Epidemiological Study of Burn Injuries in a Slum Community of Delhi

Burns are one of the top five causes of fatal injuries to people under the age of 19 years. Burns are also a significant cause of mortality and morbidity among infants and children because they are dependent on their mother/caretaker and they are unable to recognize hazardous situations leading to burns. The aged population aalso remains at higher risk for burn injury due to several pre-disposing factors associated with increased age such as reduced reaction time, poorer dexterity, decreased mobility, inaccurate assessment of risks, impaired senses and higher incidence of pre-morbid conditions such as chronic debilitating diseases, alcoholism, effect of medication, senility, and neurological and psychological disorders. In developing countries, the problem of burn injuries is more severe due to the reason that the care of burn patients requires specialized staff and medical technologies that are expensive and not always readily available. Moreover, in the big cities of these countries like Delhi there are numerous slums where majority of the housing units are made up of thatch and plastic material posing people at special risk of burn injury due to frequent exposure to fire especially during household activities. During the year 2001-2002, the Delhi Fire Services attended 13685 calls out of which 126 were from such colonies. The consequences of burn injuries can be prevented through early therapeutic interventions whereas occurrence of burn injuries may be prevented by the measures focused on prevention of exposure to fire. To develop an effective preventive programme, the epidemiology of burn injuries is to be clearly understood. Therefore, the present study was carried out to find out epidemiological details of patients exposed to burn injury and prevailing treatment practices regarding burn care in the community. Community based cross-sectional survey was carried out in a slum named Balmiki Basti from September 2003 to December 2003. This slum, situated near the Maulana Azad Medical College, New Delhi, accommodated 1597 people belonging to 400 families. All the families were covered in this study. One adult person from each family was interviewed after taking informed consent, The informant was asked about burn injuries among all family members in the past one year. A semi-structured pre-tested schedule containing openended as well as close-ended questions was administered. Information was collected regarding socio-demographic characteristics, place of burn, cause of burn, number of times the patient had been burnt, his/her body part(s) affected and the treatment sought by the injured person. Data was analyzed using Epi-info version 6.04. Chi-square test and Fischer's exact tests were used wherever applicable for finding out significant differences between comparable groups. A 'p' value less than 0.05 was considered significant. The overall prevalence of burn injury in the present study was found to be 14.2%. Females were pre-dominantly affected in all age groups except 0-5 years. A bimodal distribution of burn injuries with the peak incidence being in children less than 5 years and people aged 26- 35 years was observed. Literacy did not seem to have any influence on occurrence of burn injuries in the present study subjects. Most of the burn injuries in the present study occurred at home. The frequent exposure of females to burn injuries at home could be due to their involvement in cooking and other activities related to care of family members involving heat such as boiling of water, ironing of clothes etc. Burn injuries were received more than once in 28% of the victims in the present study could be due to failure to change their behaviour even after the first exposure. The most commonly affected body part in the present study was upper limb. Among the causative agents responsible for burns in the present study were hot objects/liquids. Although majority of victims received treatment from qualified doctors, some of them sought services of quacks and used undesirable remedies in the form of coconut oil, ghee, toothpaste etc. This is a matter of serious concern and requires intensive health education to avoid such kind of practices. Because these practices not only are undesirable but also may worsen the condition of patient leading to dreadful complications.