Necessity to employ a multifaceted approach to minimize the incidence of burns and associated sequels in low- and middle-income nations

Saurabh RamBihariLal Shrivastava; Prateek Saurabh Shrivastava

doi:10.4103/ed.ed_30_22

SHORT COMMUNICATION

Year : 2023 | Volume : 8 | Issue : 1 | Page : 22-24

Necessity to employ a multifaceted approach to minimize the incidence of burns and associated sequels in low- and middle-income nations

Saurabh RamBihariLal Shrivastava¹, Prateek Saurabh Shrivastava²
¹ Associate Dean Research, Off Campus, Sri Balaji Vidyapeeth – Deemed to be University, Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Nellikuppam, Chengalpattu District, Tamil Nadu, India
² Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpattu District, Tamil Nadu, India

Date of Submission	16-Dec-2022
Date of Decision	10-Jan-2023
Date of Acceptance	02-Feb-2023
Date of Web Publication	30-Mar-2023

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth - Deemed to be University, Thiruporur, Guduvancheri Main Road, Ammapettai, Nellikuppam, Chengalpattu - 603 108, Tamil Nadu
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/ed.ed_30_22

Abstract

The problem of burns has been recognized as one of the major global public health concerns primarily due to the millions of people succumbing to the burn-related complications each year. In addition, nonfatal burns are a predominant cause of morbidity, disability, impaired quality of life, and prolonged hospitalization, which are commonly associated with secondary infections. Acknowledging the fact that the developed nations have made remarkable progress in reducing the death rates through the strengthening of prevention strategies and improvement in medical care to the victims, it is very much possible to minimize the incidence of burns and the associated complications. To conclude, there is an immense need to have a multifaceted approach to minimize the incidence of burns and upgrade the quality of care offered to the victims, especially in low- and middle-income nations. Furthermore, sustained efforts are required to reduce the rates of disability and burn attributed death rates.

Keywords: Burns, low- and middle-income nations, public health

How to cite this article:
Shrivastava SR, Shrivastava PS. Necessity to employ a multifaceted approach to minimize the incidence of burns and associated sequels in low- and middle-income nations. Environ Dis 2023;8:22-4

How to cite this URL:
Shrivastava SR, Shrivastava PS. Necessity to employ a multifaceted approach to minimize the incidence of burns and associated sequels in low- and middle-income nations. Environ Dis [serial online] 2023 [cited 2023 Jun 3];8:22-4. Available from: http://www.environmentmed.org/text.asp?2023/8/1/22/372864

Introduction

Burns have been acknowledged as one of the major global public health concerns not only because of the impairment in the quality of life resulting because of disability but also owing to the 0.18 million deaths attributed to it annually.^[1] However, a great proportion of these deaths have been reported in low- and middle-income nations, predominantly because of the lack of or delayed medical attention to the victims.^[1],[2] It is quite alarming that a major proportion of reported deaths are from the African and South-East Asian regions. Furthermore, the estimated death rate among children is almost seven times more in developing nations than that in developed nations, and it is a cause of grave concern for the public health authorities.^[1] The epidemiological analysis reflects that the incidence of burns in both genders is quite identical and higher among children aged 1–9 years (either due to improper adult supervision or due to child maltreatment) and is more among people from poor socioeconomic status.^[1],[3]

Predisposing Factors

As already mentioned above, people from low- and middle-income nations are more vulnerable to burns, and an even higher risk is reported among children and elderly.^[1] At the same time, poverty and overcrowding have also been identified as potential factors that can augment the risk of burn-related injuries.^[1] In addition, family-related obligations, wherein young girls are either given the task to carry out cooking or take care of their younger siblings predispose them to a much higher risk of burn-related injuries.^[2],[3] From the workplace perspective, the absence of safety measures to deal with a fire-related accident can prove to be a major factor, in case a sudden accident of fire occurs.^[1],[3] In addition, we cannot rule out the fact that some of the occupations by merely their job profile place a high level of risk of burns on the involved individuals.^[2] Moreover, people with preexisting medical diseases (namely, seizures or physical/cognitive disabled persons, etc.) or people who consume alcohol in excessive amounts, and smokers are also at high risk for burns. Finally, we cannot ignore the fact that chemicals that are easily accessible to people have been readily used for assaults and that has also endangered the lives of the victims.^[1],[2],[3]

Implications of Burns on Individual, Family, and Health System Level

We must acknowledge that nonfatal burns are a predominant cause of morbidity, disability, impaired quality of life, and prolonged hospitalization, which is commonly associated with secondary infections.^[1],[2],[4] From the social perspective, depending on the site of burns or the disfigurement, often associated with stigma, rejection, mental trauma, and a dent in self-confidence among the survivor, which is extremely frequent in cases of female victims.^[1] This has been further associated with reduced financial income and makes the victim dependent on others, which is due to the loss of vocational opportunities.^[4] From the health system perspective, burns are responsible for a massive burden on the health sector, due to the extended period of care required, not only in the acute phase but also in the prolonged rehabilitation phase.^[1],[4] Even for the victims' families, it casts a significant economic burden, both in terms of direct (medical expenses) and indirect costs (loss of wages, care for deformities, etc.) involved during the care and rehabilitation.^[4]

Components of a Multifaceted Approach

The first and foremost thing which we have to realize is that burns and related injuries are very much preventable. This is clearly evident by the fact that developed nations have made remarkable progress in reducing the death rates through the strengthening of prevention strategies and improvement in medical care to the victims, it is very much possible to minimize the incidence of burns and the associated complications.^[1],[2],[3] The strategies that are planned to minimize the consequences of burn-related injuries should predominantly aim for creating awareness among the vulnerable population groups and also aim to train them to provide first aid care (namely, the does and the do not).^[5],[6],[7]

As the problem of burn is derived from an interplay of multiple factors, the effectiveness of the implemented measures can be significantly enhanced by involving all the concerned sectors.^[1],[8] This has to begin first with the policy-level decisions, wherein the policy-makers realize the magnitude of the existing problem and thereby frame and implement effective strategies (namely, setting minimum standards that must be met before approving any place) to reduce the occurrence of such incidents in both domestic and workplace settings.^[7],[8] In addition, we have to implement burn prevention programs at the community level so that the incidence of such events can be significantly reduced.^[1],[6] However, it is also crucial that we strengthen medical care services available at health-care facilities to provide quality assured and prompt care to burn victims.^[9] This in turn will require the training of health professionals and providing the desired resources and medical equipment to them.^[9] Finally, as research is the backbone for all development and advancements, we have to establish specific priorities and thereby work in that direction to identify the answers to the identified problems.^[10] From the global perspective, a registry system has been established to enable the systematic collection and compilation of data on burns and encourage collaboration among different stakeholders to develop different strategies for burn prevention.^[1]

Conclusion

To conclude, there is an immense need to have a multifaceted approach to minimize the incidence of burns and upgrade the quality of care offered to the victims, especially in low- and middle-income nations. Furthermore, sustained efforts are required to reduce the rates of disability and burn-attributed death rates.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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