Acceptability and functionality of the "Kettle Strap": An attempt to decrease kettle related burns in children.

BACKGROUND: Extensive hot water burns (HWB) are common at Red Cross War Memorial Children's Hospital (RCWMCH). The majority are caused by kettle scalds. These burn injuries usually affect toddlers living in poor socio-economic circumstances. The majority of these injuries are preventable. AIM: This trial aims to demonstrate the acceptability and functionality of the Kettle Strap as a kettle safety device. The feedback will be used for a public awareness program marketed by the Child Accident Prevention Foundation of Southern Africa and ChildSafe as part of their mandate to reduce kettle related thermal injuries. METHODS: 50 caregivers of children at RCWMCH were given a Kettle Strap for use in their homes, 25 with kettle related burns (Group I) and 25 who had no history of burns (Group II). All participants were instructed on Kettle Strap installation and use. Telephonic interviews on the acceptability and functionality of the strap occurred 1 month and 1 year later. RESULTS: The average age in Groups I and II was 25 and 22 months respectively. In Group I, the average burn surface area was 15%. Nineteen (76%) of the accidents occurred in the kitchen. Eighteen (72%) received immediate first aid. Twelve (48%) in Group I and 15 (60%) in Group II lived in formal housing. The majority of caregivers (90%) indicated that installation was quick and easy and thought that the Kettle Strap would prevent kettle burns. At 1 month follow-up, all the participants in Group I indicated that they would continue using the apparatus and felt greater protection compared to 84% of Group II. Only 40% indicated that use of the Kettle Strap raised awareness of other possible household dangers. Thirty participants were available telephonically after 1 year, 22 of these were still using the device, others had moved or lost their homes to fire. All participants had informed neighbors about the Kettle Strap and burn safety. The participants were prepared to pay ZAR 44 for the complete apparatus. CONCLUSION: The Kettle Strap is an acceptable, affordable device to improve kettle safety in the home.

Changing state of pediatric injuries in South Africa: An analysis of surveillance data from a Pediatric Emergency Department from 2007 to 2011.

BACKGROUND: Pediatric injuries are associated with significant morbidity and mortality, especially in low- and middle-income countries. Data to characterize the cause and risk factors associated with childhood injuries in low- and middle-income countries are very scarce. The aim of this study is to describe the cause of pediatric injuries and their possible changes between 2007 and 2011 using hospital-based data in Cape Town, South Africa. METHODS: Data from injured children <13 years of age who presented to the Red Cross War Memorial Children's Hospital's emergency department in 2007 and 2011 were captured in Childsafe South Africa's trauma surveillance system. Poisson regression was used to assess changes in rates of injury between 2007 and 2011 in terms of demographics, geographic location of injury, type of injury mechanism, injury severity, and anatomic region of the sustained injury. RESULTS: In total, 14,915 injured children with 15,414 injuries presented to Red Cross War Memorial Children's Hospital in 2007 and 2011. The mean age was 5.01 ± 3.5 years and 60.3% were male. Common mechanisms of injury included falls (n = 6,036; 40%), road traffic injuries (n = 1,939; 13%), burns (n = 1,885; 12.6%), and assault (n = 640; 4.3%). Comparing 2011 to 2007, the incidence of road traffic injuries has decreased by 7% (P < .05) while burn injuries increased 11% (P < .05). Seventy-three percent (73%) of injuries that presented to Red Cross War Memorial Children's Hospital occurred in the Cape Flats area of Cape Town, where many informal settlements exist. CONCLUSION: These epidemiologic findings suggest that while road traffic injuries decreased and burn injuries increased at Red Cross War Memorial Children's Hospital, there is a need for data that are population-based and not hospital based. If we could describe injuries accurately within the pediatric population of a city such as Cape Town, we could in turn use this data to strengthen the need for targeted interventions to address risk factors for pediatric injuries. Despite this, hospital-based data remain a powerful tool to study injuries in low and middle-income countries.

Pediatric burn injuries in South Africa: a 15-year analysis of hospital data.

INTRODUCTION: Burns are a significant burden of pediatric injuries, particularly in low and middle-income countries, were more than 90% of burn-related pediatric deaths occur. This study explores pediatric burn-related injuries over a fifteen year time period in South Africa through an analysis of a pediatric trauma surveillance system. METHODS: This retrospective observational study used data collected by Childsafe South Africa from the Red Cross War Memorial Children's Hospital (RCH) trauma registry in Cape Town, South Africa between 1995 and 2009 for children less than 13 years of age who presented with burn injuries to the hospital's casualty department. Demographic data and Abbreviated Injury Scores (AISs) were first assessed, followed by an analysis of time trends using Poisson regression. Logistic regression models were used to analyse factors related to hospital admissions. RESULTS: Between 1995 and 2009, 9438 children with burn-related injuries presented to RCH, of which nearly three-quarters resulted from scalds (73%; n=7024). The mean age of the injured children was 3.1 ± 2.9 years 58% were male. 11 deaths occurred in the hospital's casualty department. 39% of injuries were minor, 56% were moderate, and 5% were severe. During the 15-year study period, moderate burn injuries increased by 3%, while minor injuries decreased by 10% (p<0.05). 49% of all children were admitted to the hospital. Hospital admissions increased by 3% (p<0.05) during the study period. CONCLUSIONS: Pediatric burn injuries are a significant contributor to the burden of child diseases in developing county hospitals. Pediatric surveillance systems, such as Childsafe South Africa's, are important to study epidemiologic changes in burn injuries. Findings suggest the need for targeted interventions to address the prevention of specific burn-related injuries.