|Year : 2012 | Volume
| Issue : 1 | Page : 62-65
An epidemiological survey of burn injuries in rural area, Bhopal: A cross-sectional study
Sumit Dutt Bhardwaj, Umesh Sinha
Department of Community Medicine, Chirayu Medical College, Bhopal, India
|Date of Web Publication||13-May-2013|
Sumit Dutt Bhardwaj
Department of Community Medicine, Chirayu Medical College and Hospital, Bairagarh, Bhopal
Source of Support: None, Conflict of Interest: None
Background: A large number of burn injuries in India go unreported; injuries are largely preventable but still burn injuries lead to deformities and contractures limiting optimum and normal functioning of the individual. Materials and Methods: A community based cross-sectional study was conducted in the rural village of Phanda block. A house-to-house survey was conducted and the interview technique was employed to collect the data. Results: A total of 756 households with 3,677 population were surveyed. There were total 309 (8.4%) patients with burn injuries during the last 6 months. Majority of the patients were females (54.7%). Out of the total domestic burns, 71.3% occurred in the kitchen. Conclusion: Burn injuries are a serious public health problem. These injuries are preventable through design and promotion of more aggressive prevention programs especially for flame injuries occurring in the home environment.
Keywords: Burn injuries, epidemiology, rural
|How to cite this article:|
Bhardwaj SD, Sinha U. An epidemiological survey of burn injuries in rural area, Bhopal: A cross-sectional study. Indian J Burns 2012;20:62-5
|How to cite this URL:|
Bhardwaj SD, Sinha U. An epidemiological survey of burn injuries in rural area, Bhopal: A cross-sectional study. Indian J Burns [serial online] 2012 [cited 2019 Sep 16];20:62-5. Available from: http://www.ijburns.com/text.asp?2012/20/1/62/111788
| Introduction|| |
Injuries generally have continued to attract the attention of researchers all over the world. Burn injuries rank among the most severe types of injuries suffered by the human body with an attendant high mortality and morbidity rate.  Burn injuries are extremely common and are a major public health problem. The case studies above are real-life studies and many more are regularly reported in the media. Every day, we read, listen or witness such instances. Print and visual media gives prominence for such instances, whenever it occurs among high-profile members of the society. However, thousands of such instances happen every year taking away lives of young people. Routinely, such instances become another set of numbers to the already existing grim statistics and lessons are not learnt. During 2007 in India, 20,772 persons lost their lives in a burn injury and 2793 were seriously injured (indicating extreme under reporting of nonfatal injuries).  Apart from high numbers of deaths, the pain, suffering, and agony of burn survivors are immeasurable. Deformities and contractures result in life long physical problems along with limiting optimum and normal functioning of the individual. The psychosocial problems after burn injuries remain in the minds of affected individuals, their family members, and their young children for years to come. Burn injuries occur due to a variety of electrical, thermal, mechanical products and can be accidental, suicidal or even homicidal in nature. Hence, this study was conducted to assess demographic and socio-cultural factors responsible for the burn injuries, the type modes, causes, and risk factors for burn injuries and to study the outcome.
| Materials and Methods|| |
A community-based cross-sectional study was carried out in the field practice area of Rural health and training centre of Chirayu Medical College and Hospital, Bhopal between February 2012 and June 2012. All the villages in the Phanda block were selected for the study. There were total 16 villages in the block. A house-to-house survey was conducted and people in the household were asked whether they have suffered any burn in the last 6 months; this period was selected to avoid recall bias. For the purpose of the study, the term burn injury was defined as a body lesion due to an external cause, either intentional (alleged homicidal or suicidal) or unintentional (alleged accidental) resulting from a sudden exposure to energy (mechanical, electrical, thermal, chemical, or radiant) generated by agent-host interaction.  Data were obtained by a face-to-face interview using predesigned and pretested questionnaire. If hospital document related to burn was available it was verified but the data on burn were mainly dependent on the history given by the respondents. The data were analyzed using a Chi-square test and percentages. The analysis was performed using statistical program (SPSS Version 10.0, SPSS Inc., Chicago, USA).
| Results|| |
Total 756 households with 3,677 populations were surveyed. There were total 309 (8.4%) patients with burn injuries during the last 6 months. [Figure 1] shows the genderwise distribution of burn cases. The male-to-female ratio was 0.8:1. The mean age was 27.81 ± 15.77 years ranging from 4 months to 96 years. Majority (22.7%) of the burn cases were between 31 and 40 years of age followed by 21-30 year age group (21.4%) [Table 1]. Majority (27.5%) of the burn cases were illiterate and unskilled workers (37.3.3%). Most (34.6%) of the patients belonged to the class V socioeconomic status. Maximum number of females (88.8%) sustained burn injuries at home compared to males (48.7%), which was found to be statistically significant (P = 0.000).
Out of the total domestic burns, 71.3% occurred in the kitchen, kitchen cum living room, and kitchen cum bathroom. Most of the patients (35.6.4%) were living in kutcha and overcrowded homes (51%). Out of the total injuries, 33.0% occurred between 4 pm and 9 pm. Synthetic clothing was worn by 46.5% of the victims. Among the female patients, 71.7% were wearing synthetic clothing at the time of burn. Majority (81.6%) of the burn injuries were allegedly accidental. Flame injuries contributed to 79.4% of the total cases [Table 2]. The overall mortality was 2 (0.64%). Among the total deaths, both were females.
|Table 2: Distribution of burn cases according to the types and source of the burn|
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| Discussion|| |
The epidemiology of burns varies from one part of the world to another as it depends on the level of civilization, industrialization, and culture among other things.  Also the lack of uniformity between methodologies in addition to the existence of a plethora of variables and differences in the periods of study makes any comparison with other studies difficult.  Burn injuries and their related morbidity, disability, and mortality represent a public health problem of increasing importance in developing countries. 
In the present study 54.3% of females suffered burns in the last 6 months. Similar findings have been reported by various studies. ,,, This could be attributed to females′ close proximity to fire throughout the day and night. A total of 44% of patients were between 21 and 40 years of age, which is similar to other studies.  This is the productive age, where they are generally active and are exposed to hazardous situations both at home and at work.
Most (34.6%) of the patients belonged to the class V socioeconomic status. Hence they had the use of cheap and unstable pressure stoves, open fires, adulterated kerosene, financial problems, floor-level cooking, and kerosene lamp/bottle.
In the present study 88.8% of burn injuries in females occurred at home and 11.2% outdoors whereas in males, 52.5% sustained burns at home and 47.5% outdoors. This indicates that home is a dangerous place for burn injuries to occur as appliances are continuously being used for cooking, heating, and lighting purposes without proper precautions.
In this study, 71.3% of domestic burns occurred in the kitchen. About one-third of burn injuries occurred between 4 pm and 9 pm. These findings were similar to a study conducted in Pune and Karnataka. , All these findings indicate that the kitchen is a danger zone in every home where there are unsafe cooking appliances and there is a need for education in this respect. This period coincides with the time to prepare the meals at home. Alleged accidental burns accounted for 81.6%. This could be attributed to the carelessness of individuals while handling fire. Flame was the most common agent, responsible for more than two-thirds of cases (79.4%).
Government of India approved National program for prevention of burn injuries (NPPBI) in 2010 has successfully done the pilot project covering three states Haryana, Himachal Pradesh and Assam for 2 years. MoU with all the states has been signed. GOI is taking efforts to get the program functioning with the goal to ensure prevention and capacity building of infrastructure and manpower at all levels of health care delivery system in order to reduce incidence, provide timely and adequate treatment to burn patients to reduce mortality, complications and provide effective rehabilitation to the survivors. Another objective of the program will be to establish a central burn registry.  Though investigation and research are limited to identify patterns and causes for burns, the precise determinants and mechanisms are clearly not known. Consequently, efforts toward prevention have been limited. Hence, relevant, cost-effective, culture-specific, and sustainable interventions should be developed for burn injury prevention and control. The interventions can be translated into action through the four Es of injury prevention and control, namely, education, engineering, enforcement, and emergency care. The strength of this study is that this study is a population based one and there are very few studies which have been carried out on this subject in this setting. Hence similar kind of population based studies need to be conducted in other parts of the country to aid in comparison and help in building a larger picture on the epidemiology of burns.
| Conclusion|| |
Burn injuries are a serious public health problem. These injuries are preventable through design and promotion of more aggressive prevention programs especially for flame injuries occurring in the home environment.
| Acknowledgment|| |
We thank all the villagers and village heads for their support and encouragement.
| References|| |
|1.||Obalanji JK, Oginni FO, Bankole JO, Olaside AA. A ten-year review of burn cases seen in a Nigerian Teaching Hospital. J Burns Wounds 2003;2:1. Available from: http://www.journalofburns.com. [last cited on 2003 Nov 08]. |
|2.||National Crime Records Bureau. Accidental deaths and suicides in India. Ministry of Home Affairs, New Delhi, Government of India, 2007. |
|3.||Thacker SB, Mackenzie EJ. Injury prevention and control. Epidemiol Rev 2003;25:1-2. |
|4.||El-Gallal AR, Yousef SM, Toweir AA. Burn injuries in Benghazi: Eight years study. Ann Burns Fire Disasters 1998;11:198-202. |
|5.||Attia AF, Sherif AA, Mandil AM, Massoud NM, Arafa MA, Mervat W, et al. Epidemiological and sociocultural study of burn patients in Alexandria, Egypt. East Mediterr Health J 1997;3:452-61. |
|6.||Gupta RK, Srivastava AK. Study of fatal burn cases in Kanpur, India. Forensic Sci Int 1988;37:81-9. |
|7.||Haralkar SJ, Rayate MV. Sociodemographic profile of burn cases admitted in Shri. Chatrapati Shivaji Maharaj General Hospital Solapur. 2004 Souvenir of 31 st Annual National conference of IAPSM, Chandigarh. |
|8.||Singh D, Sing A, Sharma AK, Sodhi L. Burn mortality in Chandigarh zone: 25 years autopsy experience from a tertiary care hospital of India. Burns 1998;24:150-6. |
|9.||Peck MD. Epidemiology of burns throughout the World. Part II: Intentional burns in adults. Burns 2012;38:630-7. |
|10.||Singh MV, Ganguli SK, Aiyanna BM. A study of epidemiological aspects of burn injuries. Med J Armed Forces India 1996;52:229-32. |
|11.||Shankar G, Naik AV, Powar R. Epidemiological Study of Burn Injuries Admitted in Two Hospitals of North Karnataka. Indian J Community Med 2010;35:509-512. |
|12.||MoHFW. Programme on prevention of Burn injuries. Available from: http://mohfw.nic.in/WriteReadData/l892s/94668183Programme%20website.pdf. [Last cited on 2012 Dec 27]. |
[Table 1], [Table 2]