Burn mortality: recent trends and sociocultural determinants in rural India.

In 1998, India was the only country in the world where fire (burns) was classified among the 15 leading causes of death. High mortality in young married women from burns has already become an alarming and contentious medical problem in rural India. The incidences of burn mortality by age, sex, residence, marital status; manner and reasons have been reported only infrequently from the rural parts of India. From a total of 4042 medicolegal deaths reported at an Apex medical centre of a rural health district, over a period of 5 years 1997-2001, 942 deaths (23.3%) were due to burns; with mortality rate of 15.1 per year per 100,000 population. Of all burn death cases, 80.8% were females, 82.4% married ones, 71.9% belonged to the young age group of 21-40 years and 75.0% came from the rural parts of the district. Out of all burn deaths, 50.7% were accidental, 47.8% suicidal and 1.5% were homicidal in manner. In all female suicides, burns was the commonest method adopted by over 60% females. Torture by in-laws (32.1%) was the commonest reason for committing suicide by burns in married women. The present study has tried to identify the high-risk group and reasons for high burn mortality in this rural area. Religious and sociocultural reasons prevalent in the area are discussed, which play the determinant role in such a high mortality rate in burns in rural India. Further studies in India into psychodynamics of sociocultural, religious and family life are advised.