Burn prevention programs for children in developing countries require urgent attention: a targeted literature review.
BACKGROUND
Paediatric burns are a significant international public health problem. Developing and developed countries report similar challenges regarding paediatric burn prevention programs. Paediatric burns requiring healthcare often incur significant health and opportunity costs, death or long-term disability. This paper reviews international burn prevention strategies, and considers implementation of effective prevention strategies in South Africa. REVIEW QUESTION: Are there differences between developed and developing countries regarding causes and prevalence of paediatric burns, prevention strategies, and evidence of effectiveness? REVIEW FRAMEWORK: Implementing effective burn prevention strategies in South Africa.


METHODS
This systematic literature review identified, and narratively synthesized information from studies reporting population-based initiatives to prevent paediatric burns. Strategies from developing and developed countries were compared. Common strategies were identified, and evidence of effectiveness described.


RESULTS
30 studies were included from 16 developed/developing countries, reporting similar prevention strategies. Multi-pronged community-based interventions were most effective. Common elements comprised raising awareness of how burns occur, how burns can be prevented, the speed of sustaining significant injuries, and the short- and long-term effects of burns. Burn prevention strategies relevant to South Africa were provision of education in different formats (written, pictorial and verbal) in places frequented by children and parents, monitoring children more closely in hazardous areas (e.g. kitchens), and better planning of homes to reduce hazards.


CONCLUSIONS
More work is required to establish effective, sustainable community-wide prevention programs in developed and developing countries. Effective paediatric burn prevention programs for South Africa should acknowledge parent and child literacy, how and where information is best accessed, the need to adapt effective hazard reduction programs to informal settlements, and the importance of legislated minimum safe housing standards. This requires significant commitment from Government, communities and individuals.
Red Cross Hospital, Physiotherapy, Klipfontein Road, Cape Town, South Africa. aparbhoo@yahoo.com
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D002056:Burns / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015995:Prevalence; D017751:Safety Management / Q000379:methods; D013019:South Africa