EPIDEMIOLOGY OF ADULTS HOSPITALIZED WITH BURNS IN KARACHI, PAKISTAN

Barns are a leading cause of adult death in Karachi slums, therefore w e reviewed 1 year's logged experience (November 1992 to October 1993) at Karachi's two adult burn units for patient age, sex, burn severity and outcome. Also 47 inpatients were interviewed regarding their circu mstances of injury. We grouped these using Haddon's Matrix. The log id entified 832 patients. Females (57 per cent) outnumbered males and wer e younger an average (25.1 vs 27.6 years, P = 0.002). Females had more severe burns than males (57 per cent vs 50 per cent total body surfac e area (TBSA) burn, P = 0.002). At the unit with outcome data (n = 556 ), the case fatality was 56 per cent. The estimated adult mortality du e to burns in Karachi was 10.2/100 000, 6.8/100 000 and 14.1/100 000 f or men and women, respectively. Burns of interviewed patients were mos t often associated with flames (33/47), but stove bursts caused the mo st severe injury (52 per cent TBSA). These patients were predominantly young uneducated female houseworkers, clothed in loose attire who wer e injured during daylight at home around a floor-level stove, unaware of fire safety, and who received no first aid. It was concluded that t he high barn severity and case fatality rates demand: (1) preventive m easures, such as kitchen sand buckets, safer stove design and placemen t, and education on five safety and first aid and (2) risk factor anal ysis to refine interventions.