Poor treatment outcome and its determinants among patients with burn injuries in Ethiopia. A systematic review and meta-analysis.

BACKGROUND

Burn continues to be a major public health problem, resulting in thousands of preventable deaths and disabilities each year. Therefore, this review and meta-analysis aimed to assess the national prevalence of poor treatment outcome and its determinants.

METHODS

This systematic review was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and has been registered with PROSPERO. A structured search of databases (Medline/PubMed, Google Scholar, CINAHL, EMBASE, HINARI, and Web of Science) was undertaken. The quality of the studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool. A meta-analysis using a random-effects model was performed to estimate the pooled prevalence and associated factors. The I2 statistics was used to assess the heterogeneity of studies, and to identify the possible causes of heterogeneity, subgroup analysis and meta-regression were used. Egger's test and funnel plots were used to assess publication bias.

RESULTS

This systematic review and meta-analysis included eight studies involving a total of 9255 burn patients. The pooled national prevalence of poor treatment outcome among burn patients in Ethiopia was 20.1 % (95 %CI: 14.14, 26.06). Regional subgroup analysis showed that the pooled estimate of poor outcome was 13.12 %, 29.24 %, 26.2 %, 25.6 %, and 12.37 % in Tigray, Amhara, Oromia, Southern Nation Nationalities and People, and Addis Ababa, respectively. Moreover, subgroup analysis based on patients' age revealed that the pooled estimate of poor outcome among adults and children was 18.87 % and 21.58 %, respectively. This meta-analysis demonstrated that being a rural resident (OR = 3.24, 95 % CI: 1.66, 6.33), malnourished (OR = 3.17, 95 % CI: 1.93, 5.19), extent of burn > 10 % of TBSA (OR = 2.60, 95 % CI: 1.73, 3.90), and didn't get adequate fluid resuscitation (OR = 2.86; 95 % CI: 1.36, 6.00) were determinants of poor clinical outcome for burn patients.

CONCLUSION AND RECOMMENDATIONS: One in every five burn patients in Ethiopia had poor treatment outcome. Being a rural resident, malnourished, extent of burn > 10 %, and no getting adequate fluid resuscitation were significant predictors of poor treatment outcome. Special attention should be given to burn injured patients from rural area, malnourished, and with larger TBSA.