59 Annual Incidence of Childhood Burn Injuries and Prevalence of Household Risk Factors in Rural Ghana: A Population-based Cluster-randomized Survey

Abstract

Abstract Introduction Childhood burns are a leading cause of injury in low- and middle-income countries. Many childhood burns can be prevented by modifications in the household environment and targeted education. Therefore, we aimed to determine the incidence of childhood burn injuries and describe the prevalence of potentially modifiable household risk factors. Methods We performed a population-based, cluster-randomized, household survey of 358 households in a rural district in Ghana. From the district, 6 of 11 community clusters were randomly selected. Within these clusters, a census of all households with a caregiver of at least one child < 5 years of age was conducted. Caregivers were interviewed regarding childhood burn injury (CBI) within the past 6 months and potentially modifiable household risk factors. Results Of the 358 households sampled, most households lived in completed structures they owned (67%, 95% CI 61.9–71.6%). The adjusted annual incidence of childhood burn injury was 7.9%. The median age of burn injury was 3 years. The most common etiology of CBI was flame burn (53%, 95% CI 36.8–67.7%). Increasing year of age (AOR 0.92, 95% CI 0.84–1.01) and households with an older sibling ³12 years (AOR 0.53, 95% CI 0.24–1.17) were weakly associated with lower odds of CBI. The majority of households (84%, 95% CI 80.5–88%) used an open fire with firewood as fuel arrangement for cooking. In most households there was not a separate room used as a kitchen (90%, 95% CI 86–92.4%) and the stove/cooking arrangement height was within reach of children under five (< 1 meter; 96%, 95% CI 94.6–97%). Female gender (AOR 1.37, 95% CI 0.71–2.64), outdoor cooking arrangement (AOR 1.05, 95% CI 0.42–2.62) and an increased number of children under caregiver supervision (≥5 children; AOR 1.32, 95%CI 0.42–2.62) were not predictive of CBI. Conclusions Burns are a common cause of childhood injury in rural Ghana. There may be opportunities to reduce the risk of burn injuries in rural settings by supporting the transition to safer cooking arrangements, child barrier apparatuses (e.g. playpens that separate children from cooking arrangements), and/or health promotion initiatives. Given the high incidence of childhood burn injuries, strategic burn-related healthcare capacity development is also required to limit preventable death and disability. Applicability of Research to Practice These findings, which differ somewhat from similar studies in other LMIC communities, suggest that there is not a one-size-fits-all solution for the prevention of childhood burn injuries. Community-specific and contextually relevant interventions that aim to prevent childhood burn injuries can be identified by results from population-based surveys of injury epidemiology and potentially modifiable risk factors.