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Tiongco RFP, Ali A, Puthumana JS, Scott Hultman C, Caffrey JA, Cooney CM, Redett RJ. Food Security as a Predictor of Global Pediatric Postburn Mortality. J Burn Care Res 2023; 44:1304-1310. [PMID: 37390226 DOI: 10.1093/jbcr/irad103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Indexed: 07/02/2023]
Abstract
Food security (FS) is defined as access to sufficient and nutritious food. Children, especially those in low- and middle- income countries (LMICs), are disproportionately affected by low FS. We hypothesized high FS would be predictive of decreased pediatric postburn mortality in LMICs. Publicly-available, deidentified datasets were obtained from the World Health Organization's Global Burn Registry (GBR) and Economist Intelligence Unit's Global FS Index (GFSI). The GFSI calculates FS scores annually from intergovernmental organization data reviewed by a panel of experts. FS scores are reported on a 0 to 100 scale with 100 indicating the highest FS. Patients aged 0 to 19 yr were included; after linking GBR and GFSI datasets, countries with <100 burn patients were excluded. Data were analyzed with descriptive statistics and bivariate analyses. Multiple logistic regression controlling for confounders was used to quantify associations between mortality and FS score. Significance was set at P < 0.05. From 2016 to 2020, there were 2,246 cases including 259 deaths (11.5%) over nine countries. Those who died had a higher median age (7 [IQR 2, 15] vs 3 [2, 6] years, P < 0.001), higher proportion of females (48.6% vs 42.0%, P =0.048), and lower median FS score (55.7 [IQR 45.3, 58.2] vs 59.8 [IQR 46.7, 65.7], P < 0.001). Increasing FS score was associated with decreased odds of postburn mortality [multivariable odds ratio 0.78 (95% confidence interval 0.73 to 0.83), P < 0.001]. With the association between FS and mortality, international efforts to increase FS in LMICs may help improve pediatric burn patient survival.
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Affiliation(s)
- Rafael Felix P Tiongco
- Departmentof Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Ayman Ali
- Department of Surgery, Duke University, Durham, NC, USA
| | - Joseph S Puthumana
- Departmentof Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Charles Scott Hultman
- Departmentof Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Julie A Caffrey
- Departmentof Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Carisa M Cooney
- Departmentof Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Richard J Redett
- Departmentof Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, MD, USA
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Caffarelli C, Santamaria F, Piro E, Basilicata S, D'Antonio L, Tchana B, Bernasconi S, Corsello G. Advances for pediatricians in 2022: allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology. Ital J Pediatr 2023; 49:115. [PMID: 37679850 PMCID: PMC10485969 DOI: 10.1186/s13052-023-01522-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023] Open
Abstract
The last year saw intensive efforts to advance knowledge in pediatric medicine. This review highlights important publications that have been issued in the Italian Journal of Pediatrics in 2022. We have chosen papers in the fields of allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology. Novel valuable developments in epidemiology, pathophysiology, prevention, diagnosis and treatment that can rapidly change the approach to diseases in childhood have been included and discussed.
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Affiliation(s)
- Carlo Caffarelli
- Clinica Pediatrica, Department of Medicine and Surgery, Azienda Ospedaliera- Universitaria, University of Parma, Parma, Italy.
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Ettore Piro
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Simona Basilicata
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Lorenzo D'Antonio
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Bertrand Tchana
- Cardiologia Pediatrica, Azienda-Ospedaliero Universitaria, Parma, Italy
| | | | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
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Deribe Z, Desta D. Pattern, Cause of Childhood Burn injuries and their Management Outcome At Jimma Medical Center, Jimma Zone, Oromia Region, Southwest Ethiopia. Clin Cosmet Investig Dermatol 2023; 16:1505-1514. [PMID: 37337570 PMCID: PMC10277001 DOI: 10.2147/ccid.s411693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/08/2023] [Indexed: 06/21/2023]
Abstract
Purpose Burn injuries are prevalent worldwide, especially in developing countries; and there are significant pediatric burn injuries in Ethiopia. This study was performed to analyze the pattern, cause, and management outcome of burn injuries in Jimma Medical Center. Methods A hospital‑based retrospective cross‑sectional study was conducted at Jimma university medical center burn unit. Data were collected through chart review of pediatric patients aged 0 to 14 years who were admitted to the burn unit with a burn injury. A total of 92 hospitalized children were studied from Jan 1, 2020 to Dec 31, 2021 GC. Data were analyzed using SPSS version 25. The statistical significance was determined using odds ratio (OR) with a 95% confidence interval (CI) and the corresponding P-value of less than 0.05. Results The majority of the patients were males (52.2%). Scald burn was the most common cause of burn in 57(62.0%). The TBSA of majority of the patients (52.2%) was found to be between 11% and 20%. After adjusting for possible confounders in the multivariate analysis, preexisting illness and time of presentation to care were found to have a statistically significant association with the outcome of burn at discharge (P= 0.007) (P= 0.021) respectively. Conclusion The most common cause of burn in our setup was scald burn; upper extremities were also the most affected site. According to our study, the factors associated with the outcome of burn injury were preexisting illness and late presentation to health facilities.
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Affiliation(s)
- Zekarias Deribe
- Department of Surgery, Faculty of Medical Science, Jimma Medical Center, Jimma, Ethiopia
| | - Diliab Desta
- Department of Anatomy, Faculty of Medical Science, Jimma University, Jimma, Ethiopia
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Adane MM, Admasie A, Shibabaw T. Risk Factors of Cooking-related Burn Injury Among Under-Four Children in Northwest Ethiopia: A Community-Based Cross-Sectional Study. Indian Pediatr 2023; 60:119-122. [DOI: 10.1007/s13312-023-2808-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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Mamo ST, Addisie AA, Heye TB, Tegegne OA. Clinical Pattern and Outcome of Burn Injury in Children in AaBet Trauma Center Addis Ababa Ethiopia: Prospective Study. SAGE Open Nurs 2023; 9:23779608231186864. [PMID: 37435578 PMCID: PMC10331214 DOI: 10.1177/23779608231186864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/13/2023] Open
Abstract
Introduction Burn injuries are among the most prevalent health conditions worldwide that happen mainly in children, military, and victims of fire accidents. The previous literature had general limitations in that it focused on the retrospective study design, which can be prone to incomplete data or lack the full evidence of the problem, however, this study is a prospective study that gives a clue to the possible determinant factors of burn injury in pediatrics. Objectives The purpose of this study was to assess the clinical pattern and outcome of burn injury in children at the AaBet trauma center in Addis Ababa, Ethiopia, between July 2016 and July 2020. Methods An institutional-based prospective study was conducted in an AaBet trauma center. The study participants were chosen using a systematic random sampling method and followed for 4 years to determine their clinical outcomes after burn injury. A pretested observational check list was used to collect the data. The collected data were coded, entered Epi-data version 4.6, and exported to SPSS version 26 for descriptive and inferential analysis. A binary logistic regression model was used to identify factors associated with burn injury on the adjusted odd ratio with a 95% confidence interval at a p-value of < .05. Results A total of 256 patients were recruited for this study. Scald burns accounted for 50.8% of the injury mechanisms, with 93.8% of the incidents occurring in private residences. Second-degree burns were the most common presentation of the victims (83%). Lower limbs were the most frequently burned body part (47%). Over 70% of the victims had 20% of their body surface area burned. Intentional burns accounted for 1.2% of all burn victims. The length of the hospital stay ranged from 1 day to 164 days with a mean stay of 24.73 days. Eight patients (3.1%) died during the study period. Conclusion and recommendation Pediatric burn incidences showed no significant discrepancies between males and females. Scald and open flame are the common causes of burn injury. Most incidents occurred in indoor settings, and most of the victims had not received first aid at home. Most patients left the hospital with no or minimal complications. Only 3.1% of the patients died. Patients who had burn-associated injuries were 98.8% less likely to be alive than those who had no associated injuries at all. For all governmental and non-governmental bodies, it is highly recommended to give priority to preventive measures and education on the need for appropriate prehospital care.
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Affiliation(s)
- Sosina Tamre Mamo
- Department of Emergency, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Asmamaw Abebe Addisie
- Department of Emergency, College of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tigist Bacha Heye
- Pediatrics and Child Health Department, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Ousman Adal Tegegne
- Department of Emergency, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Mulatu D, Zewdie A, Zemede B, Terefe B, Liyew B. Outcome of burn injury and associated factor among patient visited at Addis Ababa burn, emergency and trauma hospital: a two years hospital-based cross-sectional study. BMC Emerg Med 2022; 22:199. [PMID: 36494642 PMCID: PMC9733383 DOI: 10.1186/s12873-022-00758-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Burn is one of the critical health problems worldwide. Developing countries with sub-Saharan and Asian populations are affected more. Its mortality and non-fatal complications depend on several factors including age, sex, residency, cause, the extent of the burn, and time and level of care given. OBJECTIVE The purpose of this study was to assess the outcome of burn injury and its associated factor among patients who visited Addis Ababa burn emergency and trauma hospital. METHODS The institutional-based, retrospective cross-sectional study design was conducted from April 1, 2019, to March 30, 2021. After checking the data for its consistency the data were entered and analyzed by using SPSS version 25. A total of 241 patients who had visited Addis Ababa burn, emergency and trauma Hospitals after sustained burn injury were recruited through convenience sampling method for final analysis. Model goodness-of-fit was checked by Hosmer and Lemeshow test (0.272). After checking multi-collinearity both the bi-variable and multivariable logistic regression model was fitted and variables having a p-value less than or equal to 0.05 at 95% CI in the multivariable analysis were considered statistically significant. RESULT Adults (age 15 to 60 years) are the most affected groups accounting for 55.2% followed by pediatric age groups (age <15 years) (43.6%) and the elderly (age > 60 years) (1.2%). Scald burn was the major cause accounting for 39 % followed by Flame burn (33.6%), Electrical burn (26.6%), and chemical burn (0.8%). The mean TBSA% was 15.49%, ranging from1% to 64%. Adult males are more affected by electrical burns while adult females and the elderly encounter flame burn. 78.4% of patients were discharged without complications, 14.9% were discharged with complications and 6.6% died. The commonest long-term complication is the amputation of the extremity (19, 7.9%). Age greater than 60 years and TBSA% greater than 30% is a strong predictors of mortality with odds of 2.2 at 95% CI of [1.32, 3.69] and 8.7 at 95% CI of [1.33, 57.32] respectively. CONCLUSION AND RECOMMENDATION The mortality rate show decrement from previous studies. Overall scald burn is common in all age groups but electrical burns and flame burns affected more adult and elderly age groups. Extremities were by far, the commonest affected body parts. The extent of burn injury and the age of the patient independently predict mortality. Early intervention will reduce mortality and complications.
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Affiliation(s)
- Damena Mulatu
- grid.59547.3a0000 0000 8539 4635Department of internal medicine, School of medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayalew Zewdie
- grid.460724.30000 0004 5373 1026Department of Emergency Medicine and Critical Care, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Biruktawit Zemede
- grid.460724.30000 0004 5373 1026Department of Emergency Medicine and Critical Care, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Bewuketu Terefe
- grid.59547.3a0000 0000 8539 4635Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bikis Liyew
- grid.59547.3a0000 0000 8539 4635Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, P.O.BOX 196, Gondar, Ethiopia
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Adane MM, Admasie A, Shibabaw T. Prevalence and risk factors of cooking-related burn injury among under-five-years old children in a resource-limited setting: a community-based cross-sectional study in Northwest Ethiopia. Int J Inj Contr Saf Promot 2022; 30:220-231. [PMID: 36137170 DOI: 10.1080/17457300.2022.2125534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Cooking-related child burn injury causes a greater health burden in low-and-middle-income countries. Therefore, a community-based cross-sectional study was conducted among 5830 under-five-years old children in a resource-limited community in Northwest Ethiopia to determine the prevalence and risk factors of this child health problem. Data were collected by trained nurses using a questionnaire and the logistic regression analysis method was applied to identify factors linked with burn injury. Injury prevalence was 6.2% (95% CI:5.5-6.8); and this burden was linked with several risk factors such as lower literacy status of caretakers [AOR = 2.21 (95% CI:1.05-4.67)], overcrowding [AOR = 2.35(95% CI:1.25-4.43], lack of separate kitchen [AOR =2.19 (95% CI:1.56-3.07)], using traditional cookstove [AOR = 2.04 (95% CI:1.23-3.36)], and lack of child supervision [AOR = 2.27 (95% CI:1.63-3.17)]. In conclusion, children experience a high burden of burn injury. Thus, stakeholders should work to reduce child burn injury by modifying the aforementioned risk factors.
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Affiliation(s)
- Mesafint Molla Adane
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amha Admasie
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tebkew Shibabaw
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Halpern D, Cohen A, Sharon N, Krieger Y, Silberstein E, Michael T, Douvdevani A, Shoham Y. Admission Circulating Cell-Free DNA Levels as a Prognostic Factor in Pediatric Burns. Biomed Res Int 2022; 2022:5004282. [PMID: 35722456 DOI: 10.1155/2022/5004282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 11/17/2022]
Abstract
Background Burn injuries in children are a major physical and psychological trauma, often a severe condition with long-term consequences. Current methods of assessing the extent of burn injuries on admission are inaccurate. Circulating cell-free DNA (cfDNA) is a potential marker of tissue damage that may be useful in burn care. Objective To explore the use of cfDNA admission levels as a prognostic marker of pediatric burn severity and outcome. Methods cfDNA levels of 38 pediatric burn patients (otherwise healthy) and 12 matched pediatric controls (minor elective surgery patients) admitted to our center were quantified by a direct fluorometric assay. Results We found significantly higher admission cfDNA levels in the patient group (median 724 ng/ml, range 44-4405), compared to the control group (median 423 ng/ml, range 206-970, Mann–Whitney, P = 0.03) and a significant difference between cfDNA levels of partial-thickness burns (median 590 ng/ml, range 44-2909) and full-thickness burns (median 2394 ng/ml, range 528-4405, Mann–Whitney, P = 0.01). We also found significant correlations between cfDNA levels and hospitalization duration (Spearman, R = 0.42, P < 0.01) and undergoing surgical procedures (Spearman, R = 0.40, P < 0.01). PICU admission did not correlate to cfDNA levels (Spearman, R = 0.14, P = NS). Discussion. Admission cfDNA levels may be a valuable objective tool for assessing the severity of pediatric burn injuries on admission, including correlations with the length of hospitalization and surgical burden. Conclusion Admission cfDNA levels may be a promising novel pediatric burn assessment method. Further investigation of cfDNA levels in healthy children standardized to age and larger cohorts are needed to establish cfDNA as a valuable prognostic factor for pediatric burn injury.
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