ABSTRACT
The estimated annual burn incidence in India is approximately 6-7 million per year. The high incidence is attributed to illiteracy, poverty and low level safety consciousness in the population. The situation becomes further grim due to the absence of organized burn care at primary and secondary health care level. But the silver lining is that 90% of burn injuries are preventable. An initiative at national level is need of the hour to reduce incidence so as to galvanize the available resources for more effective and standardized treatment delivery. The National Programme for Prevention of Burn Injuries is the endeavor in this line. The goal of National programme for prevention of burn injuries (NPPBI) would be to ensure prevention and capacity building of infrastructure and manpower at all levels of health care delivery system in order to reduce incidence, provide timely and adequate treatment to burn patients to reduce mortality, complications and provide effective rehabilitation to the survivors. Another objective of the programme will be to establish a central burn registry. The programme will be launched in the current Five Year Plan in Medical colleges and their adjoining district hospitals in few states. Subsequently, in the next five year plan it will be rolled out in all the medical colleges and districts hospitals of the country so that burn care is provided as close to the site of accident as possible and patients need not to travel to big cities for burn care. The programme would essentially have three components i.e. Preventive programme, Burn injury management programme and Burn injury rehabilitation programme.
ABSTRACT
This chapter deals with the magnitude of the problem of burns in a developing country and describes the epidemiology. The common causes of burn injury have been illustrated by suitable photographs. The author feels that a large percentage of both domestic and industrial burns are preventable by simple modification of the agents or environment, and by public education. He recommends that public, social workers, professional persons, industrialists, government and nongovernment agencies undertake a programme for prevention of such accidents.
Subject(s)
Burns/epidemiology , Burns/prevention & control , Child , Female , Humans , India , MaleABSTRACT
In a controlled trial burn patients at risk of Pseudomonas aeruginosa septicaemia were passively immunised with an immunoglobulin prepared from plasma from healthy human volunteers vaccinated with a polyvalent pseudomonas vaccine; passively immunised and vaccinated; or only vaccinated. In children the mortality was lowest in those passively immunised (0%, 0/18); it was 21% (9/42) in controls. In adults the mortality rate of those receiving immunoglobulin or vaccine was 10% (3/30) or 8.3% (5/60), respectively, compared with 36% (22/61) in controls. Combined vaccine and immunoglobulin treatment gave rather less protection (mortality 13.6%, 3/22) than vaccine alone. Pseudomonas infection of burns was less common in patients who received immunoglobulin than in vaccinated or control patients.
Subject(s)
Bacterial Vaccines/therapeutic use , Burns/complications , Immunization, Passive , Immunoglobulins/therapeutic use , Pseudomonas Infections/prevention & control , Pseudomonas/immunology , Vaccination , Adolescent , Adult , Age Factors , Child , Child, Preschool , Clinical Trials as Topic , Humans , Infant , Middle Aged , Pseudomonas Infections/mortality , Risk , Sepsis/prevention & control , Wound Infection/prevention & controlABSTRACT
A polyvalent pseudomonas vaccine has been tested in controlled clinical trials at two burns units, in Birmingham and New Delhi, in children and adults with burns more than 15% full skin thickness. None of the vaccinated patients in either trial showed blood cultures containing Pseudomonas aeruginosa, and vaccinees showed raised titres of protective antibody and increased phagocytic activity against Ps. aeruginosa. In the New Delhi unit, where death from Ps. aeruginosa infection is common, the mortality in adults was reduced from 40.6% (13/32) in the unvaccinated group to 6.6% (2/30) in the vaccinated group, and in children from 20.8% (5/24) in the unvaccinated group to 4.8% (1/21) in the vaccinated group.
Subject(s)
Bacterial Vaccines/administration & dosage , Burns/therapy , Pseudomonas Infections/prevention & control , Pseudomonas aeruginosa/immunology , Adolescent , Adult , Aged , Antibodies, Bacterial/analysis , Burns/microbiology , Child , Child, Preschool , Clinical Trials as Topic , England , Humans , India , Infant , Male , Middle Aged , Phagocytosis/drug effects , Pseudomonas Infections/mortalityABSTRACT
In a controlled clinical trial of a polyvalent pseudomonas vaccine in burned patients infected with Pseudomonas aeruginosa all 18 vaccinated patients survived, whereas 8 of 20 unvaccinated patients died.
