title: The role of seizure disorders in burn injury and outcome in Sub-Saharan Africa.
abstract: Patients with epilepsy have higher incidence and severity of burn injury. Few studies describe the association between epilepsy and burns in low-income settings, where epilepsy burden is highest. The authors compared patients with and without seizure disorder in a burn unit in Lilongwe, Malawi. The authors conducted a retrospective study of patients admitted to the Kamuzu Central Hospital burn ward from July 2011 to December 2012. Descriptive analysis of patient characteristics and unadjusted and adjusted analyses of risk factors for mortality were conducted for patients with and without seizure disorder. Prevalence of seizure disorder was 10.7% in the study population. Adults with burns were more likely to have seizure disorder than children. Flame injury was most common in patients with seizure disorder, whereas scalds predominated among patients without seizure disorder. Whereas mortality did not differ between the groups, mean length of stay was longer for patients with seizure disorder, 42.1 days vs 21.6 days. Seizure disorder continues to be a significant risk factor for burn injury in adults in Malawi. Efforts to mitigate epilepsy will likely lead to significant decreases in burns among adults in Sub-Saharan Africa and must be included in an overall burn prevention strategy in our environment.
authors.affiliation: From the *Department of Surgery, University of North Carolina at Chapel Hill; †Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi; and ‡North Carolina Jaycee Burn Center, University of North Carolina at Chapel Hill.
authors.forename: Laura P
authors.initials: LP
authors.lastname: Boschini
authors.forename: Anna F
authors.initials: AF
authors.lastname: Tyson
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Samuel
authors.forename: Claire E
authors.initials: CE
authors.lastname: Kendig
authors.forename: Stephano
authors.initials: S
authors.lastname: Mjuweni
authors.forename: Carlos
authors.initials: C
authors.lastname: Varela
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Cairns
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Charles
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D002053:Burn Units; D002056:Burns / Q000453:epidemiology* / Q000628:therapy; D004827:Epilepsy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome