Prevalance, Clinical Presentation and Outcome of Paediatric Patients with Burns Managed and Admitted at Kiryandongo District Hospital Uganda

ABSTRACT 

Back ground: Burn injuries are a global public health problem, accounting for an estimated 195 000 deaths annually. The majority of these occur in low- and middle-income countries and the rate of child deaths from burns is currently over seven times higher in low- and middle income countries than in high-income countries. Burn injuries are largely considered as being preventable. However, one needs to know the patterns, causes and outcomes of burn injuries if intervention measures are to be effective. 

Objective: the aim of this study was to determine the prevalence, clinical presentation and outcome of pediatric patients with burns managed and admitted at kiryandongo district hospital Uganda from January 2018 – March 2018. 

Methodology: This study was conducted at kiryandongo district hospital from January March 2018 by implementing a retrospective cross sectional study design. A total of 199 burn patients were recruited by simple random sampling method. Data was collected from patients’ medical record cards retrospectively. SPSS version 20 for widows was used for data entry and analysis. Descriptive statistics and logistic regression were used to analyze the data. 

Result: Burn accounted for 13.07% of patients who had visited KDH during the study period. Children less than 3 years of age had the highest proportion of patients (53.3%) and the median total body surface area (TBSA) burned was 11% with a range of 1-95%. The most frequent burn injuries were scalds, followed by flame burns, contact burns with hot solid object and chemical burns with 59.8%, 33.17%, 3% and 1% respectively. Most of the burns (53.77%) healed with no or minor sequel and 3.52% of patients died in the study period. Cause of burn has statistically significant association with death (P= 0.027). 

Conclusion and recommendation: The leading causes of burn are scalds which are preventable. Children should not be allowed in the kitchen and they should be kept in open safe paly areas or in their room with someone while their mothers are doing housework chores. The most effective way to prevent burns is public education. 

Key words/phrases: pediatric burn injuries, scald, partial thickness burn, full thickness burn, TBS x

TABLE OF CONTENTS

DECLARATION ........................................................................................................................i

APPROVAL ..............................................................................................................................ii

ACKNOWLEDGEMENT....................................................................................................... iii

LIST OF FIGURES ............................................................................................................... viii

LIST OF TABLES................................................................................................................. viii

OPERATIONAL DEFINITIONS.............................................................................................ix

LIST OF ABBREVIATIONS AND ACRONYMS ..................................................................x

ABSTRACT..............................................................................................................................xi

CHAPTER ONE........................................................................................................................1

1.0 INTRODUCTION ...............................................................................................................1

1.1 Historical Perspective ..........................................................................................................1

1.2 Theoretical Perspective........................................................................................................3

1.3 Conceptual Perspective........................................................................................................3

1.4 Contextual Perspective.........................................................................................................4

1.5 Problem Statement...............................................................................................................6

1.6 General Objective ................................................................................................................6

1.7 Specific Objectives ..............................................................................................................6

1.8 Research Questions..............................................................................................................7

1.9 Research Hypothesis........................................................................................................7

1.9.1 Null Hypothesis (Ho)........................................................................................................7

1.9.2 Alternative Hypothesis (Ha) .............................................................................................7

1.10 Significance of the Study...................................................................................................7

1.11 Conceptual Framework......................................................................................................7

1.12 Scope..................................................................................................................................9

CHAPTER TWO .....................................................................................................................10

2.0 LITERATURE REVIEW ..................................................................................................10

2.1 Risk Factors for Burn Injuries............................................................................................10

2.2 Epidemiology’s Of Burn Injuries.......................................................................................11

2.3 Impact of Burn Injuries......................................................................................................12

2.4 Preventive Strategies for Burn Injuries..............................................................................13

CHAPTER THREE .................................................................................................................15

3.0 STUDY DESIGN AND METHODOLOGY.....................................................................15

3.1 Study Design......................................................................................................................15

3.2 Study Site ...........................................................................................................................15

3.3 Source Population ..............................................................................................................15

3.4 Eligibility Criteria ..............................................................................................................16

3.4.1 Inclusion Criteria ............................................................................................................16

3.4.2 Exclusion Criteria ...........................................................................................................16

3.5 Measurement Variables .....................................................................................................16

3.5.1 Dependent Variables.......................................................................................................16

3.5.2 Independent Variables ....................................................................................................16

3.6 Sample Size and Sampling Procedure ...............................................................................16

3.6.1 Sample Size Determination.............................................................................................16

3.6.2 Sampling Procedure ........................................................................................................17

3.7 Data Collection ..................................................................................................................17

3.9 Data Entry and Analysis ....................................................................................................17

3.10 Quality Control ................................................................................................................17

3.11 Ethical Consideration.......................................................................................................17

CHAPTER FOUR....................................................................................................................19

4.0 RESULT ............................................................................................................................19

4.1 Age and Sex .......................................................................................................................19

4.2 Geographical Distribution and Residence .........................................................................20

4.3 Extent and Severity of Burn Injuries .................................................................................20

4.4 Causes of Burn Injuries......................................................................................................20

4.5 Anatomic Locations and Setting of Burn Injuries .............................................................21

4.6 Provision of Pre Hospital Care ..........................................................................................21

4.7 Length of Hospital Stay and Duration of Injuries before Presentation..............................22

4.8 Clinical Condition at Time of Presentation .......................................................................23

4.9 Outcome of Pediatric Burn Patients...................................................................................23

CHAPTER FIVE .....................................................................................................................25

5.0 DISCUSSION....................................................................................................................25

5.1 Introduction........................................................................................................................25

5.2 Socio-Demographic Characteristics...................................................................................25

5.3 Type of Burn......................................................................................................................26

5.4 Clinical Condition at Time of Presentation .......................................................................26

5.5 Seeking Medical Help........................................................................................................27

5.6 Duration of Hospital Stay ..................................................................................................27

5.7 Total Body Surface Area of Burns.....................................................................................28

5.8 Care Of Burns....................................................................................................................28

5.9 Limitation...........................................................................................................................29

5. 10 Conclusion ......................................................................................................................29

5.11 Recommendation .............................................................................................................30

REFERENCES ........................................................................................................................31

APPENDICES .........................................................................................................................33

Appendix 1: Information Sheet...............................................................................................33

Appendix 2: Hospital Consent Form .......................................................................................34

Appendix 3: Data Collection Sheet For Pediatric Patients In KGH ........................................35

Appendix 4: Work Plan ...........................................................................................................37

Appendix 5: Estimated Budget ................................................................................................38

Appendix 6: Introductory Letter..............................................................................................39

Appendix 7: Map of Kiryandongo District.............................................................................40

Appendix 8: Map of Uganda....................................................................................................41