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Epidemiology of burns in South- Asian countries Syed Moniruzzaman, PhD Centre For Public Safety 2017-08-22

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  • Epidemiology of burns in South-Asian countries

    Syed Moniruzzaman, PhDCentre For Public Safety

    2017-08-22

  • References

    • He, S., Alonge, O., Agrawal, P., Sharmin, S., Islam, I., Mashreky, S. R., & Arifeen, S. E. (2017). Epidemiology of burns in rural Bangladesh: An update. International journal of environmental research and public health, 14(4), 381.

    • Mashreky, S. R., Rahman, A., Svanström, L., Khan, T. F., & Rahman, F. (2011). Burn mortality in Bangladesh: findings of national health and injury survey. Injury, 42(5), 507-510.

    • Sanghavi, P., Bhalla, K., & Das, V. (2009). Fire-related deaths in India in 2001: a retrospective analysis of data. The Lancet, 373(9671), 1282-1288.

    • Farooq, U., Nasrullah, M., Bhatti, J. A., Majeed, M., Hanif, M., Khan, J. S., & Khan, M. M. (2011). Incidence of burns and factors associated with their hospitalisation in Rawalpindi, Pakistan. Burns, 37(3), 535-540.

    • Laloe, V. (2002). Epidemiology and mortality of burns in a general hospital of Eastern Sri Lanka. Burns, 28(8), 778-781.

    • Mashreky, S. R., Rahman, A., Chowdhury, S. M., Giashuddin, S., Svanström, L., Linnan, M., ... & Rahman, F. (2008). Epidemiology of childhood burn: yield of largest community based injury survey in Bangladesh. Burns, 34(6), 856-862.

  • o Burn is a significant burden of illness in the region

    http://www.google.se/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&ved=0ahUKEwjspfeA197VAhXCO5oKHdjJAQIQjRwIBw&url=http://www.thefinancialexpress-bd.com/index.php?ref%3DMjBfMDFfMjhfMTNfMV8xXzE1ODMxNw%3D%3D&psig=AFQjCNGhnbjHRRqDbPxAJT1gHilxwsvAIA&ust=1503073420653548

  • Epidemiologic transition in developing countries

    4

    0

    20

    40

    60

    80

    100

    0

    10

    20

    30

    40

    50

    83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 0

    % o

    f all

    deat

    hs

    Mor

    talit

    y/1,

    000

    All cause mortality Drowning mortality

    % drowning deaths

    Drowning Deaths in 1- 4 year olds, Matlab 1983- 2000

    Chart4

    838383

    848484

    858585

    868686

    878787

    888888

    898989

    909090

    919191

    929292

    939393

    949494

    959595

    969696

    979797

    989898

    999999

    000

    All cause mortality

    Drowning mortality

    % drowning deaths

    Mortality/1,000

    % of all deaths

    28.5

    3

    10

    33

    2.9

    9

    20.5

    3.1

    12

    28

    2.9

    10

    13

    3

    18

    8

    3.1

    28

    9

    2.5

    27

    9.5

    2.4

    25

    5

    2.4

    24

    8

    2

    18

    8

    2.3

    21

    7.5

    2

    18

    6

    2.4

    30

    7

    2.5

    31

    6.75

    2.3

    24

    6.5

    2.4

    33

    6.25

    2.5

    39

    6

    2.5

    54

    Drowning

    83848586878889909192939495969798990

    All cause mortality28.53320.52813899.55887.5676.756.56.256

    Drowning mortality32.93.12.933.12.52.42.422.322.42.52.32.42.52.5

    % drowning deaths10912101828272524182118303124333954

    Drowning

    &A

    Page &P

    All cause mortality

    Drowning mortality

    % drowning deaths

    Mortality/1,000

    % of all deaths

    Drowning deaths in 1- 4 year olds, Matlab 1983- 2000

    Seasonality

    JanFebMarAprMayJunJulAugSepOctNovDec

    122850708269866783603828

    Seasonality

    Seasonality of drowning at Matlab 1983-95

    Trends

    80-8483-8786-9089-9392-9695-99

    1008850383631

    685832242220

    Trends

    Matlab-nonICDDR,B

    Matlab-ICDDR,B

    Trends in 1-4 age deaths/1,000LB

    Agerates

    12-2324-3536-4748-59

    51.510.8

    Agerates

    Age in months

    Mortality rate/1,000

    Drowning death rates/1,000 by age in months

    bdhs

    IMRtrend

    19661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000

    110125122130135148125122138178140117

    118118921001059911787828080777880816462526250514243

    IMRtrend

    PreMatlab

    PostMatlab

    Infant Mortality Rate

    Trends in infant mortality, Matlab

    vitalrates

    198919901991199219931994199519961997199819992000

    838299858276656664605251

    11510812811511299939286807470

    vitalrates

    U5MRtrend

    197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000

    Others13018060657070606555767560456560606565656261555050454038

    Drowning101581088898791088101081089910109101112

    Measles020250810810881510600000000000000

    Tetanus3550303560506555504030402575430000000000

    ARI203020121220142527152412252025202125222525252520151514

    Dia+Dys406535254225252338497542413838202524232020191817151615

    U5MRtrend

    Others

    Drowning

    Measles

    Tetanus

    ARI

    Dia+Dys

    Causes

    OthersDia+DysNutritionARIDrowning

    54461530

    8207857

    Causes

  • 0 5 10 15 20 25

    Sri Lanka

    Afghanistan

    Nepal

    India

    Pakistan

    Bangladesh

    Bhutan

    Age-std death rates/100,000

    Fire injuries by sex

    Females

    Males

    WHO, 2008

  • Burn injuries (non-fatal) in rural Bangladesh

    He, el.al. 2017

    Household survey

    Rates 528/100, 000

    Females 71%Males 29%

    Flames 25%Others 75%

    Kitchen 71%Bedroom 4%

    Rural

  • Fatal burns in Bangladesh

    Mashreky et. al., 2011

    Household survey

    Rates 2.2/100 000

    Females 78%Males 22%

    Flames 89%Others 11%

    Kitchen 71%Bedroom 4%

  • Fire related mortality, India

    Medical registration and verbal autopsy

    2% of all deaths

    Females 65%Males 35%

    Urban 41%Rural 59%Sanghavi, Bhalla, & Das, 2009

  • Why it occurs?

  • Busy mother

  • Why it occurs?

    Kupi Bati

    PresentatörPresentationsanteckningarChildren are more than three vulnerable in families using Kupi Bati

    http://www.google.se/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiLv_K7rNnVAhXjB5oKHS6ZBmcQjRwIBw&url=http://www.hardrainproject.com/hrpl?n%3D5307&psig=AFQjCNHNGCF5TMCBPqgLpDLQAQd9w8vjDQ&ust=1502890204027602

  • 12

    - First AidLack of Life Skills

    Why it occurs ?

    Health system is not well equipped

    Care seeking from unskilled providers

  • Home safety program

    PresentatörPresentationsanteckningarModifications in a kitchen setup, use of safe cook-stoves and heating sources, complete barricading of the cooking area to prevent contact with children and burn injury prevention educational programs for women are some relevant interventions that may be implemented in rural Bangladesh with involvement from communities to reduce burn related accidents and deaths and thereby reduce the loss of subsequent school and work hoursAge-targeted interventions, awareness of first aid protocols, and improvement of acute care management would also be potential leads to curb death and disability due to burn injuries.

  • 14

    Institutional supervision, most vulnerable time for injury, most vulnerable age groups

    Children 1-5 year olds 20-25 children Live within 60-70 households cluster

    Anchal Ma Woman from the community Age 18-35 years old Secondary level education Assisted by one assistant

    Institutional supervision

    PresentatörPresentationsanteckningarInstitutional supervision (Anchal)

  • 15

    Communication Activities

  • 16

    Community Participation

    UIPC

    UCC

    • Supervise prevention activities• Support and promote program activities• Motivate people to be involved in the program

    VIPC

    PresentatörPresentationsanteckningarThere are Injury Prevention Committees as village and union level. The committees meet on a regular basis and guide and support the project activities.

  • Epidemiological data remain incomple

    Epidemiology of burns in South-Asian countriesReferencesBildnummer 3Epidemiologic transition in developing countriesBildnummer 5Burn injuries (non-fatal) in rural BangladeshFatal burns in BangladeshFire related mortality, IndiaWhy it occurs?Busy motherWhy it occurs?Bildnummer 12Home safety program����������Bildnummer 15Bildnummer 16Epidemiological data remain incomple


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