Caregiver-related predictors of thermal burn injuries among Iranian children: A case-control study.

Homayoun Sadeghi-Bazargani,Saeid Safiri,Amir Almasi-Hashiani,Reza Pakzad,Mark J M Sullman,Erfan Ayubi,Reza Mohammadi,Animesh Biswas

doi:10.1371/journal.pone.0170982

Abstract

PurposeBurns are a common and preventable cause of injury in children. The aim of this study was to investigate child and caregiver characteristics which may predict childhood burn injuries among Iranian children and to examine whether confounding exists among these predictors.MethodsA hospital based case-control study was conducted using 281 burn victims and 273 hospital-based controls, which were matched by age, gender and place of residence (rural/urban). The characteristics of the children and their caregivers were analyzed using crude and adjusted models to test whether these were predictors of childhood burn injuries.ResultsThe age of the caregiver was significantly lower for burn victims than for the controls (P<0.05). Further, the amount of time the caregiver spent outdoors with the child and their economic status had a significant positive association with the odds of a burn injury (P<0.05). A multivariate logistic regression found that Type A behaviour among caregivers was independently associated with the child's odds of suffering a burn injury (OR = 1.12, 95% CI: 1.04–1.21). The research also found that children with ADHD (Inattentive subscale: Crude OR = 2.14, 95% CI: 1.16–3.95, Adjusted OR = 5.65, 95% CI: 2.53–12.61; Hyperactive subscale: Crude OR = 1.73, 95% CI: 1.23–2.41, Adjusted OR = 2.53, 95% CI: 1.65–3.87) also had increased odds of suffering a burn injury. However, several variables were identified as possible negative confounder variables, as the associations were stronger in the multivariate model than in the crude models.ConclusionThe caregiver's characteristics which were predictors of burn injuries among Iranian children were: being younger, high socio-economic status, Type A behavioural pattern and spending more time outdoors. In addition, the relationship between a child's ADHD scores and the odds of a burn injury may be negatively confounded by the caregivers predictor variables.

Highlights

Unintentional injuries are a health concern in every country around the world and result in over 5 million deaths per year, or 16,000 deaths per day [1]
A multivariate logistic regression found that Type A behaviour among caregivers was independently associated with the child’s odds of suffering a burn injury (OR = 1.12, 95% CI: 1.04–1.21)
The research found that children with attention deficit hyperactivity disorder (ADHD) (Inattentive subscale: Crude odds ratios (OR) = 2.14, 95% CI: 1.16–3.95, Adjusted OR = 5.65, 95% CI: 2.53–12.61; Hyperactive subscale: Crude OR = 1.73, 95% CI: 1.23–2.41, Adjusted OR = 2.53, 95% CI: 1.65–3.87) had increased odds of suffering a burn injury

Summary

Introduction

Unintentional injuries are a health concern in every country around the world and result in over 5 million deaths per year, or 16,000 deaths per day [1]. According to the World Health Organization’s Global Burden of Disease Study, unintentional injuries accounted for over 3.9 million deaths in 2004. Five of the 15 leading causes of death among persons 15– 29 years of age are accidental, including: road traffic injuries, drowning, burns, poisoning, and falls [1]. A worldwide increase in prevention efforts and early intervention programmes have substantially reduced the burden of unintentional injuries as a public health concern [2]. Over 95% of fatal fire-related burn injuries occur in low- and middle-income countries [3, 6, 7]

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