The aetiology of adult burns in the Western Cape, South Africa.

Rural to urban migration to major cities in South Africa continues to lead to the proliferation of informal settlements. There is little recent published data on the epidemiology of adult burns in the Western Cape, South Africa. A retrospective review of patients on the Burn Unit database was undertaken, looking at patients admitted to the Burn Unit between January 2003 and December 2008. This study discusses the characteristics and outcome of patients who were treated at the Tygerburg Burn unit. A total of 1908 patients were admitted to the burn unit during the 6 year period under review. Most fatal injuries occurred in the 20-40 year age group. Injuries due to shack fires and fuel stoves comprised 21% (399) of all admissions. Mortality due to these injuries comprised 28% (137) of total mortality. Gas stoves accounted for 24% with kerosene stoves accounting for 71% of injuries. The burn death rate in this study (25%) was found to have increased dramatically from the last audit done from 1986 to 1995 in which a burn death rate of 7.5% was observed. Reasons for this are explored. It is likely that those with HIV/AIDS have poorer outcomes. Shack fires and injuries due to fuel stoves are a common reason for admission to the burn unit and mostly involve young male individuals. Other research from the Southern African region does not mention shack fires as a separate entity making it difficult to obtain an accurate idea of the scale of the problem. Their injuries are severe with a high mortality. The use of kerosene stoves are a major contributing factor. Recommendations include enforceable legislation to promote safer stove design, research into safer bio fuels and materials for building shacks as well promoting fire safety among schoolchildren in the community. Further research is needed to determine the impact of HIV/AIDS on the outcome of acute burns within the Southern African region.