Burn admissions across low- and middle- income countries: a repeated cross-sectional survey

Burn injuries have decreased markedly in high-income counties while the incidence of burns remains high in Low- and Middle- Income Countries (LMICs) where over 90% of burns are thought to occur. However, the cause of burns in LMIC is poorly documented. The aim was to document the causes of severe burns and the changes over time. A cross-sectional survey was completed for 2014 and 2019 in eight burn centres across Africa, Asia and Latin America: Cairo, Nairobi, Ibadan, Johannesburg, Dhaka, Kathmandu, Sao Paulo and Guadalajara. The information summarised included demographics of burn patients, location, cause and outcomes of burns. In total, 15,344 patients were admitted across all centres, 37% of burns were women and 36% of burns were children. Burns occurred mostly in household settings (43% to 79%). In Dhaka and Kathmandu, occupational burns were also common (32% and 43%, respectively). Hot liquid and flame burns were most common while electric burns were also common in Dhaka and Sao Paulo. The type of flame burns varies by centre and year, in Dhaka, 77% resulted from solid fuel in 2014 while 74% of burns resulted from Liquefied Petroleum Gas in 2019. In Nairobi, a large proportion (32%) of burns were intentional self-harm or assault. The average length of stay in hospitals decreased from 2014 to 2019. The percentage of deaths ranged from 5% to 24%. Our data provides important information on the causes of severe burns which can provide guidance in how to approach the development of burn injury prevention programs in LMIC.