Elsevier

Health Policy

Volume 96, Issue 3, August 2010, Pages 226-230
Health Policy

Determinants of childhood burns in rural Bangladesh: A nested case–control study

https://doi.org/10.1016/j.healthpol.2010.02.004Get rights and content

Abstract

Background

Burn is one of the major causes of childhood illnesses in Bangladesh and is the third leading cause of illness of 1- to 4-year-old children. Rural children are more at risk compared to urban-dwelling children.

Objective

The study was designed to identify the risk factors of childhood burn in rural Bangladesh.

Methods

This nested case–control study was conducted in rural Bangladesh. The study population was children of less than 10 years old in three sub-districts of Bangladesh.

Results

Children of families who did not have a household with a separate kitchen, a common occurrence in rural areas, were at significantly higher risk of burn (OR 1.65; 95% CI 1.22–2.24). A kitchen without a door was also found to create a more hazardous environment compared to a kitchen with a door. The traditional kerosene lamp (kupi bati) was found to be one of the major determinants of childhood burn in rural Bangladesh (OR 3.16; 95% CI 1.58–6.35). No use or restricted use of kupi bati significantly reduces the risk of childhood burn. Children of nuclear families were at significantly higher risk of burn compared to combined families.

Conclusion

Cooking in an open place and use of the traditional kerosene lamp are the major determinants of childhood burn in rural Bangladesh. A combined family environment reduces the risk of childhood burn. Childhood burn can be reduced by prohibiting use of kupi bati and limiting children's access to the cooking area. Promoting combined family could be an initiative of childhood burn prevention program.

Introduction

Burns are one of the most devastating injuries in the world [1]. Children are the most vulnerable group as they have limited perception of dangerous situations and limited ability to react promptly and properly [2]. The survival of burn patients has markedly improved with the advancement of medical care, however in terms of morbidity and disability it still remains a huge public health problem all over the world [3]. It remains a major cause of unintentional injuries in many of the high income countries [3], [4], [5], [6]. In Africa and many of the South-Asian countries, including India, Pakistan, Nepal, Sri Lanka and Afghanistan, burn injuries have emerged as a major public health issue [7], [8], [9], [10], [11], [12], [13], [14].

About 173,000 children are burnt every year in Bangladesh and among them 3400 children become permanently disabled [15], [16]. Childhood burn was ranked as the fifth leading cause of childhood illness among 1- to 17-year-old children and is the third leading cause of illness among children aged 1–4 years old [15]. It was found to be a major cause of hospital admission and prolonged hospital stay [17]. Alongside permanent disability, it is a major cause of school absence and workday loss for children [16], creating a huge social and economic burden for the families and the nation [16], [17]. Compared to urban children, rural children are 4 times more likely to suffer a burn [15]. To address this huge burden to health, social and economic issues a comprehensive burn prevention program is necessary. To design a prevention program the risk factors of burn injury must be identified. This study was designed to identify the determinants of childhood burn in rural Bangladesh.

Section snippets

Study design and population

A nested case–control study was conducted to determine the risk factors of childhood burn in rural Bangladesh. The study was conducted in 2008 in the project area of Centre for Injury Prevention and Research, Bangladesh (CIPRB) where all of the 600,000 population is monitored through a sentinel surveillance system. The study area is in three sub-districts of Bangladesh, represent the majority of rural Bangladesh.

Study population

The study population consisted of children less than 10 years old in three

Results

The study was conducted to explore the association between childhood burn and the physical environment of the home and the behavioral practices of the household occupants (Table 1).

The type of family which the children lived in, that is either nuclear or combined, was identified as one of the contributory factors for childhood burn. Compared to nuclear families, children living in combined families were found to be safer from burn injury. Children of nuclear families were at a significantly

Discussion

The risk of childhood burn associated with age, sex and socioeconomic condition of families has been investigated in Bangladesh in previous studies [15], [18]. However not much information has been explored regarding the physical environment of the household and the home occupant's behavior which are important predictors for child survival and development [19]. This study explored the risk factors of childhood burn related to these factors.

We found children of nuclear families were at

Competing interests

None declared.

Funding

The study was funded by the Centre for Injury Prevention and Prevention and Research Bangladesh (CIPRB).

Ethical issues

Ethical clearance was obtained from the ethical committee of Centre for Injury Prevention and Research Bangladesh. Participants were informed about the benefits and objectives of the study. Verbal consent was obtained from each head of household before proceeding with the interviews.

Acknowledgement

We would like to thank Stephanie Ryan for assistance with translation.

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