Burns at KCMC: epidemiology, presentation, management and treatment outcome.

BACKGROUND: About 90% of the global burden of burns occurs in the low and middle income countries. In Africa it is estimated that between 17,000 and 30,000 children under five die each year due to burns. In Tanzania there are no specialized burn centers. Burn patients are often managed in the general surgical wards in most hospitals. Kilimanjaro Christian Medical Centre is one of the four tertiary referral hospitals in Tanzania. RATIONALE: This study aimed to review the epidemiology presentation management and outcome of burn patients in this challenging environment. PATIENTS AND METHODS: A cross-sectional prospective study involving 41 patients was undertaken from October 2011 to April 2012.
RESULTS: 65.9% were males. The largest age group was below 5 years (36.6%). 19.5% were epileptic. More than half of the burns were due to open flame. 80.5% had second degree burns. 56.1% had a BSA of 15% or less and 56.1% had an APACHE score of 10 or less. It was found that 73.2% of burns occurred at home. The commonest prehospital first aid applied was honey. Only 41.5% arrived in hospital within the first 24h after burn. Among the 14.6% who had skin grafting, none had early excision of burn wound. 53.7% developed wound sepsis while 24.4% developed contractures. The mortality rate was 26.8%.
CONCLUSION: Children under five are the worst affected by burns. Most patients had second degree burn wounds. Inappropriate management of the burn wound started just after injury and continued even in hospital. Mortality and complication rates are high.