The national burden of mortality and its associated factors among burn patients in Ethiopia. A systematic review and meta-analysis

Abstract

Background: Despite all advances in burn prevention, treatment, acute care, and rehabilitation, burn injuries continue to cause significant mortality and disability in Ethiopia. Thus, this review and meta-analysis aimed to assess the pooled prevalence and the determinants of mortality in Ethiopia.

Methods: This systematic review was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A structured search of databases (Medline/PubMed, Google Scholar, CINAHL, EMBASE, HINARI, and Web of Science) was undertaken. Selection, screening, reviewing, and data extraction were done by independent reviewers using a Microsoft Excel spreadsheet. The quality of the included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool. A random-effects meta-analysis model with a 95 % confidence interval was computed to estimate the pooled effect size (i.e., prevalence and odds ratio). Publication bias was checked using the funnel plot, Egger's, and Begg's tests. The heterogeneity of studies was assessed using I² statistics. Subgroup analysis based on the region and age group was done.

Results: This systematic review and meta-analysis included a total of ten studies. The pooled prevalence of mortality among patients with burn injuries in Ethiopia was found to be 6.01 % (95 % CI: 2.75, 9.26). Subgroup analysis based on the region showed that the pooled prevalence of mortality was highest in the Oromia region (12.02 %), followed by the Amhara region (8.5 %). Additionally, subgroup analysis based on patients' ages revealed that the pooled estimates of mortality among all age groups and children were 5.18 % and 7.91 %, respectively. The meta-analysis demonstrated that the extent of burn > 10 % TBSA (OR = 5.04, 95 % CI: 2.72, 9.35), presence of comorbidity (OR = 4.01, 95 % CI: 1.44, 11.18), and presence of a 3rd degree burn (OR = 10.64, 95 % CI: 2.82, 40.16) were significantly associated with mortality among burn patients.

Conclusion and recommendations: The national prevalence of mortality among burn patients in Ethiopia was high. The extent of burn, presence of comorbidity, and 3rd degree burns were significant predictors of mortality. We strongly recommend that health care workers give special attention to burn patients with greater extent and depth of burn, and for those who have comorbid diseases.

Keywords: Burn; Meta-analysis; Mortality; Systematic review.