Community-based interventions for the prevention of burns and scalds in children

BACKGROUND: Burns and scalds are a significant cause of morbidity and mortality in children. Successful counter-measures to prevent burn and scald-related injury have been identified. However, evidence indicating the successful roll-out of these counter-measures into the wider community is lacking. Community-based interventions in the form of multi-strategy, multi-focused programmes are hypothesised to result in a reduction in population-wide injury rates. This review tests this hypothesis with regards to burn and scald injury in children. OBJECTIVES: To assess the effectiveness of community-based interventions, defined as coordinated, multi-strategy initiatives, for reducing burns and scalds in children in children aged 0-14 years. SEARCH STRATEGY: The search strategy was based on electronic searches, handsearches of selected journals and snowballing from reference lists of selected publications. SELECTION CRITERIA: Studies were independently screened for inclusion by two reviewers. Included studies were those that reported changes in medically attended burn and scald-related injury rates in a paediatric population (age 0 - 14 years), following the implementation of a controlled community-based intervention. DATA COLLECTION AND ANALYSIS: Data were independently extracted by two reviewers. Meta-analysis was not appropriate, due to the heterogeneity of the included studies. MAIN RESULTS: Of 32 identified studies, only three met the criteria for inclusion. Only one of these three studies showed a significant decrease in paediatric burn and scald injury in the intervention community compared with the control community. The failure of the other two studies to show a positive result may have been due to limited time-frame for the intervention and/or failure to adequately implement the counter-measures in the communities. REVIEWERS' CONCLUSIONS: There are a very limited number of research studies allowing conclusions to be drawn about the effectiveness of community-based injury prevention programmes to prevent burns and scalds in children. There is a pressing need to evaluate high-quality community-based intervention programmes based on efficacious counter-measures to reduce burns and scalds in children. It is important that a framework for considering the problem of burns/scalds in children from a prevention perspective be articulated, and that an evidence-based suite of interventions be combined to create programme guidelines suitable for implementation in communities throughout the world.