNigeria. Afr J Paediatr Surg 2009;6:24‑7.

17. Atiyeh B, Masellis A, Conte C. Optimizing burn treatment indeveloping low‑and middle‑income countries with limited health careresources (Part 2). Ann Burns Fire Disasters 2009;22:189‑95.

18. Forjuoh SN. Burns in low‑ and middle‑income countries: A review ofavailable literature on descriptive epidemiology, risk factors, treatment,and prevention. Burns 2006;32:529‑37.

19. Datubo‑Brown DD. Deliberate burns in Nigerians. Trop Doct1989;19:137‑40.

20. Ahuja RB, Bhattacharya S. Burns in the developing world and burndisasters. BMJ 2004;329:447‑9.

21. World Health Organization. The Injury Chart Book: A GraphicalOverview of the Global Burden of Injuries. Dept of Injuries andViolence Prevention + Non‑Communicable Diseases and Mental HealthCluster. Geneva: World Health Organization; 2002.

22. Oduwole EO, Odusanya OO, Sani AO, Fadeyibi A. Contaminatedkerosene burns disasters in Lagos, Nigeria. Ann Burns Fire Disasters2003;16:208‑12.

23. Olugbenga SA. Adulterated kerosene burn disaster: The Nigeriaexperience. Ann Burns Fire Disasters 2005;18:34‑40.

24. Olugbenga SA. Adulterated kerosene burn disaster: The Nigeriaexperience. Ann Burns Fire Disasters 2005;18:40‑4.

25. Asuquo ME, Ekpo R, Ngim O, Agbor C. A prospective study ofburn trauma in adults at the university of Calabar teaching hospital,Calabar (South Eastern Nigeria). Eplasty 2008;8:e36.

26. Baxter CR, Shires T. Physiological response to crystalloid resuscitationof severe burns. Ann N Y Acad Sci 1968;150:874‑94.

27. Hettiaratchy S, Papini R. Initial management of a major burn:II – Assessment and resuscitation. BMJ 2004;329:101‑3.

28. Vilasco B, Bondurand A. Burns in Abidjan, cote D’lvoire. Bums1995;21:291‑6.

29. Momoh MI, Okugbo SU, Ohanaka EC, Ugbeye ME. Causes andrisk factors in burns; experience from Benin city. Niger J Surg Sci2000;10:103‑11.

30. Nwachukwu C, Adeyemi K, Oke B, Adetayo O, Obasola K. Pastpipeline explosions. The Punch; 17 September, 2006. p. 1‑2.

31. Ohiomogbe H. Kerosene Deaths. Available from: http://www. nigerdeltacongress.com. [Last accessed on 2014 May 26].

32. Jeanine C. UN Office for the Coordination of Humanitarian Affairs. OCHA Situation Report no. 1. Kenya: Fire; 2 February, 2009.

33. Federal Road Safety Corps. 2015 Report. Abuja: FRSC; 2016.

34. Wolf SE, Herndon DN. Burns. In: Townsend CM, editor. SabistonTextbook of Surgery. 20th ed. St. Louis: W.B. Saunders; 2016.

35. Van Der Merwe E. Burn patients in Africa die of shock or sepsis. CritCare 2008;26:428‑30.

36. Dongo AE, Irekpita EE, Oseghale LO, Ogbebor CE, Iyamu CE,Onuminya JE, et al. A five‑year review of burn injuries in Irrua. BMCHealth Serv Res 2007;7:171.

37. Bariar LM, Vasenwala SM, Malik A, Ansari GH, Chowdhury TE. A clinicopathological study of infections in burn patients and importanceof biopsy. J Indian Med Assoc 1997;95:573‑5.

38. Song C, Chua A. Epidemiology of burn injuries in Singapore from 1997to 2003. Burns 2005;31 Suppl 1:S18‑26.

Downloads

Published

2018-06-30

How to Cite

Ibeanusi, S. E., & Kejeh, B. (2018). Burns Care in Sub‑Saharan Africa: Experience from a Trauma Registry in Nigeria – An Observational Study. Nigerian Journal of Orthopaedics and Trauma, 17(1), 29-33. https://njot.org/njot/article/view/6