Burns among adults in a major Malawian burn unit: epidemiology and factors associated with prolonged hospital stay

Malawi Med J. 2023 Sep;35(3):132-140. doi: 10.4314/mmj.v35i3.1.

Abstract

Aim: This study sought to describe the epidemiology of burns and factors associated with prolonged hospital stay among adult patients admitted in the Queen Elizabeth Central Hospital burns unit.

Methods: All files of patients aged at least 17 years and admitted in the Queen Elizabeth Central Hospital burns unit between 1 June 2007 and 31 May 2017 with acute burns, were reviewed. Data on socio-demographic characteristics, injuries sustained, comorbidities, length of hospital stay, and clinical outcomes were extracted from the files. Summary statistics, independent sample T-test, and odds ratios were computed to determine the distribution and associations of the variables collected.

Results: A total of 515 patient files, all from rural or informal urban settlements, were reviewed. The median age at the time of presentation was 32 years (IQR: 25-45), and 52% (n=279) were male. Most of the burns occurred at home (81.0%; n=379), were of flame etiology (75.7%; n=385), and were reported to have been accidental (94.7%, n=445). The mean monthly rate of new burn injury patients was highest in the cool-dry season, and epileptic seizures were a common precedent of burn injury (30.7%; n=158). Most (62.7%) of the patients with recorded burn sites sustained multiple burns injuries, and more than half of the patients had upper and lower limb burns (64.6% & 59.5% respectively). Thirty patients sustained additional non-burn injuries, and 26.4% (n=132) of all patients with recorded outcomes died in the hospital.

Conclusion: The data on burn injuries among adults presenting at the QECH burns unit suggests the existence of socio-economic inequalities associated with burn incidence. There is also a need for improvement in the quality and uptake of epilepsy care in primary care facilities.

Keywords: Adult; Biomass; Burns; Comorbidity; Epidemiology; Epilepsy; Malawi; Southern Africa.

MeSH terms

  • Adult
  • Burn Units*
  • Comorbidity
  • Female
  • Hospitalization*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors