Publications

Work at the Centre for Global Burn Injury Policy & Research has been collated into various forms of publications including informative posters, presentations, articles, and papers. We are able to share some of these with our community and those interested in global health, specifically burn care. 

Burns in Nepal: a participatory, community survey of burn cases and knowledge, attitudes and practices to burn care and prevention in three rural municipalities.

AUTHORS: Kamal Phuyal, Edna Adhiambo Ogada , Richard Bendell, Patricia E Price , Tom Potokar2,3

ABSTRACT: Objectives As part of an ongoing, long-term project to co-create burn prevention strategies in Nepal, we collected baseline data to share and discuss with the local community, use as a basis for a co-created prevention strategy and then monitor changes over time. This paper reports on the method and outcomes of the baseline survey and demonstrates how the data are presented back to the community. Design a community-based survey. Setting Community based in three rural municipalities in Nepal. Participants 1305 households were approached: the head of 1279 households participated, giving a response rate of 98%. In 90.3% of cases, the head of the household was male. Results We found that 2.7% (CI 1.8 to 3.7) of 1279 households, from three representative municipalities, reported at least one serious burn in the previous 12 months: a serious burn was defined as one requiring medical attention and/or inability to work or do normal activities for 24 hours. While only 4 paediatric and 10 adult cases in the previous 12 months reached hospital care, the impact on the lives of those involved was profound. Only one patient was referred on from primary to secondary/ tertiary care; the average length of hospital stay for those presenting directly to secondary/tertiary care was 21 days. A range of first aid behaviours were used, many of which are appropriate for the local context while a few may be potentially harmful (e.g., the use of dung). Conclusion. The participatory approach used in this study ensured a high response rate. We have demonstrated that infographics can link the pathway for each of the cases observed from initial incident to final location of care.

PUBLISHED IN: Phuyal KOgada EABendell R, et alBurns in Nepal: a participatory, community survey of burn cases and knowledge, attitudes and practices to burn care and prevention in three rural municipalities

Review of the epidemiology of burn injuries in Ethiopia; implications for study design and prevention

AUTHORS: Edna Adhiambo Ogada, Abiye Hailu Gebreab , Thomas Stephen Potokar

ABSTRACT: Background: 90% of burn deaths occur in lower resource settings, where prevention programs are uncommon. Efficient planning and resource allocation for prevention requires consistent and reliable data. Published research on burn epidemiology from these settings is limited in scope and rigor and often not replicable. Objective: The objective of the review was; to examine the literature to determine what information exists on the epidemiology of burn injuries in Ethiopia; to assess its utility and suitability for planning interventions for burn prevention. Methods: Taking a public health approach in which burn injuries fall within the broader field of injury, a broad key term search was performed in Safety Lit and MEDLINE. We reviewed the literature on burn epidemiology in Ethiopia, to assess its utility and suitability for planning interventions for burn prevention. Results: Our search strategy yielded more information than burn specific search strategies. We identified 23 studies drawn from observational and primarily hospital-based, cross sectional studies. They offer a preliminary evidence base that can be used to make recommendations for future surveillance, risk factor exploration and prevention initiatives. Conclusion: We conclude that the low rate of burn cases identified from observational studies; the challenge of defining and coding injury in the field; recall bias; mean case series data from tertiary units are more efficient and sustainable for monitoring burn epidemiology in Ethiopia. We recommend the establishment of a national trauma registry or WHO’s Global Burn Registry (GBR) to gather data in Ethiopia and countries in comparable settings. Community studies, provide the best avenue to gauge knowledge, attitudes and practices relevant to injury prevention, first aid and health seeking behaviour. This critical preliminary synthesis on burn epidemiology frames future national research and policy on burn surveillance and prevention.

PUBLISHED IN: Edna Adhiambo Ogada, Abiye Hailu Gebreab, Thomas Stephen Potokar, ‘Review of the epidemiology of burn injuries in Ethiopia; implications for study design and prevention’, Burns Open 3 (2019), pp. 75–82. https://doi.org/10.1016/j.burnso.2019.05.002.

Estimating the cost impact of dressing choice in the context of a mass burns casualty event

AUTHORS: Lowin J, Winfield T, Price P, Anderson P, Potokar T

ABSTRACT: Mass casualty burn events (MCBs) require intense and complex management. Silver-infused longer use dressings might help optimise management of burns in an MCB setting. We developed a model estimating the impact of dressing choice in the context of an MCB. The model was developed in Excel in collaboration with experienced emergency response clinicians. The model compares use of silver-infused dressings with use of traditional dressings in patients with partial thickness burns covering 30% of their body. Costs were estimated from a UK perspective as a proxy for a funded emergency response team and limited to cost of dressings, bandages, padding, and analgesia and staff time. Expected patient costs and resource use were summarised over an acute 2-week intervention period and extrapolated to estimate possible timesaving’s in a hypothetical MCB. Per patient costs were estimated at £2,002 (silver) and £1,124 (traditional) (a daily additional spend of £63). Per patient staff, time was estimated at 864 minutes (silver) and 1,200 minutes (traditional) (a daily time saving of 24 minutes). Multiplying up to a possible MCB population of 20 could result in a saving equivalent to 9 staff shifts over the 2-week intervention period. The model was sensitive to type of silver dressing, frequency of dressing change and staff costs. We found increased costs through use of silver dressings but timesavings that might help optimise burns management in an MCB. Exploring the balance between costs and staff time might help future MCB response preparation.

PUBLISHED IN: Lowin J., Winfield T., Price P., Anderson P., Potokar T., ‘Estimating the cost impact of dressing choice in the context of a mass burns casualty event’, Annals of Burns and Fire Disasters, vol. XXXII n. 3, (2019), pp. 222-226. https://cronfa.swan.ac.uk/Record/cronfa53529http://www.medbc.com/annals/review/vol_32/num_3/v32n3content.htm

Developing and implementing a community led burn prevention programme and first aid programme in three rural municipalities in Nepal.

AUTHORS: Edna Adhiambo Ogada, Kamal Phuyal, Richard Bendell, Patricia Price, Tom Potokar

ABSTRACT: A poster to summaries the work carried out in Nepal. The poster highlights the geographic regions of the community survey into burn incidence and treatment, the main objectives and methods, proposed interventions, and the barriers and facilitators to the prevention propositions. It showcases how the CGBIPR uses implementation science to study knowledge, attitudes and practices surrounding burns and design effective community prevention programmes.

PRESENTED AT: Phuyal, Kamal; Ogada, Edna (presenter); Bendell, Richard; Price, Patricia and Potokar, Thomas, ‘Developing and implementing a community-led burn prevention and first aid programme in three rural municipalities in Nepal’, presented at Global Implementation Conference, Glasgow, 16-17 September 2019.

Implementation and Improvement Science: A course for nurses working in burns units in Malawi and Ethiopia

AUTHOR: Maria Holden

ABSTRACT: A poster detailing the course aims and summary for the Implementation & Improvement Science workshop. The workshop was designed for nurses working in low to middle income countries in burn care settings and this pilot took place with nurses from five hospitals in Malawi and Ethiopia. The aim of this course was to improve the burn care in these areas by training nurses in quality improvement processes to be applied on their own wards.

PRESENTED AT: Beard, Maria (presenter); Ogada, Edna, ‘Implementation and Improvement Science: A course for nurses working in burns units in Malawi and Ethiopia’, presented at International Nurses Day is Nurses: A Voice to Lead – Health for All Event at University of Nottingham, Nottingham, 2019.

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