Abstract
BackgroundBurns are a persisting public health problem in low- and middle-income countries; however, epidemiologic data for these settings is scarce. South Africa is no exception although there is an emerging knowledge base, especially for paediatric burns. The current study describes the epidemiology of burn mortality across the lifespan in Cape Town (2.9 million inhabitants in 2001), one of the six South African metropolitan centres.MethodsThe distribution of burn mortality across socio-demographic groups and also their circumstances of occurrence were investigated using four year (2001 to 2004) surveillance data from the National Injury Mortality Surveillance System (n = 1024 cases).ResultsBurn mortality occurred at a rate of 7.9 per 100 000 person-years (95% CI: 7.3-8.3). Males sustained fatal rates 2.2 times more than that for females (p < 0.001), with rates significantly higher in the 25 to 38 and 39 to 50 age groups than at other ages (p < 0.001). The greatest difference between male and female deaths was observed in the 25 to 38 year age group, when almost three male deaths occurred for every female one. The vast majority of fatal burns were registered as accidental and occurred in the home, either over the cold and wet months or during recreational periods over weekends and across the year. Alcohol intoxication was reported for the majority of those adults whose alcohol blood levels were tested (i.e. 52.6% of cases aged 16+ years).ConclusionBesides paediatric burns, the high prevalence and circumstances of occurrence of burns among middle age men are a source of concern. There are reasons to believe that this over-representation is a reflection of detrimental living conditions, life-style and poor socio-economic status. It is recommended that there be greater prioritisation of prevention activities that involve the control or management of kerosene heat sources, the provision of alternatives to flammable housing materials, and the implementation of strategies to reduce harmful drinking practices.
Highlights
Burns are a persisting public health problem in low- and middle-income countries; epidemiologic data for these settings is scarce
The current study investigated burn mortality data recorded by the National Injury Mortality Surveillance System (NIMSS)
Data sources Injury data The NIMSS produces and disseminates descriptive epidemiological information on deaths due to non-natural causes, which are subject to a medico-legal autopsy and which by law must be followed for all deaths known or suspected to have arisen from unnatural causes, irrespective of whether these are referred via the public or private health sector [7,13,14]
Summary
Burns are a persisting public health problem in low- and middle-income countries; epidemiologic data for these settings is scarce. BMC Public Health 2009, 9:374 http://www.biomedcentral.com/1471-2458/9/374 tion of the extent of global burn morbidity or hospitalizations across the lifespan, over half a million paediatric hospitalizations are estimated to occur each year [2]. In 2001, the rates of fire mortality in LMICs were 4 per 100 000 persons and 7 per 100 000 persons for males and females, respectively. Overall, these rates were around 9 times higher than for high-income countries (HICs) (4.53 compared to 0.51 per 100 000) [3]. Fire-related mortality rates are especially high in South East Asia (11.6 deaths per 100 000); and high in the Eastern Mediterranean (6.4 per 00 000) and Africa (6.1 per 100 000) [1,3]
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