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The elderly population is on the increase globally according to the current global demographic changes and is more vulnerable to burn injuries. Despite recent advances in burn care, the outcome of burns in the elderly has only marginally improved when compared with children and younger adults. The objective of this study was to determine the patterns and outcomes of burns in the elderly and eventually proffer prevention strategies. A retrospective review of all the elderly (65 years and older) burn patients managed at the Burn Centre of National Orthopaedic Hospital Igbobi Lagos (NOHIL) between January 2015 and December 2019 was performed. The socio-demographic data, clinical information surrounding the burn injury and management were extracted from the medical records, analyzed and presented. A total of 21 patients were included in this study, with a male to female ratio of 1:1.1. Flame burns represented the commonest cause of burns (85.7%) and the majority had pre-injury comorbidities (57.1%). All the patients with %TBSA of less than 40% were successfully managed and discharged while death occurred in all the patients with %TBSA of 40% and above, with a mortality rate of 11.1%. This study provided an epidemiological profile of elderly burn patients in Nigeria. One in five burn admissions is elderly, with flame burns being the major cause of burns. Most of the burns occurred indoors and were related to cooking activities. Prevention strategies were recommended to improve home safety and make the home a safer place for the elderly. [ABSTRACT FROM AUTHOR]

Objectives: To assess burn injury knowledge and its predictors among reproductive-age women attending an urban and a semi-rural hospital in Northwest Nigeria DESIGN: A descriptive cross-sectional study SETTING: It was conducted in the general and paediatric outpatient clinics of Aminu Kano Teaching Hospital in Kano (urban setting) and the general outpatient, paediatric outpatient and antenatal clinics of Federal Medical Centre Birnin Kudu (semi-rural setting)., Participant: In 2021, 362 women aged 18-44 years were randomly selected from clinic attendees over six weeks. Of them, 217 were from the urban hospital. Data regarding their sociodemographic characteristics and knowledge of burn injuries was collected using a pretested, semi-structured interviewer-administered questionnaire., Outcome Measure: Knowledge of burn injuries RESULTS: About 83.4 %, 77.1 % and 77.6 % of respondents had adequate general, primary prevention and overall knowledge of burn injuries, respectively. Their mean overall knowledge score was 18.6 out of 24, but only 55.5 % had adequate first-aid knowledge. The study sites did not significantly differ in burns first-aid, prevention and overall knowledge scores. However, urban respondents were more ignorant about the cause of burns and knew that burn injuries could be fatal. More semi-rural respondents knew that flames and chemicals cause burn injuries. Predictors of overall knowledge were age, educational level, number of children in their household, previously seeing a burn-injured child, and primary source of burns-related information., Conclusions: The proportion of respondents with adequate overall burn injury knowledge was high; however, knowledge gaps exist among them. Overall, their first-aid knowledge was relatively low. The urban and semi-rural respondents had no significant differences in first-aid, prevention, or overall knowledge of burn injuries. However, knowledge of the causes of burns and burn complications differed between the urban and semi-rural study locations. Therefore, the clinical settings of this study present opportunities for similar burn-related educational interventions., (Copyright © 2024 Elsevier Ltd and ISBI. All rights reserved.)

The pediatric age group has been noted to be particularly vulnerable to burn injuries. Burn is the fifth most common cause of childhood injuries. Nigeria has a very young population with a median age of 18.1 years. Scald is the most common form of burn injuries in this age group globally; however, previous reports from our institution found flame to be the most common form of burn in pediatric age. The most recent report from 13 years ago still maintained flame as the most common cause of pediatric burn injury. This study was carried out to determine the changes in epidemiology and outcome of pediatric thermal burn injury. This was a retrospective study carried out between January 2013 and December 2022. Data were analyzed using the statistical package for social sciences software version 23. The significance was set at a P-value of .05. Two hundred and sixty-five children presented with thermal burn with a male-to-female ratio of 1.3:1. 63.4% occurred in children 0-5 years. Scald (59.6%) was the most common cause of injury. Most flame injuries in females were due to liquified petroleum gas cookstove explosion, while petrol explosion was the most common cause in males (P ≤ .001). There is a yearly increase in burn depth (P = .009). Most inhalation injuries occurred in those aged 11-16 years (P = .006). Mortality rate was 10.2%, with total body surface area burned (P ≤ .001), burn depth (P ≤ .001), and inhalation injury (P ≤ .001) associated with increasing mortality. Scald is now the most common cause of thermal burn in our institution, with a remarkable reduction in mortality rate., (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Worldwide, thermal burn is the leading etiological type of burn injury accounting for 86% of burn injuries requiring admissions. Flame, Scald, and contact burn are the leading causes of thermal burn. Changes in the sociodemographic characteristics of societies have led to alterations in the epidemiology of burn. An understanding of such changes in the epidemiology of burn is essential in formulating and executing adequate burn prevention programs. We sought to establish the current trend in the etiology, gender distribution, age, occurrence of inhalation injury, burn surface area, burn depth, and mortality rate of thermal burns at Ibadan. This was a retrospective study carried out between January 2013 and December 2022. Thermal burns constitute 92% of burn injuries. The male-to-female ratio was 1.4:1. There were 265 (45%) patients in the pediatric age group and 323 adults (55% of the patients). The proportion of flame, scald, and contact burns were 378 (58%), 203 (32%), and 14 (2%), respectively. Flame burns resulting from liquified petroleum gas (LPG) explosion show a rising trend, with a decline in flame burns from kerosene (P < .001). One hundred and ninety (32%) patients had inhalation injury. The overall mortality was 19% (N = 114). Kerosene flame, 38% (17 of 45 patients), and LPG, 32% (41 of 130 patients), were the most lethal causes of flame injuries (P < .043). The study shows the increasing contribution of LPG to the etiology of thermal burn injuries. Burn prevention programs should target safe use of LPG stoves and cylinders., (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The coronavirus disease and the subsequent pandemic that followed drastically changed human civilization with disruptive effects on health and overall wellbeing of mankind. This disruptive effect has been shown to include changes in epidemiology of burn injuries. This study therefore aimed to determine the impact of covid-19 on acute burn presentation at the University College Hospital (UCH), Ibadan. This was a retrospective study carried out between April 1, 2019 and March 31, 2021. The period was divided into two: April 1, 2019 to March 31, 2020 and April 1, 2020 to March 31, 2021. Data obtained from the burn unit registry were analyzed using the Scientific Package For Social Sciences version 25. The only statistically significant finding from this study was the marked reduction in burn ICU admission during the pandemic (P < 0.001). A total of 144 patients presented to the burn intensive care unit at UCH, Ibadan during the period under review with 92 patients in the prepandemic year, and 52 patients in the pandemic year. Patient group from 0- to 9-year-olds representing 42% in prepandemic, and 30.8% in the pandemic period was the most affected age group. Scald was predominantly among the pediatric age group in both groups. Males were more likely to suffer flame burn in both study periods with a near gender equilibration during the pandemic. Burn injury during the pandemic resulted in more total body surface area burned. The lockdown effect of the pandemic resulted in a significant reduction in acute burn admissions at the UCH, Ibadan., (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Burn injuries account for 4.8% of trauma deaths in Nigeria and annually for 20,000 deaths., Aim: This study was to catalogue the demographics of patient who presented at a referral center in Nigeria., Patients and Methods: In a retrospective study, we reviewed the records of all burn patients who presented over a 36-month period (January 2018 to December 2020). The clinical and demographic data was extracted using a self-designed questionnaire. Information obtained included biodata, etiology, time of presentation, first aid used, TBSA, length of hospital stay (LOHS), and outcome which was analyzed with SPSS version 28., Results: A total of 112 burn patients presented at our facility, 87 male and 25 female (m: f = 3.5:1). Forty-four percent were children 10 years old and below. Though scalding with hot liquids was the commonest cause of injury in children, flame burn was the commonest etiology (57.1%). Inhalational injuries occurred in 14.2%. Raw eggs and pap were used as first aid by 23%. Most patients were discharged home, and 19.6% died., Conclusion: The prevalence of burn injuries remains high in developing countries. Most causes of burns are preventable. Dangerous traditional practices add to patient morbidity. Education on effective prevention strategies is important in reducing morbidity and mortality., (Copyright © 2023 Copyright: © 2023 Nigerian Journal of Clinical Practice.)

Burn injuries have decreased markedly in high-income countries while the incidence of burns remains high in Low- and Middle-Income Countries (LMICs) where more than 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 centers 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 centers, 37% of burns were women and 36% of burns were children. Burns occurred mostly in household settings (43-79%). 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 center 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 provide 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., (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Burn Association.)

Burn injuries contribute significantly to childhood morbidity and mortality. This study was designed to document the pattern of presentation and outcome of pediatric burn injury in Enugu., Methods: All children with burn injuries over a 7-year period (June 2011 to May 2018) and were managed at three tertiary health institutions, were studied. Information including their socio-demographics, clinical features and treatment outcome were obtained and analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0., Results: 198 out of 201 records were available for analysis. Most (186; 93.9%) burn injuries occurred at home. Hot liquid (112; 56.7%) was the commonest cause of burn injury. A lot of substances were used topically for first aid, raw eggs (52; 31%) being the commonest. The outcome had significant association with cause of injury, depth of injury, total burn surface area (TBSA), and inhalation injury. Most were safely discharged home while a total of thirteen (6.6%) children died. LA 50 was 54.87%, while the maximum TBSA salvaged was 65%., Conclusion: Burn injuries in children in this environment remain a serious challenge in the face of widespread lack of awareness regarding safe practices in handling hot and flammable items at home., (Copyright © 2021 Elsevier Ltd and ISBI. All rights reserved.)

Background: Burns in pregnancy is often associated with high maternal and fetal morbidity and mortality especially when the total burn surface area (TBSA) involved is high. This study aims to review management outcome of cases of burns in pregnancy at Alex Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA)., Methods: A five year retrospective study of all pregnant women that presented at AE-FUTHA with burn injury between April 2014 and March 2019. Information was collected from the medical records using a proforma and analyzed with IBM SPSS Statistics version 20.0 (IBM Corp., Armonk, NY, USA) using descriptive statistics., Results: A total of 222 cases of burns were managed but only 8 were pregnant, giving an incidence of 3.6%. The commonest causes were flame (62.5%), scald (25%) and friction (12.5%) occurring mostly during the harmattan season. The median age of participants was 25-34 years. The burns affected 12.5% of the patients in the first trimester and 62.5% and 25% in the 2nd and 3rd trimesters respectively. Most patients (62.5%) had superficial burns while 25% had other associated injuries in addition to burns. About 87.5% had term spontaneous vaginal delivery. There was no maternal death but, there was an early neonatal death., Conclusion: The good outcome observed in this study with a 100% survival, could be explained by inter-disciplinary management approach given, even as most cases were minor degrees of burns. Early involvement of obstetricians in all burns affecting pregnant women is advised especially in burn centres where obstetricians are hardly in the employ., (© 2021 The College of Medicine and the Medical Association of Malawi.)

Background: Unintentional injuries from burns comprise a significant proportion of public health morbidity in Nigeria. In order to understand the type and impact of burns on youth in Low-and-Middle-Income countries, the epidemiology of burns must be adequately assessed., Methods: This review describes the epidemiological patterns of burn occurrences in the pediatric populations and proposes interventions using the Haddon Matrix to address injuries in specific populations in Nigeria. A literature search was conducted using the Proquest, CINAHL, and PubMed databases at the Johns Hopkins University library (January 1, 1990 to August 14, 2018), on burns or thermal injury among pediatric populations in Nigeria. The review focused on the forms of injury, risk factors and potential interventions., Results: Ten studies were identified and the main risk factors for burns were socioeconomic status, overcrowding, and involving young girls in traditional cooking roles. The main types of injuries include scald injuries (50%) and fire burns (45%) affecting mainly children aged 14 and below with significant regional epidemiological variations. We created a novel intervention to develop countermeasures and reduce the number of pediatric burns based on biological, physical and sociocultural environment.., Conclusion: Interventions such as improved supervision of children, improved emergency infrastructure and culturally sensitive first aid education and treatment can help ensure a reduction in morbidity and mortality resulting from burns. Epidemiological studies can provide an accurate depiction of the burden of burn injuries in different regions of Nigeria., (© 2020 Banerjee S et al.)

Background: Injury threatens children lives worldwide. Most studies from Nigeria have been on accidental injuries in children., Objectives: To study the profile of non-accidental injuries among children receiving care at a tertiary hospital in Nigeria., Methods: Children with non-accidental injuries were serially recruited and studied. The Paediatrics Trauma Score (PTS) was tested against the outcome., Results: Non-accidental injuries accounted for 0.84% of all 5264 patients and 21.3% of the 207 injured. The case fatality rate was 6.8%. Physical abuse, sexual assault, drowning/near drowning, gunshot, poisoning and human bite caused the injuries in 68.2, 13.6, 6.8, 4.5, 4.5 and 2.3%, respectively. One-way analysis of variance and Tukey post hoc analysis showed that the mean PTS score of patients who died was significantly lower than the scores of those who were either discharged home or who discharged against medical advice (p < 0.001)., Conclusion: The burden of non-accidental childhood injuries was high in the study area., (© The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: When there is an insurgency, the use of force in the form of weaponry, is employed. This may lead to the total breakdown of law and order, resulting in destruction of life and property. Health workers may be killed or captured, and, health facilities destroyed or stretched beyond their functional capacity. This is a report of experience with injuries seen in a tertiary hospital in north eastern Nigeria, under an insurgency situation., Materials and Methods: After obtaining clearance from the medical Ethics Committee of UMTH, we reviewed the case files of all patients treated for injuries sustained as a result of the Boko Haram insurgency from January 2009 to December 2013. Those brought in dead, were not included in the study., Results: We reviewed the case files, theatre notes, admission and discharge registers of 1339 cases. 1223 (91.3%) of the victims were males, while 116 (8.7%) were females. Gunshot wounds accounted for 1229 (91.8%) of the injuries, bomb blast 90 (6.7%), others 15 (1.1%) knife (Cut throat) 4 (0.3%) and road traffic accident 1 (0.01%). Casualties were made up of civilians 1144 (85.4%), the joint task force (a force made up of the Military, Police, Customs and Immigration, against the insurgents) 117 (8.7%), and insurgents 22 (1.6%). The ages of the patients ranged from 1 to 80 years, peaking at the 21-40 age brackets (796 or 59.4%). The extremities were most affected, 734 (54.8%), followed by the torso 423 (31.6%), multiple injuries 93 (6.9%) and head and neck 89 (6.6%). 1226 (91.6%) of the victims survived while 113 (8.4%) died from their injuries. This followed massive blood loss from injuries to the torso 69 (61.1%) multiple injuries 15 (13.3) and extremities 6 (5.3%). Others causes were fatal injuries to the head and neck 22 (19.5%) and 90% burns following bomb blast 1 (0.9%)., Conclusion: Injuries resulting from insurgency will continue to be a problem in many developing countries because their health facilities in terms of personnel and materials are ill prepared for such a situation .

Children constitute a significant proportion of burn victims in most studies from the developing countries. While there has been a progressive improvement in the outcome from childhood burn in many developed nations, the morbidity and mortality remains high in many low and middle income countries. The aim of our study is to evaluate the demographic characteristics and prognostic indicators of childhood burn in a major referral teaching hospital in a developing country. A review of the records of 638 patients with acute burns managed over a 10-year period from January 2001 to December 2010 at the University College Hospital, Ibadan Nigeria was done. The clinical and epidemiological data were retrieved from computerized data base using the ISBI proforma. Information obtained includes Biodata, Etiology, location, TBSA, presence of Inhalation injury and the treatment outcome. Data of patients aged 16 years and below were analyzed using the SPSS version 16. The main outcome measure was the patient's survival. 289 children representing 45.3% of the total number of burn patients were managed over the period. The M:F ratio was 1.1:1. The median age of the cohort was 4.0 years while the median TBSA was 21.0%. Non-intentional causes were responsible for 89.6% cases. Most of the injuries (88.6%) occurred at home. Eighty-three patients had inhalation injury out of which 57 (68.7%) deaths were recorded. The overall mortality rate in the cohort was 39.5% with an LA50 of burn size of 45%. The TBSA was also found to be a determinant of outcome. Majority of childhood burns are from preventable causes with attendant dismal mortality figures. Effective burn prevention strategies and improved quality of care remain pivotal in reducing childhood burn morbidity and mortality in the developing countries., (Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.)

Background: Burns in the neonate are rare and result mostly from iatrogenic sources in developed countries. The socioeconomic settings of developing countries are different from those in the developed countries. A review of the epidemiology and management of burns in the neonates in Lagos, Nigeria is presented., Methods: The case notes of burns in patients less than 29 days-old from 2004 to 2008 in 4 tertiary health institutions in Lagos were retrieved from the Medical Records Department; necessary data were extracted and analyzed., Results: There were 21 neonates with burns within the study period. The incidence of neonatal burns ranged between 0.5 and 2.5%/year. The mean age was 16.38 ± 1.84 days and the mean BSA of 26.00 ± 5.53%. The etiology of burns was thermal in 19(90.5%) and chemical in 2(9.5%). Hypokalemia was common at early stages of their treatment. Burns were sustained at home in 90.5% of the cases. The mortality rate was 43.5%. Inhalation and thermal injuries were associated with most of the deaths., Conclusion: Domestic incidents from flames are the commonest causes of neonatal burns in the study environment. These are associated with prolonged morbidity and high mortality rate. Health education, highlighting methods of prevention should be undertaken in the community. Well equipped burn centers should be established to treat burns in all age groups., (Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.)

Background: Trauma is a common cause of death amongst children/adolescents, and data on its epidemiology and pattern are crucial for policy formulation. The aim of this study was to determine the epidemiology and pattern of paediatric/adolescent trauma death in a Nigerian referral trauma centre., Methods: The clinical and autopsy data of all paediatric/adolescent trauma death at the University of Benin Teaching Hospital between 1999 and 2010 were analysed in a retrospective study., Results: Of 905 trauma-related deaths, 78 (9%) involved children/adolescents who comprised 49 males and 29 females, with a male/female ratio 1.7:1 and a mean age of 9.2 ± 5 years (range <1-18 years). The Injury-Arrival time varied from 1h to 4 days (mean 18 h). Thirteen (17%) cases were dead on arrival (DOA), and majority of the deaths occurred within the first week on admission. Road traffic accident (RTA), accounting for 61 (78%) cases, was the leading cause of trauma death. Other causes included burns, eight (10%); gunshot injury, five (6%); and stab and sport injuries, two (3%) cases each. Head injury which occurred in 44 (56%) cases was the commonest cause of death, followed by haemorrhagic shock in 25 (32%), hypovolaemic shock in five (6%), septic shock in three (4%) and spinal cord injury in one (1%)., Conclusion: Head injury following RTA was the major cause of paediatric/adolescent trauma deaths. Increased road safety campaign, appropriate injury control policies, legislations, enforcement, development of high-quality trauma system, and emergency medical services are advocated., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Burn injury has been observed as a worldwide problem. The knowledge of the epidemiology is important for planning of management and preventive programmes. This is a retrospective review of burn patients who presented with acute burn injuries between January 2006 and December 2010. Admission registers and patients' folders were the sources of information. The information obtained includes: age, gender, number of patients who died, sources of burn injury and outcome of management. A total of 407 patients with acute burn injuries were studied. Males numbered 274 (67.3%), females 133 (32.7%). A majority, 98 (24%) of burn injuries occurred in the year 2010 and mortality in the series increased progressively except for 2006 which is explainable by the strike due to industrial disputes between and among various health disciplines over the period. Mortality was highest in 2010 (30%). The prevalence was higher among males than females throughout the 5-year period. The incidence, prevalence and mortality of burn injury have remained high in this environment. We suggest a well-targeted prevention campaign program to reduce this high incidence and high mortality in burn injury in Nigeria.

Background: Children are the most risk prone in cases of burns. The previous epidemiologic study of paediatric burns in Lagos-Nigeria was carried four decades ago. A new study becomes necessary in view of the increasing incidences of petroleum related fire disasters in Nigeria., Patients and Methods: : Children up to the age of 14 years admitted for major burns at the Lagos State University Teaching Hospital (LASUTH), Ikeja-Lagos, Nigeria between January 1, 2004 and December 31, 2008 were studied. Information about the demographics, mechanism/circumstances of burns, associated injuries, surface extent (TBSA) and depth, modes of management and outcome, length of admission, and post mortem findings in cases of death were collected., Results: : A total of 298 children with major burns were seen; 198 were males and 100 females. The ages ranged from 1 day to 14 years with mean of 4.56 ± 3.95 years. Forty percent of the cases occurred among the toddlers and 25.5% in the 2-5 years age group. Fire was the leading cause of burns, occurring in 198 (66.4%) cases. The TBSA ranged from 1% to 100% with mean of 29.67 ± 21.98. The mortality rate was 29.9%. Autopsy showed asphyxia as the primary cause of death in 14 (48.27%) cases, multiple organ dysfunctions in 27.59% and septicaemia in 13.79%., Conclusion: This study identifies the main causes of paediatric burns and the major factors responsible for morbidity and mortality at the present time in a low income country. The level of awareness about burns prevention among the populace and health care facilities should be improved., (Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.)

Introduction: Petroleum products are mostly inflammable and require strict regulations for safe handling. This study characterises the epidemiology of people who sustained burns from leaking petroleum pipes in Lagos, Nigeria. Risk factors for the leaks were determined and proposals for preventive measures made., Materials and Methods: Records of burn patients treated in our hospital from June 1999 to September 2004 were studied and victims of petroleum pipeline fires treated from October 2004 to May 2007 interviewed., Results: Nine incidents of pipeline fire disasters occurred during the study period. A total of 646 victims sustained 100% burns and died at the disaster sites. Deliberate pipeline damage caused explosions in 55.6% of the cases and spontaneous ruptures in 44.4%. Forty-eight patients were admitted to our hospital for major burns from pipeline explosions. Their ages ranged from 15 to 50 years with a mean of 25.36 ± 5.62 years. The total body surface area (TBSA) involved in burns ranged from 31% to 100% with a mean of 75.71 ± 18.60. Over 40% of the patients had burns beyond 80% TBSA. Mortality rate was 67.3%. Poverty, irregular supply and high prices of petroleum products were responsible for the deliberate pipeline damage and lack of maintenance and surveillance for the spontaneous ruptures., Conclusion: The incidents of fire disasters from broken petroleum pipelines increased over the study period with considerable mortality. Programmes to reduce poverty, regular product supply, pipeline maintenance and surveillance may reduce the occurrence of the disasters., (Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.)

Background: Paediatric hand trauma represents a subset of hand injury that can be quite challenging to manage. Local studies on this injuries are few therefore a 4 year retrospective study at the Trauma and hand rehabilitation unit of the Lagos University teaching hospital was carried out., Objectives: To determine the percentage of hand trauma occurring in the paediatric age group, the predominant age group involved, place of injury, the major injury types occurring as well as the most common surgical procedure required., Methods: The case records of all cases that presented at the hand rehabilitation clinic or the emergency center of the Lagos University teaching hospital over a 4 year period were reviewed. Those below the age of 12 years were studied. Their biodata, type of injury, place of injury and other details were obtained., Results: 634 patients were seen over the study period, 61 cases of hand injuries were in the paediatric age group. Hand trauma constituted less than a third of all paediatric hand cases. The commonest age group affected was 2-6 years. Most of the injuries occurred around the home. Burns injury, blunt trauma, glass and knife cuts were the commonest causes of hand trauma. Soft tissue reconstruction was commonest procedure done., Conclusion: Infants and toddlers were the most vunerable groups while burns injury was the commonest cause of hand trauma seen at the Lagos university teaching hospital.

Background: Burns are among the most devastating injuries seen in the emergency units. The epidemiology varies from one part of the world to another. This communication is a 3-year report of burns in children in an attempt to provide information on the current epidemiology of burns in this centre., Method: Children admitted into the University of Calabar Teaching Hospital, Calabar with burns were prospectively studied from February 2005 and January 2008., Results: There were 56 patients (28 males and 28 females). The ages ranged from 9 days and 14 years (mean 3.5 years) and 19 (73.1%) were preschool children. There were 39 (69.6%) who sustained scald injuries while 17 (30.4%) suffered flame injuries. Twenty-six (46.4%) patients sustained burns with total burn surface area above 10%., Conclusion: Education of the public on burns prevention based on the factors highlighted, establishment of burns support groups dedicated to publicity on prevention and provision of financial aid would sustain strategies when adopted.

Background: Burns injuries are recognized as a major health problem worldwide. In children and, particularly, in our environment where poverty, ignorance and disease are still high, they constitute significant morbidity and mortality. Previous studies on this topic in parts of Nigeria either lumped adults and children together or were retrospective. We, therefore, prospectively studied the current trends in burns in children., Patients and Methods: This prospective study of burns spanned over a period of 18 months (June 2006-December 2007) at the Paediatric Surgery Units of the Imo State University Teaching Hospital, Orlu, and the Federal Medical Centre, Owerri, Imo State. Data were collected and analysed for age, sex, cause/type of burn, place of burn, presence or absence of adult/s, initial prehospital intervention, interval between injury and presentation, surface area and depth of burn and treatment and outcome., Results: Fifty-three patients were studied, 31 (58.4%) were male and 22 (41.6%) were female (M:F = 1.4:1). Patients mostly affected were aged 2 years and below. The most common cause of burns was hot water in 31 (58.5%) patients. The vast majority of these injuries happened in a domestic environment (92.5%) and in the presence of competent adult/s (88.7%). Outcome of treatment was good: there were two (3.8%) deaths and 46 (86%) patients had complete recovery., Conclusion: Burns is still a major health problem among children in south eastern Nigeria. Fortunately, outcome of appropriate treatment is good. However, we think that poor safety consciousness among parents is a major predisposing factor. Public enlightenment on measures to ensure safe home environment may be necessary to avoid or limit childhood burns.

Background: Burn injury is one of the most severe forms of trauma that can afflict mankind. Although several forms of suicide and para suicide have been reported worldwide, severe burn injuries from deliberate self-harm have been poorly documented in Africa., Aim: To evaluate the pattern of deliberate self-harm by burning in our environment., Method: This is a 5-year retrospective analysis of all patients who sustained burns from deliberate self-harm (DSH) seen at the Usmanu Danfodiyo University Teaching Hospital, Sokoto from June 1998 to May 2003. The patients' data and other necessary information were extracted from the case notes., Results: Seven patients were seen over the study period. There were six females and one male, giving a female to male ratio of 6:1. All the injuries occurred at home from kerosene flame burns. In all cases, the intent was to take the patient's own life. The triggering factors were mainly psychosocio-economic. Six patients had up to secondary education while one patient had a degree certificate. None of the patients was gainfully employed at the time of incidence. Two patients had previously attempted suicide. Only one patient had a history of psychiatric illness. All sustained severe flame burns ranging from 45% - 98% body surface area (BSA). Compliance to treatment was generally poor. All patients were managed at the intensive care unit (ICU) of the hospital.. Five patients died, while the remaining two signed against medical advice (SAMA) during the course of management. The duration of hospital stay ranged from 2 - 10 days., Conclusion: Severe burn injury from DSH, although previously poorly documented in Africa, is not uncommon in our environment. The morbidity and mortality are high, not only because of the nature of injury, but probably because of poor compliance to treatment. We advocate community based studies and routine screening of adolescents to identify those at risk. The need for the establishment suicide information, intervention and prevention centre in Nigeria cannot be overemphasised.

The records of 168 children managed for burns in a teaching hospital in northwestern Nigeria, between April 1998 and March 2003, were assessed to determine the factors that are responsible for high rates of morbidity and mortality in paediatric burns. The causes of burns were hot water in 86 cases (51.2%), flame in 45 (26.8%), hot soup in 32 (19%) and electricity in five (3%). The main complications were wound infections in 109 (64.9%) patients, anaemia in 68 (40.5%), malnutrition in 54 (32.1%), contracture in 50 (29.8%), persistent hypothermia in 27 (16.1%), tetanus in 14 (8.3%) and one case (0.6%) of massive upper gastrointestinal bleeding, possibly as a result of Curling's ulcer.

The Queen Elizabeth II Hospital is the apex of the health care services in the Kingdom of Lesotho but has no designated burns unit. A review of patients managed during a 5-year period was done to document our experience so as to show what can be achieved even without a standard burns unit. We reviewed the clinical course of children who were admitted for care of acute thermal injuries during a 5-year period, May 1997 to April, 2002 inclusive. All were treated in the children surgical ward in accordance with a protocol of care emphasizing urgent care of shock, accurate fluid therapy, open wound care and early enteral feeding. Ninety-eight children (51 males and 47 females) aged 4 months to 43 months (mean 21.66 +/- 11.30 months) were admitted on account of acute thermal injuries during the study period. The injuries included scalding (46%) involving predominantly the upper part of the body and full thickness burns (87%). Skin grafting was needed in 82% of the patients. The common complications were infection, fluid imbalance, respiratory problems, and contracture deformities. The mean duration of hospital stay was 40 +/- 4.43 days and the case fatality rate was 9%. The case fatality rate in this series is considered high and could be improved if there were a well staffed specialized burns unit.

Background: Burns and scalds are common presentation to many of our health institutions. Most of these injuries are preventable. Many of the patients however end with severe morbidity or even death. People affected are mostly of poor socioeconomic status. The cost of managing these injuries is high. Coupled with this are poor facilities in most parts of the developing countries like Nigeria and insufficient personnel to take care of this group of people. Study of the epidemiology as well as suggestions on preventive measures are therefore overdue and hence this publication., Methods: A review of the literature on this subject with emphasis on Nigeria was done bearing in mind the epidemiology and prevention of burn. Literature search was done using the medline as well as local journals., Results: Causes of burn injuries are many in the developing countries. Most of these are however preventable. Some preventive measures have been suggested by workers in this part of the world. Some measures that have worked in reducing burn injuries in some advanced countries and that may be appropriate to our situation are noted and are also suggested in this paper., Conclusion: Prevention of burn injuries, based on the epidemiology of burn in developing countries, remains a major way of reducing the current spate of morbidity and mortality in our patients.

Background: Burns is a global problem and has its toll especially in a developing region like ours where poverty and ignorance are still rife. Previous studies in the sub-region have lumped children and adults together. We retrospectively studied the factors that lead to burns in children and the peculiarities in managing them., Methods: All case notes of burns injury in children managed at the University of Maiduguri Teaching Hospital between 1991-2000 were retrospectively studied., Results: A total of 219 children were studied. Children of age below 5 years were affected more than children above 5 years (168 vs. 51) with toddlers 1-2 years constituting a significant proportion of those below 5 years (71 vs. 168). The male to female ratio was 1.6:1 with a preponderance of male children below 10 years and the females between 11-15 years of age. The commonest cause of burns was scald (64.4%) in the household, which is usually accidental, but 3 were suicide attempts by teenage pregnant females 11-15 years protesting forced marriages, a cultural problem in our environment. Flame burns ranked second (27.4%) and results mainly from careless storage, adulteration and hawking of petroleum products. More than 50% of the patients sustained major burns resulting in high morbidity and mortality rate of 16%., Conclusion: Burn is a major public health problem and will require public/school health education campaign on childhood household safety. Appropriate legislation and enforcement on the sale of petroleum products would help to reduce the scourge.

Objective: This study was designed to determine the aetiological factors and pattern of oro-facial soft tissue injuries among children in a suburban Nigerian population. The problems encountered in the management of the patients are also highlighted., Setting: Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife, Osun State Nigeria., Sample and Methods: This prospective study was carried out in children aged < or = 15 years who presented with oro-facial soft tissue injuries between July 1996 and December 1997. Data was collected from a clinical examination of the child and a questionnaire completed by the parent or carer., Results: During the study period, 174 children were managed for oro-facial soft tissue injuries, an incidence of 1.1%, out of a total of 15 582 child admissions. A male preponderance was found (1 : 0.74). The mean age +/- SD was 7.3 +/- 4.2 years and the range was 9 months-15 years. Falls were the most common aetiology followed by road traffic accident. The forehead was the most frequently injured site. A mortality of 3.4% was found. Although animal bites and burns accounted for only 13.8% of all injuries, all the deaths were a result of these aetiologies. Road traffic accidents and burn victims had the longest hospital stay., Conclusion: Although falls and road traffic accidents are frequent causes of oro-facial soft tissue injuries, less common causes, like burns and dog bites are more likely to result in death.

This 2-Year (1999-2000) prospective study was undertaken to determine the pattern and outcome of childhood burns at the Usmanu Danfodio University Teaching Hospital Sokoto, North Western Nigeria. A total of 108 children, 15 years and below, were seen. There were 67 males and 41 females giving a male to female ratio of 1.6:1. Domestic accidents were responsible for 100 (92.6%) cases. Hot liquids as the agents of injuries were recorded in 72 (66.7%) children. The mortality rate was 6.5% (7 cases), all males. Petrol explosion was responsible for 4 deaths. Another case is made for the reduction in the incidence, morbidity and mortality of burns by elevating the socio economic status of the community.

Burn injury is a worldwide problem. We examine the epidemiological factors which cause conditions in which burns are more likely to occur. Seasonal variation influences (i.e. the cold dry harmattan period), certain cultural factors such as 'Wankan Jego', and using platforms with bedside fires, are contributing factors. The faulty storage of petroleum product has its toll. Poor architectural design and a low level of education in addition to poor socio-economic condition are factors that need to be addressed to reduce the incidence.

A retrospective study of bacterial infection in 71 burned patients over a 5-year period (1993-1997) was carried out. The commonest colonizing organism was Klebsiella species (26.7%) followed by Staph aureus (25.6%). There was a very high degree of resistance by these organisms to commonly available antibiotics in Nigeria, with the result that more expensive antibiotics such as the cephalosporins were required. The poor socioeconomic condition of most of the patients was a very important pre-disposing factor to burn wound infection, as only 25% of patients were able to afford the cost of wound microscopy and culture, thus leading to limited numbers of cultures being performed, the result being their prescription of antibiotics was made generally on an empirical basis. Restriction in the misuse of antibiotics and establishment of an infection control until will help to lower the incidence of infection.

This is a retrospective study of 84 children aged 36 months and less who were admitted for burns care from January 1980 to December 1989. Fifty-four (64%) had scalds, 28 (33%) had flame burns and in two children the cause was not known. The upper extremities were most commonly involved. Sixty-five per cent of the children were admitted during the cool, dry Harmattan season. Associated factors included cooking at floor level, bedside fires, epileptic fits in the mothers and general architectural factors. Wound infection was the commonest complication. The overall mortality rate was 27.4%. Burns prevention demands improvement in the design of houses, cooking methods, treatment of epilepsy and abandoning puerperal bathing by mothers.

From 1980 to 1989, 45 patients with clothing burn injuries were admitted into the Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Children aged 15 years and below numbered 30 and adults aged 16 years and above totalled 15. There was a female preponderance in the ratio of 1.8:1. The cumulative monthly frequency between October and February recorded the highest number of admissions (77 per cent) with a peak in January (31 per cent). The involvement of women and children especially those below the age of 5 years is noteworthy. Eighty per cent of the patients had a major injury with a total mortality of 42 per cent. The improvement in the economic standard of the populace shown by the improvement in cooking methods, the proper use of gas cookers and kerosene lanterns, the avoidance of bedside fires during the night, the guarded use of loose indigenous garments, and the use of nursery schools for the care of children below 5 years of age will help to lower the incidence of clothing burn injuries in our environment.

Fifty three patients admitted for burn care during a 12 month period from September 1987 to August 1988 were prospectively studied. There were 36 males (60%) and 21 females (40%) with ages ranging from 3 months to 60 years. Children aged 0-4 constituted 40% but 32 (60%) were younger than 16 years. Flame burns affected 26 (49%) patients, scalds in 22 (12%), electrical burns affected four patients and chemical burn was in one. Scald was the commonest injury among children aged 0-4 (70%). Flame, affected 33% of those aged 16 and above. Clothing fire was the commonest flame injury and it was a cause of very extensive injury (mean % BSA 45). Kerosene burn, gas and clothing burns caused the most extensive injury with a mean % BSA 46, 41 and 45 respectively. The commonest complication was burn wound sepsis most frequently by a gram-negative bacilli (65.63%) of which Pseudomonas aeruginosa were that commonest organisms. Pseudomonas and Staphylococcus aureus were about same frequency. Duration of hospital stay ranged from 6 days to 300 days with a mean of 46.52 days. 8 patients absconded, two were transferred to a hospital near their home and 9 died, giving a mortality rate of 17%. Since burn injuries are largely preventable, it is important to define clearly the social, cultural and economic factors which contribute to burn causation in order to combat them effectively.

A review of 156 patients with burn injuries admitted over a 5-year period (January 1988-December 1992) at Wesley Guild Hospital, Ilesha, was undertaken. The male:female ratio was 1.6:1. About 70% of the cases were between 1 and 10 years of age (mean 9 years). Scalds were responsible for 50.6% of the cases while naked flames, including kerosene explosion and burns at road traffic accidents, were responsible for 43.5%. Seventy-one per cent were due to domestic accidents. The burns were categorized as major in 70% of cases. The trunk accounted for 56.4% of anatomical areas involved, upper limbs 51.3%, lower limbs 48%, while head and neck accounted for 28.8%. Open dressings were used in 70.5% of the cases, combined open and closed dressings in 22.4% and closed dressings in 10.3%. In about 90% of cases, silver sulphadiazine was used as a topical antimicrobial agent while natural honey was used on the rest. Wound infection was the commonest complication occurring in 24.4%, while mortality was recorded in 7.7% of cases.

Burn care in Africa is hampered by inadequate facilities, inadequate infrastructure, and inadequately trained staff. Burn units with burn teams are few. Burn injuries carry a high mortality rate with delayed healing and high complication rates among survivors. Most burns occur in the home from flame and scalding, and children are more affected than adults. Burn sepsis is mostly from staphylococci and pseudomonas. Various studies on epidemiology, sepsis, protein metabolism, and repigmentation indicate methods of prevention and improved care, including greater resort by surgeons to skin grafting, which speeds healing and both prevents and treats scarring, contractures, and depigmentation. Governments, industries, and entrepreneurs are exhorted to promote burn prevention, research, improved care, and rehabilitation, particularly through the establishment of burn units with burn teams, to reduce the misery and suffering caused by the high mortality and morbidity from burns in Africa.

The results of a retrospective study of thermal injuries among 644 Nigerian children in Enugu, over a 6-year period, were analysed. Children in the first and second years of life were mostly at risk and there was a distinct seasonal incidence. Most burns occurred in January, April, July, August and December. Socioeconomic factors played a significant role in the aetiogenesis of these injuries. A mortality rate of 9.87 per cent was achieved in burns over 10 per cent of total body surface area (TBSA), despite considerable physical and financial constraints in the unit.

Seven pregnant women aged 20 to 30 years were among the burn patients treated at Ahmadu Bello University Hospital in Zaria, Nigeria. Five suffered flame burns and two were scalded. The burned surface area ranged from 4% to 80%. One patient was in the first trimester, two in the second, and four in the third. Six (86%) of the mothers and five (71%) of the fetuses survived.

The pattern of burn injuries in Port Harcourt, Nigeria is presented for the first time. Ninety-two patients were studied and 43 (46.74 per cent) of them were children in the 0-5 years age range. Thirty-seven of the children in this group suffered from scalds and six from flame burns. Petrol fire was the commonest cause of flame burns. The overall mortality was 26.09 per cent and the majority of deaths occurred in burns covering over 50 per cent of the total body surface area. Improved parental supervision of children, in particular toddlers, a more reliable public power supply system, a ban on carrying petrol in open containers in the streets and public enlightenment campaigns are advocated by the authors as preventive measures.

Eighty-nine cases of burns admitted to the Lagos University Teaching Hospital during an 8-year-period (1968-75) have been studied. The age incidence ranged from 1 day to 54 years. Fifty cases (56.2 per cent) occurred in children below the age of 15 years. Thirty-nine (43.8 per cent) were adults, aged 15 years and above. Sixty-three cases (70.8 per cent) were domestic accidents. There was a mortality rate of 13.5 per cent. There was severe morbidity in the surviving cases, the average admission period in 73 cases being 37 days and the average total healing time in 57 cases being 54 days. The most troublesome late complications were contractures, hypertrophic or keloid scars and failure of repigmentation. Gram-negative bacteria accounted for 64 per cent of the incidence of wound sepsis. Health education has an important role to play in the prevention of burn accidents both in the home and in industry. In particular, it is suggested that cooking above floor level and closer supervision of children should reduce the incidence of domestic burns in younger children, while stricter factory inspection, with rigorous enforcement of industrial safety laws, should reduce the incidence of industrial burn accidents in the working adult population.

Burns are rapidly assuming greater importance as a cause of ill health in the developing nations. The major factors include gross ignorance of fire prevention, the quick spread of slums and the persistence of old traditional customs and beliefs. One hundred and forty-one new cases of burns were treated at the University of Calabar Teaching Hospital (UCTH) in a 2-year period from January 1984 to December 1985. A large proportion of the patients (91, or 64.5 per cent) were minor burns, while 40 (28.4 per cent) were serious burns, and 10 patients (7.1 per cent) suffered major burns. Thirteen patients (9.2 per cent) left hospital against medical advice or absconded without completing their treatment. There were six deaths (4.3 per cent), most of the deaths occurred in the major burns group. Lack of drugs and intravenous fluids, delay in bringing the patients to hospital, ignorance, superstition and old cultural and traditional beliefs contributed to the morbidity and mortality. Most of the burn injuries were caused by domestic accidents and were therefore preventable.

A study of 55 cases of burns admitted to the Lagos University Teaching Hospital in the month of March 1984 revealed that 96 per cent were caused by flame burns due to explosions that occurred during the use of kerosene appliances for cooking and lighting. Thirty-four (62 per cent) were children, while 21 (38 per cent) were adults. In each of seven families, two or more people were affected. The overall mortality was 44 per cent, of which the larger contribution of 30 per cent was in children. By comparison, in the two preceding months there was a total of 17 and 20 burns admissions respectively. The mortality rate was 16 per cent while in March 1983 there was no death among the six paediatric admissions. Investigations showed that the explosions occurred due to petrol contamination of the kerosene before delivery to the domestic users. Appropriate precautions by kerosene suppliers and users, and health education can help prevent similar disasters in the future.

From 1971 to 1981, 245 adults with burn injuries were admitted to the Ahmadu Bello University Hospital, Zaria. The burns were major in 197 patients, moderate in 28 and minor in 20. Socioeconomic factors contributing to the injuries included the use of wood fires for cooking, for warming the body and the dwelling during the cool harmattan season, loose indigenous garments, thatch-roofed huts, petrol hoarding and epileptic seizures. Flame burns exceeded scalds with a high seasonal frequency in both men and women during the harmattan. Scalds occurred predominantly among the women, puerperal hot baths being a major cause. The overall mortality rate of 22 per cent is excessive. General economic development, architectural improvements, proper handling of petrol and kerosene, modification or abandonment of the puerperal ritual of hot baths, the maintenance of chronic epileptics on anticonvulsants and a programme of universal active immunization against tetanus would contribute to the prevention of burns and complications in adults and decrease the mortality rate.

Of the 35 women who sustained burn injuries during the puerperium in Zaria, 31 had practised ritual hot baths or "Wankan-jego" which caused severe scalds. Five of the women also developed peripartum cardiac failure. Two died. Three of the newborns also died partly as a result of the mothers' illness. Formal education and general economic development would help in eliminating this preventable source of maternal and infant morbidity and mortality.