Management of paediatric burns in low- and middle-income countries: assessing capacity using the World Health Organization Surgical Assessment Tool. Int Health 2020 Sep 01;12(5):499-506
Date
10/16/2019Pubmed ID
31613329DOI
10.1093/inthealth/ihz068Scopus ID
2-s2.0-85089822120 (requires institutional sign-in at Scopus site) 7 CitationsAbstract
BACKGROUND: Burns are a leading cause of global disease burden, with children in low- and middle-income countries (LMICs) disproportionately affected. Effective management improves outcomes; however, the availability of necessary resources in LMICs remains unclear. We evaluated surgical centres in LMICs using the WHO Surgical Assessment Tool (SAT) to identify opportunities to optimize paediatric burn care.
METHODS: We reviewed WHO SAT database entries for 2010-2015. A total of 1121 facilities from 57 countries met the inclusion criteria: facilities with surgical capacity in LMICs operating on children. Human resources, equipment and infrastructure relevant to paediatric burn care were analysed by WHO Regional and World Bank Income Classifications and facility type.
RESULTS: Facilities had an average of 147 beds and performed 485 paediatric operations annually. Discrepancies existed between procedures performed and resource availability; 86% of facilities performed acute burn care, but only 37% could consistently provide intravenous fluids. Many, particularly tertiary, centres performed contracture release and skin grafting (41%) and amputation (50%).
CONCLUSIONS: LMICs have limited resources to provide paediatric burn care but widely perform many interventions necessary to address the burden of burns. The SAT may not capture innovative and traditional approaches to burn care. There remains an opportunity to improve paediatric burn care globally.
Author List
Thomson IK, Iverson KR, Innocent SHS, Kaseje N, Johnson WDAuthor
Katie Iverson MD, MPH Assistant Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentBurns
Child
Child, Preschool
Developing Countries
Female
Humans
Infant
Infant, Newborn
Male
Pediatrics
Poverty
Practice Guidelines as Topic
