title: Baseline assessment of inpatient burn care at Tenwek Hospital, Bomet, Kenya.
abstract: BACKGROUND
  Burn injuries are a significant source of both death and disability in developing countries. The objective of this project was to create a database of baseline inpatient burn care data to facilitate improvement of preventive measures and clinical outcomes at Tenwek Hospital, Bomet, Kenya.
  
  
  METHODS
  Both demographic and clinical data were obtained through a retrospective chart review conducted on inpatient burn patients admitted to Tenwek Hospital between January 1, 2006 and May 31, 2010.
  
  
  RESULTS
  Of the 269 patients studied, 53 % were male and 47 % were female. More than half (59 %) of the burns occurred in children younger than age 5 years. All-cause mortality rate of inpatient burn patients was 12 %. Cardiac arrest, sepsis, and respiratory failure/pneumonia caused 81 % of the deaths. Scalds caused 55 % of the burns. Thirteen percent of the burns were seizure-related. Second degree burns accounted for 76 % of the burns. Forty-three percent of patients received at least one surgical debridement during their hospital stay. Thirty-seven percent of patients received at least one split-thickness skin graft. Antibiotic treatment was administered to 55 % of patients. Fifty-three percent of patients presented to Tenwek Hospital 1 day or more from the time of injury.
  
  
  CONCLUSIONS
  We propose that prevention efforts focus on minimizing children's exposure to boiling liquids and open flames in homes, providing appropriate and consistent treatment to epileptics to prevent seizure-related burns, and stressing the importance of early presentation for treatment. A more selective approach to antibiotic use should be encouraged to decrease costs to the patient and hospital and lessen the risk of antibiotic resistance.
authors.affiliation: The Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903, USA. craig_otteni@brown.edu
authors.forename: Craig R
authors.initials: CR
authors.lastname: Otteni
authors.forename: Seno Ivan
authors.initials: SI
authors.lastname: Saruni
authors.forename: Vincent P
authors.initials: VP
authors.lastname: Duron
authors.forename: Jeremy P
authors.initials: JP
authors.lastname: Hedges
authors.forename: Russell E
authors.initials: RE
authors.lastname: White
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002053:Burn Units / Q000592:standards / Q000706:statistics & numerical data*; D002056:Burns / Q000209:etiology / Q000401:mortality / Q000517:prevention & control / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016208:Databases, Factual; D003661:Decision Support Techniques; D003906:Developing Countries; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D058996:Quality Improvement; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000592:standards / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult