59 Annual Incidence of Childhood Burn Injuries and Prevalence of Household Risk Factors in Rural Ghana: A Population-based Cluster-randomized Survey

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S39-S39
Author(s):  
Kajal Mehta ◽  
Adam Gyedu ◽  
Charles Mock ◽  
Barclay T Stewart
Keyword(s):  
Risk Factors ◽  
Burn Injury ◽  
Household Survey ◽  
Female Gender ◽  
Population Based ◽  
Annual Incidence ◽  
Burn Injuries ◽  
Middle Income ◽  
Rural Ghana ◽  
Cluster Randomized

Abstract Introduction Childhood burns are a leading cause of injury in low- and middle-income countries. Many childhood burns can be prevented by modifications in the household environment and targeted education. Therefore, we aimed to determine the incidence of childhood burn injuries and describe the prevalence of potentially modifiable household risk factors. Methods We performed a population-based, cluster-randomized, household survey of 358 households in a rural district in Ghana. From the district, 6 of 11 community clusters were randomly selected. Within these clusters, a census of all households with a caregiver of at least one child < 5 years of age was conducted. Caregivers were interviewed regarding childhood burn injury (CBI) within the past 6 months and potentially modifiable household risk factors. Results Of the 358 households sampled, most households lived in completed structures they owned (67%, 95% CI 61.9–71.6%). The adjusted annual incidence of childhood burn injury was 7.9%. The median age of burn injury was 3 years. The most common etiology of CBI was flame burn (53%, 95% CI 36.8–67.7%). Increasing year of age (AOR 0.92, 95% CI 0.84–1.01) and households with an older sibling ³12 years (AOR 0.53, 95% CI 0.24–1.17) were weakly associated with lower odds of CBI. The majority of households (84%, 95% CI 80.5–88%) used an open fire with firewood as fuel arrangement for cooking. In most households there was not a separate room used as a kitchen (90%, 95% CI 86–92.4%) and the stove/cooking arrangement height was within reach of children under five (< 1 meter; 96%, 95% CI 94.6–97%). Female gender (AOR 1.37, 95% CI 0.71–2.64), outdoor cooking arrangement (AOR 1.05, 95% CI 0.42–2.62) and an increased number of children under caregiver supervision (≥5 children; AOR 1.32, 95%CI 0.42–2.62) were not predictive of CBI. Conclusions Burns are a common cause of childhood injury in rural Ghana. There may be opportunities to reduce the risk of burn injuries in rural settings by supporting the transition to safer cooking arrangements, child barrier apparatuses (e.g. playpens that separate children from cooking arrangements), and/or health promotion initiatives. Given the high incidence of childhood burn injuries, strategic burn-related healthcare capacity development is also required to limit preventable death and disability. Applicability of Research to Practice These findings, which differ somewhat from similar studies in other LMIC communities, suggest that there is not a one-size-fits-all solution for the prevention of childhood burn injuries. Community-specific and contextually relevant interventions that aim to prevent childhood burn injuries can be identified by results from population-based surveys of injury epidemiology and potentially modifiable risk factors.

scholarly journals Epidemiology of Scars and Their Consequences: Burn Scars

2020 ◽  
pp. 37-43
Author(s):  
Margriet E. van Baar
Keyword(s):  
Risk Factors ◽  
Burn Injury ◽  
Healing Process ◽  
Total Body Surface Area ◽  
Female Gender ◽  
Burn Injuries ◽  
Post Injury ◽  
The People ◽  
Total Body ◽  
Burn Depth

AbstractPathological scarring in burn wounds can result in hypertrophic scars and/or contractures. Prevalences of hypertrophic scarring after burn injuries between 8% and 67% are reported. A recent prospective study revealed a prevalence of 8%. Data on prevalence of burn scar contractures are limited; reported prevalence at discharge varied between 38 and 54% and decreased with an increasing time post burn. About 5–20% of the people who suffered from burn injuries received reconstructive surgery after burns, up to 10 years post injury.Factors predicting pathological scar formation after burn injuries include patient, injury and treatment characteristics. Injury- and treatment-related characteristics are the main predictors of scar outcomes after burn injury. These characteristics are related to burn size (total body surface area burned) and burn depth (number or type of surgery) or the overall healing process in general (length of stay, wound healing complications). Intrinsic patient-related risk factors seem to play a role as well but are less consistent predictors of scar outcome. This includes the risk factors like the female gender and also a younger age and darker skin.Knowledge on risk factors for poor scar outcome can be used to tailor treatment, aftercare and scar prevention to these patients with a high-risk profile.

74 Epidemiology and Outcomes of Cooking and Cookstove-related Burn Injuries: A World Health Organization (WHO) Global Burn Registry (GBR) Report

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S51-S52
Author(s):  
Kajal Mehta ◽  
Nikitha Thrikutam ◽  
Kiran K Nakarmi ◽  
Paa Ekow Hoyte-Williams ◽  
Michael Peck ◽  
...  
Keyword(s):  
Risk Factors ◽  
World Health Organization ◽  
Total Body Surface Area ◽  
Burn Injuries ◽  
World Health ◽  
Common Mechanism ◽  
Structural Factors ◽  
Middle Income ◽  
Improved Cookstove ◽  
Health Organization

Abstract Introduction Cooking- and cookstove-related burns (CSBs) comprise a large proportion of burn injuries globally. A cookstove is any apparatus that provides heat and is used for cooking (e.g., three-stone fire, traditional or improved cookstove). There are limited data on patterns of cooking behaviors and CSBs to inform prevention initiatives and advocacy. We aimed to describe the epidemiology, risk factors and outcomes of cooking-related burns and CSBs, specifically. Methods Patients with cooking and non-cooking related burns from 2018 to 2020 were identified in the World Health Organization (WHO) Global Burn Registry (GBR). Patient demographics, cooking arrangement, injury characteristics [mechanism, total body surface area (TBSA), revised Baux score] and outcomes were described. Differences in proportions and medians were compared. Bivariate regression was performed to identify risk factors associated with occurrence of CSB. Results GBR contained data of 6,965 burn-injured patients from 17 countries; 88% were from middle-income countries. One quarter of burn injuries (1,723 burns) were cooking-related. More than half of cooking-related burns (55%) occurred in females. Median age for cooking-related burns was 11 years (IQR 2–35). Of cooking-related burns, 22% were cookstove-related burns (CSBs; 311 burns). The most common mechanism in CSB was flame (87%), whereas the most common mechanism in other cooking burns was scald (62%). Patients with CSBs were more often female (65% vs 53%; p< 0.001) and much older than patients with other cooking burns (32 years, IQR 22–47 vs 5 years, IQR 2–30). CSBs were significantly larger in TBSA size (30%, IQR 15–45% vs 15%, IQR 10–25%; p< 0.001), had higher revised Baux scores (70, IQR 46–95 vs 28, IQR 10–25; p< 0.001) and more often resulted in death (41 vs 11%; p< 0.001) than other cooking burns (Table1). Patients with CSBs were more likely to be burned by fires (OR 4.74; 95% CI 2.99–7.54) and explosions (OR 2.91, 95% CI 2.03–4.18) than other cooking injuries. Kerosene had the highest odds of CSB than all other cooking fuels (OR 2.37, 95% CI 1.52–3.69). Conclusions Cooking-related burns are common and have different epidemiology than CSBs, specifically (e.g., more often female, older, larger burn size, higher mortality). CSBs were more likely caused by structural factors (e.g., explosion, fire) than behavioral factors (e.g., accidental movements) when compared to other cooking burns.

scholarly journals The case for case–control studies in the field of suicide prevention

2019 ◽  
Vol 29 ◽  
Author(s):  
Jane Pirkis ◽  
Angela Nicholas ◽  
David Gunnell
Keyword(s):  
Risk Factors ◽  
Stressful Life Events ◽  
Suicide Attempts ◽  
Hospital Admissions ◽  
Population Based ◽  
Case Control ◽  
Psychological Autopsy ◽  
Case Control Studies ◽  
Middle Income ◽  
Risk Factors For Suicide

Abstract Much of our knowledge about the risk factors for suicide comes from case–control studies that either use a psychological autopsy approach or are nested within large register-based cohort studies. We would argue that case–control studies are appropriate in the context of a rare outcome like suicide, but there are issues with using this design. Some of these issues are common in psychological autopsy studies and relate to the selection of controls (e.g. selection bias caused by the use of controls who have died by other causes, rather than live controls) and the reliance on interviewing informants (e.g. recall bias caused by the loved ones of cases having thought about the events leading up to the suicide in considerable detail). Register-based studies can overcome some of these problems because they draw upon contain information that is routinely collected for administrative purposes and gathered in the same way for cases and controls. However, they face issues that mean that psychological autopsy studies will still sometimes be the study design of choice for investigating risk factors for suicide. Some countries, particularly low and middle income countries, don't have sophisticated population-based registers. Even where they do exist, there will be variable of interest that are not captured by them (e.g. acute stressful life events that may immediately precede a suicide death), or not captured in a comprehensive way (e.g. suicide attempts and mental illness that do not result in hospital admissions). Future studies of risk factors should be designed to progress knowledge in the field and overcome the problems with the existing studies, particularly those using a case–control design. The priority should be pinning down the risk factors that are amenable to modification or mitigation through interventions that can successfully be rolled out at scale.

Purulent septic infections in patients with severe burn injuries. Etiology, prevalence, and risk factors

2020 ◽  
Vol 18 (3) ◽  
pp. 98-103
Author(s):  
Yu.Yu. Kutlaeva ◽  
◽  
A.A. Golubkova ◽  
V.A. Bagin ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Burn Injury ◽  
Venous Catheter ◽  
Severity Index ◽  
Burn Injuries ◽  
Burn Wound ◽  
Open Flame ◽  
Burn Center ◽  
Increased Risk ◽  
Epidemiological Characteristics

Objective. To assess epidemiological characteristics of purulent septic infections (PSIs) in the intensive care unit (ICU) of a burn center. Patients and methods. In this retrospective epidemiological study, we analyzed medical records of 399 patients with burn injuries and the results of laboratory testing (2,572 samples). The majority of ICU patients were men aged 30–39 years. Almost half of the patients were workers. Burns were primarily caused by an open flame and were mainly received at home. Of note, 45.4% of patients who had burns caused by an open flame also had respiratory tract lesions. More than half of the patients had deep burns. A total of 18.6% of patients (95% CI 14.8–22.7) died. Results. The incidence of PSIs in the ICU of the burn center was 533,8‰ (95% CI 483.5–583.6), which is 2.5 times higher than that in the official statistics (210,1‰ (95% CI 182.5–239.9)). More than half of PSIs (50.2% (95% CI 43.3–57.1)) were burn wound infections. Conclusion. The following factors were found to be associated with an increased risk of PSIs: burn area >40%, burn severity index >30, SOFA score >4, deep burns, surgery, stay in the ICU for >10 days, artificial ventilation for >1 day, and placement of a central venous catheter or an urinary catheter for >1 day. Most frequently, PSIs were caused by non-fermenting gram-negative bacteria such as Pseudomonas аeruginosa and Acinetobacter baumannii. Key words: burn injury, purulent septic infections, risk factors, infection control

Epidemiologic study of risk factors for meningioma in the Mayo Clinic Study of Aging.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 2067-2067
Author(s):  
Alissa Butts ◽  
Jeremy A. Syrjanen ◽  
Jeremiah Aakre ◽  
Paul D. Brown ◽  
Clifford R. Jack ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mayo Clinic ◽  
Large Population ◽  
Epidemiologic Study ◽  
Significant Risk ◽  
Female Gender ◽  
Population Based ◽  
Continuous Variable ◽  
Health Study ◽  
Clinic Study

2067 Background: An estimated 2% of the general population has a meningioma (Vernooij et al. 2007), which accounts for about 36% of all primary intracranial tumors (Ostrom et al. 2015). The most established risk factors are older age and female gender. One small study identified gender but no other risk factors with meningioma (Krampla et al 2004). A larger study using the Iowa Women’s Health study data found lower levels of physical activity, greater body mass index (BMI), greater height and uterine fibroids were associated with meningioma (Johnson et al. 2011). We sought to replicate these findings and to identify additional risk factors related to meningioma in a large population-based sample. Methods: Study participants were enrolled in the Mayo Clinic Study of Aging (MCSA), a population-based sample of Olmsted County, Minnesota residents used to study prevalence, incidence, and risk-factors for Mild Cognitive Impairment and dementia and includes a variety of medical factors. Using a text search of radiologists’ notes of 2,402 MCSA individuals, mean age 77±8 years and scanned between 2004-2014.We identified 52 subjects who had at least one meningioma. We estimated the association of selected potential risk factors with presence of meningioma using odds ratios and 95% confidence intervals from logistic regression models adjusted for age and gender, which informed the multivariable models. Results: In the initial models, significant risk factors identified included BMI (as a continuous variable) (OR = 1.06 95%CI 1.01 to 1.12), taking NSAIDS (OR = 2.11, 95%CI 1.13 to 3.95), aspirin (OR = 1.90, 95%CI 1.04 to 3.46), and blood pressure lowering medication (OR = 2.06, 95%CI 1.07 to 3.99). Protective factors included male gender (OR = 0.51, 95%CI 0.29 to 0.90), coronary artery disease (CAD; OR = 0.46, 95%CI 0.22 to 0.97) and higher Beck Anxiety Inventory (BAI) total score (OR = 0.88, 95%CI 0.78 to 0.98). Simultaneous adjustment for these factors in a multivariable model did not attenuate these associations. Conclusions: Findings reveal gender and BMI as risk factors for meningioma. Additionally, certain medications such as NSAIDS and BP lowering medications warrant follow up as potential factors related to development of meningioma.

scholarly journals The Prevalence and Risk Factors of Gallstone among Adults in Karachi, South Pakistan: A Population-Based Study

2016 ◽  
Vol 9 (4) ◽  
pp. 106
Author(s):  
Muhammad Bilal ◽  
Abdul Haseeb ◽  
Muhammad Saad ◽  
Muhammad Ahsan ◽  
Madiha Raza ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Gallstone Disease ◽  
Physiological Mechanism ◽  
Female Gender ◽  
Population Based ◽  
Daily Physical Activity ◽  
Logistic Regression Models ◽  
Married Individuals ◽  
Study Participants

<p><strong>INTRODUCTION: </strong>The present study was aimed to determine the prevalence and risk factors of GSD among a sample of general population in Karachi, South Pakistan.</p><p><strong>METHODOLOGY: </strong>A multistage random sampling method was employed on 30 clusters, where 60 subjects of age&gt;=25 years were randomly recruited from the study population from June 2013 till March 2015. Finally, data was analyzed and logistic regression models were used to find the correlation between selected variables and gallstone disease.</p><p><strong>RESULTS: </strong>It was found that 184 patients had echogenic mass with shadowing on ultrasonography; yielding a prevalence of 10.2% for gallstones in the study participants. The occurrence was higher in females (14.8%) than in male participants (5.7%). Further, participants over 40 years of age and single, widow/separated subjects had higher incidence of gallstones than married individuals. Moreover, an indirect correlation was obtained with daily physical activity, consumption of fruits, vegetables and fish with development of GD.</p><p><strong>CONCLUSION: </strong>It can be evaluated that daily physical activity, female gender, increasing age and marital status play an important role in progression of GSD. Understanding pathogenesis and physiological mechanism involved in GSD can help to determine therapeutic options other than surgical treatment.</p>

scholarly journals Improvement of Abandonment of Therapy in Pediatric Patients with Cancer in Guatemala

2016 ◽  
Vol 2 (3_suppl) ◽  
pp. 76s-76s ◽  
Author(s):  
Elysia Alvarez ◽  
Midori Seppa ◽  
Kevin Messacar ◽  
John Kurap ◽  
E. Alejandro Sweet-Cordero ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psychosocial Intervention ◽  
Intervention Program ◽  
Proportional Hazards ◽  
Conflicts Of Interest ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Middle Income ◽  
Targeted Interventions ◽  
Increased Risk

Abstract 59 Background: Abandonment of therapy is a major cause of therapeutic failure in the treatment of childhood cancer in Low and Middle Income Countries (LMIC). This study examines factors associated with increased risk of therapy abandonment in Guatemalan children with cancer and the rates of therapy abandonment before and after implementation of a multidisciplinary psychosocial intervention program. Methods: A retrospective population-based study was performed to identify risk factors for abandonment of therapy in Guatemalan children, ages 0-18, with cancer who were seen at UNOP from 2001-2008. Patient data was collected from the Pediatric Oncology Networked Database (POND4Kids). Abandonment was defined as a lapse of 4 weeks in planned treatment or failure to begin treatment for a potentially curable cancer. Cox proportional hazards analysis identified the effect of age, sex, year of diagnosis, distance travelled to UNOP, ethnicity, and principal diagnosis on abandonment of therapy. Kaplan Meier analysis was used to evaluate survival. Results: A retrospective analysis of 1,789 charts was performed and 367 patients abandoned therapy. The rate of abandonment decreased from 27% in 2001 to 7% in 2008 following a multidisciplinary psychosocial intervention program. Greater distance to UNOP (p = 0.00), younger age (p = 0.02) and earlier year of diagnosis (p = 0.00) were associated with increased risk of abandonment. Abandonment of therapy correlated with decreased survival. The cumulative survival at 8.3 years was 0.57 ± 0.02 (survival±SE) for those who completed therapy vs 0.06 ± 0.02 for those who abandoned and refused therapy (p=0.000) in an abandonment sensitive analysis. Conclusion: This study identified distance, age, and year of diagnosis as risk factors for abandonment of therapy for pediatric cancer in Guatemala. This study highlights risk factors for abandonment of therapy and the role of targeted interventions in altering rates of abandonment that could be replicated in other LMIC countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

scholarly journals Gridded Population Survey Sampling: A Review of the Field and Strategic Research Agenda

2020 ◽  
Author(s):  
Dana R. Thomson ◽  
Dale A. Rhoda ◽  
Andrew J. Tatem ◽  
Marcia C. Castro
Keyword(s):  
Population Survey ◽  
Household Survey ◽  
R Package ◽  
Population Based ◽  
Survey Sampling ◽  
Population Estimates ◽  
Population Surveys ◽  
Middle Income ◽  
Middle Income Countries ◽  
Household Survey Data

Objective: In low- and middle-income countries (LMICs), household survey data are a main source of information for planning, evaluation, and decision-making. Standard surveys are based on censuses, however, for many LMICs it has been more than ten years since their last census and they face high urban growth rates. Over the last decade, survey designers have begun to use modelled gridded population estimates as sample frames. We summarize the state of the emerging field of gridded population survey sampling, focussing on LMICs. Methods: We performed a systematic review and identified 43 national and sub-national gridded population-based household surveys implemented across 29 LMICs. Findings: Gridded population surveys used automated and manual approaches to derive clusters from WorldPop and LandScan gridded population estimates. After sampling, many surveys interviewed all households in each cluster or segment, though some sampled households from larger clusters. Tools to select gridded population survey clusters include the GridSample R package, Geo-sampling tool, and GridSample.org. In the field, gridded population surveys generally relied on geographically accurate maps based on satellite imagery or OpenStreetMap, and a tablet or GPS technology for navigation. Conclusions: For gridded population survey sampling to be adopted more widely, several strategic questions need answering regarding cell-level accuracy and uncertainty of gridded population estimates, the methods used to group/split cells into sample frame units, design effects of new sample designs, and feasibility of tools and methods to implement surveys across diverse settings.

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