TY - JOUR
T1 - Burns in Baghdad from 2003 to 2014
T2 - Results of a randomized household cluster survey
AU - Stewart, Barclay T.
AU - Lafta, Riyadh
AU - Esa Al Shatari, Sahar A.
AU - Cherewick, Megan
AU - Burnham, Gilbert
AU - Hagopian, Amy
AU - Galway, Lindsay P.
AU - Kushner, Adam L.
N1 - Funding Information:
We thank the dedicated supervisors and enumerators who for their contribution to understanding injury in Baghdad and helping to plan a response. Funding for logistics in Baghdad was provided by the United States based non-governmental organization, Surgeons OverSeas. Data analysis and manuscript preparation was done with support from the United States National Institutes of HealthFogarty International Center through the Northern Pacific Global Health Researc Fellows Training Consortium under grant R25TW009345. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
We thank the dedicated supervisors and enumerators who for their contribution to understanding injury in Baghdad and helping to plan a response. Funding for logistics in Baghdad was provided by the United States based non-governmental organization, Surgeons OverSeas . Data analysis and manuscript preparation was done with support from the United States National Institutes of HealthFogarty International Center through the Northern Pacific Global Health Research Fellows Training Consortium under grant R25TW009345 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2015 Elsevier Ltd and ISBI. All rights reserved.
PY - 2016
Y1 - 2016
N2 - Purpose Civilians living amid conflict are at high-risk of burns. However, the epidemiology of burns among this vulnerable group is poorly understood, yet vital for health policy and relief planning. To address this gap, we aimed to determine the death and disability, healthcare needs and household financial consequences of burns in post-invasion Baghdad. Methods A two-stage, cluster randomized, community-based household survey was performed in May 2014 to determine the civilian burden of injury from 2003 to 2014 in Baghdad. In addition to questions about cause of household member death, households were interviewed regarding burn specifics, healthcare required, disability, relationship to conflict and resultant financial hardship. Results Nine-hundred households, totaling 5148 individuals, were interviewed. There were 55 burns, which were 10% of all injuries reported. There were an estimated 2340 serious burns (39 per 100,000 persons) in Baghdad in 2003. The frequency of serious burns generally increased post-invasion to 8780 burns in 2013 (117 per 100,000 persons). Eight burns (15%) were the direct result of conflict. Individuals aged over 45 years had more than twice the odds of burn than children aged less than 13 years (aOR 2.42; 95%CI 1.08-5.44). Nineteen burns (35%) involved ≥20% body surface area. Death (16% of burns), disability (40%), household financial hardship (48%) and food insecurity (50%) were common after burn. Conclusion Civilian burn in Baghdad is epidemic, increasing in frequency and associated with household financial hardship. Challenges of healthcare provision during prolonged conflict were evidenced by a high mortality rate and likelihood of disability after burn. Ongoing conflict will directly and indirectly generates more burns, which mandates planning for burn prevention and care within local capacity development initiatives, as well as humanitarian assistance.
AB - Purpose Civilians living amid conflict are at high-risk of burns. However, the epidemiology of burns among this vulnerable group is poorly understood, yet vital for health policy and relief planning. To address this gap, we aimed to determine the death and disability, healthcare needs and household financial consequences of burns in post-invasion Baghdad. Methods A two-stage, cluster randomized, community-based household survey was performed in May 2014 to determine the civilian burden of injury from 2003 to 2014 in Baghdad. In addition to questions about cause of household member death, households were interviewed regarding burn specifics, healthcare required, disability, relationship to conflict and resultant financial hardship. Results Nine-hundred households, totaling 5148 individuals, were interviewed. There were 55 burns, which were 10% of all injuries reported. There were an estimated 2340 serious burns (39 per 100,000 persons) in Baghdad in 2003. The frequency of serious burns generally increased post-invasion to 8780 burns in 2013 (117 per 100,000 persons). Eight burns (15%) were the direct result of conflict. Individuals aged over 45 years had more than twice the odds of burn than children aged less than 13 years (aOR 2.42; 95%CI 1.08-5.44). Nineteen burns (35%) involved ≥20% body surface area. Death (16% of burns), disability (40%), household financial hardship (48%) and food insecurity (50%) were common after burn. Conclusion Civilian burn in Baghdad is epidemic, increasing in frequency and associated with household financial hardship. Challenges of healthcare provision during prolonged conflict were evidenced by a high mortality rate and likelihood of disability after burn. Ongoing conflict will directly and indirectly generates more burns, which mandates planning for burn prevention and care within local capacity development initiatives, as well as humanitarian assistance.
KW - Burn
KW - Electrical injury
KW - Epidemiology
KW - Global surgery
KW - Iraq
KW - War
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U2 - 10.1016/j.burns.2015.10.002
DO - 10.1016/j.burns.2015.10.002
M3 - Article
C2 - 26526376
AN - SCOPUS:84961967563
SN - 0305-4179
VL - 42
SP - 48
EP - 55
JO - Burns
JF - Burns
IS - 1
ER -