Childhood Thermal Injuries At Kenyatta National Hospital. A Socio-economic And Aetiological Study Over A Two Year Period.

Abstract

Burns (Thermal) injury is a common cause of admission to the hospital. All age groups are affected. Majority of thermal injuries do occur in chl1dre. below fifteen years of age. The symptoms of thermal injuries are obvious. The physical signs and diagnosis are made by seeing the patient. There is little confusion between burns injuries and other diseases. Thermal injuries are taken for grated by all those who manage these patients. The patients are usually admitted, treated and discharged home and no more is thought about the root cause of this disease. few people realise the long term effects of thermal injuries to those affected. Ia our set up we rarely follow up those patients to be able to evaluate their disabilities arising from the burn's injuries. With this in mind I therefore undertook this study to prove; (1) that for every child admitted to hospital with a thermal injury, there .a~ be social factors beh1ad his accident. (ii) that economic factors are involved in the causation of burns injuries. (iii) that thermal injuries are largely preventable. In my two year prospective study I analysed various social circumstances that surround these patients. I also analysed the causative factors of these accidents 1a detail. The study was carried on two hundred and eighty-four children admitted to the Burns Unit at Kenyatta National Hospital. All the patients analysed were between one year and fifteen year of age.

60.2% of the patients were males and 39.8% were females. 96% of all the patient8 reported to hospital within twenty-four hours from the time of injury. The remaining four per cent were delayed, because of difficulty in transport, or because they went to another hospital or health unit but later were transferred to Kenyatta National Hospital. The study has shown the various causes of burns and has revealed that certain age groups of children have a higher risk than the rest of the population. The study has highlighted the areas in the house and in the community where thermal injuries are likely to occur. It i8 8hown that males tend to be more prone to injury as compared to the females, the ratio of 2 I 1. Toddlers are likely to get scalds in the kitchen or dining hall, while the other age groups receive flame burns outside the house. Thermal injuries are more common in the large and congested family units. The study has a180 8hown clearly that m08t children receive burn8 at the time when there is no responsible adult pre8ent. This is relevant to our society because most children are left at home under the care of other children. The nature of work of the mother does influence the incidence of thermal injuries. 68.6% of all the mothers who~children were burnt were full-time employed. The study has revealed clearly that thermal injuries are very prevalent in low income earners and the unemployed. 7 of all the children burnt came from this group. Thermal injuries are a public risk, there is a need for a National prevention programme for thermal injuries. Education of the whole population and legislation to protect fire heaters and other place8 would be a big step in reducing the mortality and mobidity of this