Global burn burden, LMIC, and health-equity disparities

Overview

Severe burn is highly unevenly distributed across global health systems. Burns produce more than 250,000 deaths and the loss of approximately 18 million disability-adjusted life-years annually, more than 90 percent of which occur in LMICs, according to a Rybarczyk et al. systematic review of WHO estimates ^[1]. A separate Cameroonian mortality analysis by Forbinake et al. cites a worldwide figure of an estimated 265,000 deaths from fires alone each year, with 96 percent of those deaths falling on LMICs ^[6]. Severe burn is a major public-health issue in developing nations, and the burden of suffering from fire is concentrated among the poor ^[5].

The injury epidemiology in HICs and LMICs is broadly similar in pattern but radically different in scale and outcome: Forjuoh's review of 117 LMIC studies found largely the same descriptive epidemiological characteristics as HICs, with slightly different risk factors centered on child supervision, flammable-fuel storage in the home, low maternal education, and overcrowding ^[4]. Outcome gaps persist for decades; Potokar et al. summarise the literature plainly: consistent evidence has emerged over many years that mortality and morbidity outcomes for burn patients in LMICs lag behind those in more resource-rich countries ^[8].

This page covers four interlocking surfaces: global epidemiology and the income-mortality gradient; the household, gender, and fuel risk patterns that drive LMIC incidence; the access, transfer, surgical-capacity, and rehabilitation gaps that explain why outcomes differ at similar burn size; and the equity disparities that persist within HICs (race, insurance, geography) and at the conflict and refugee margins.

Epidemiology

The largest single statistic — over 90 percent of burn deaths concentrated in LMICs — recurs across primary studies and reviews [1, 3, 19, 29]. Atiyeh et al. quantify this more sharply: over 90 percent of fatal fire-related burns occur in LMICs, with South-East Asia alone accounting for over half of these fire-related deaths ^[3]. Ahuja and colleagues estimate that 90 percent of the world incidence of severe burn occurs in LMICs and 50 percent in South-East Asia ^[10].

The economic gradient is robust. Peck et al. performed a retrospective review of 189 countries for 2008-2010 using World Bank economic data and WHO mortality data and found statistically significant associations between burn mortality and GDP per capita (r=-0.26), GNI per capita (r=-0.36), and Gini coefficient (r=+0.17): a nation's income level is negatively correlated with burn mortality, the lower the income level, the higher the burn mortality, and inequitable income distribution within a country also correlates with burn mortality ^[2]. Spronk et al. note that estimates of non-fatal burden vary by method; applied to Western Australian Burns Service registry data, the GBD method gave YLDs of 89 to 120 per 100,000, the dedicated INTEGRIS-burns method estimated 209 to 324, and the Injury-VIBES method estimated 610 to 1,085 ^[31]. The Western-Australia scope means the ranges illustrate methodological variability rather than provide a global registry; the implication for global-burden statistics is that the choice of estimator drives the headline number.

The HIC numerator continues to fall and the LMIC numerator does not. Tevlin et al. note that improved education in burns has driven a reduction in burn mortality in HICs while 95 percent of burns continue to occur in low-income countries, causing enormous suffering, death, and disability ^[45].

Risk factors and mechanisms

Risk in LMICs concentrates on the household and the cooking fire. Peck et al.'s review of non-electric domestic-appliance burns and fires found that incidence of injuries is largely associated with the use of stoves and lamps, and from kerosene or petroleum as well as butane, liquid petroleum gas, and alcohol; industry and government regulations and standards are either nonexistent or not adequately enforced ^[5]. A distinctive LMIC pattern is flame ignition of loose garments at open-flame or ground-level cooking, which sweeps women and girls disproportionately into the case mix; Banerjee and colleagues, reviewing paediatric burns in Nigeria, identified the main risk factors as socioeconomic status, overcrowding, and involving young girls in traditional cooking roles ^[22], and Ahuja's Delhi series similarly tracks kitchen scald and flame from cooking as the dominant case-mix drivers ^[10]. The same Delhi series tracks the household fuel transition: LPG leaks accounted for only 0.72 percent of kitchen accidents in Phase I and rose to 10.74 percent in Phase II ^[10].

Geography within an LMIC also matters. Sanane et al., comparing rural and urban under-five children in the Dodoma region of Tanzania, found that 60.3 percent of burn-wound cases occurred in rural areas and that the dominant rural predictor was poor caregiver supervision, while the dominant urban predictor was household hazards ^[41]. The Forjuoh review converges on the same household drivers: presence of pre-existing impairments in children, lapses in child supervision, storage of flammable substances in the home, low maternal education, and overcrowding ^[4].

The same household structure that produces injury also defines who is exposed. Buyukbese Sarsu et al. demonstrate the converse in a war setting: among 707 paediatric burn patients comprising 469 Turkish and 238 Syrian children, mortality from third-degree burns reached 100 percent in Syrian children compared with 23.3 percent in Turkish children, related to refugee-camp and tent-city living conditions and to war-inflicted blast and flame burns ^[24].

Assessment

First-aid knowledge — the gateway to outcome at the household level — is consistently inadequate. Alomar et al., surveying 408 caregivers presenting to a paediatric emergency department, found that 41 percent treated burns with cool or cold water but 97 percent had inappropriate or no knowledge of the duration; 32 percent applied non-scientific remedies including honey, egg white, toothpaste, white flour, tomato paste, yogurt, tea, sliced potato, butter, or ice; only 15 percent had received first-aid training ^[19]. Phuyal and colleagues' community survey in Nepal found a range of first-aid behaviours including some appropriate practices and some potentially harmful ones such as the use of dung ^[20]. Michael and colleagues, surveying 362 reproductive-age women in Northwest Nigeria, found that mean overall knowledge was 18.6 out of 24 but only 55.5 percent had adequate first-aid knowledge ^[21].

The pattern crosses income levels. Davies et al. in the UK found that only 32 percent of parents had adequate burns first-aid knowledge while 43 percent had poor or no knowledge, and inadequate knowledge correlated with lower socioeconomic group ^[35]. Hodgins et al. compared 1,146 participants across Wales, Pakistan, India, Botswana, and Zambia: a higher proportion of UK respondents had received information on prevention (51.4 percent versus 38.1 percent) and on first aid (70.9 percent versus 40.1 percent) than the four LMIC sites ^[9]. The gap is not knowledge alone — Jain et al.'s outreach-camp series across the Middle East, Russia, and South Asia documented first-aid as performed in only 7 percent of 167 burn cases ^[25].

Management

When first aid is delivered properly, the effect is measurable. Wood et al.'s bi-national cohort study reported that 68 percent of patients had cooling before burn-centre admission, with at least 20 minutes of cooling for 46 percent; cooling reduced probability of grafting by 13 percent, intensive-care admission by 48 percent, and hospital length of stay by 2.27 days, and showed a dose-response relationship between duration of first aid and every outcome except death ^[17]. Wright et al., using a human model of burn injury, found that cooling salvaged on average 25.2 percent of dermal thickness and that public-health messaging should emphasise cooling as first aid for burns ^[18].

Transfer and surgical-capacity gaps then determine what happens next. Botman et al. studied 67 burn patients at a regional referral hospital in Tanzania: among acute wounds, only 50 percent reached a facility within 24 hours and 74 percent had referrals from other facilities made within three weeks; among contracture patients, 74 percent had sought health care after the acute injury but only 4 percent had received skin grafts beforehand and 70 percent had never received surgical care or a referral ^[14]. Lack of trust, surgical capacity, and referral timeliness were the dominant negative factors; accounting for hospital fees, patients routinely exceeded the catastrophic-expenditure threshold, with no financial risk protection ^[14].

Surgical-capacity interventions can move outcomes. Purcell et al., studying 1,785 children at Kamuzu Central Hospital in Malawi, found in a propensity-score-weighted logistic regression that patients undergoing surgery after burn injury had increased odds of survival (OR 5.24, 95% CI 2.40-11.44, p=0.003), and concluded that efforts to enhance burn infrastructure to deliver surgical care are imperative to attenuate burn mortality in resource-poor settings ^[15]. Puri et al., comparing early excision with conservative grafting in an Indian centre, reported mean hospital stay of 15.1 days for early excision and grafting versus 36.2 days for delayed grafting (p=0.001), with a 90 percent graft take versus 95 percent and a higher mean blood loss (346 versus 241 mL) in the early-excision group ^[16].

System-level capacity building is a parallel surface. Potokar et al. describe Interburns' cyclical framework for quality improvement, developed iteratively over a decade and demonstrating sustained improvement over a three-year cycle; their Delivery Assessment Tool produced more than 19 percent score improvement at sites in Nepal and Bangladesh [8, 43]. Roberson et al. note that LMIC healthcare systems rarely have access to allografts, which may contribute to limited survival of patients with large burns in these settings, and identify implementation issues common to all-income-level tissue-banking programs ^[30]. Borg et al. argue that burns-care training should be accessible at a global scale and involve simulation, courses, and fellowship programmes that are affordable and accessible to surgeons in low-income countries ^[38]. Spiwak et al. showed that it is possible to create a standardised burn course that translates HIC knowledge to meet the needs of the end-user in a low-income-country setting ^[37].

Outcomes

The mortality and morbidity gap is the central global-burden finding. Jacobs et al., analysing 1,995 patients across 10 LMICs and 4 HICs in the WHO Global Burn Registry, found significantly higher mortality in LMICs (17 percent versus 9 percent, p<0.001) with no significant difference between income regions for injury patterns (p=0.062) or total body surface area (p=0.077) ^[7]. HICs had lower overall mortality even with higher rates of concurrent injuries and longer length of stay ^[7]. Eleven percent of LMIC hospitals in that dataset did not have reliable access to an operating theatre ^[7]. The authors conclude that investing in health-care infrastructure could lead to improved outcomes for patients in low-resource settings ^[7].

Forbinake et al.'s eight-year Cameroonian series of 440 burn patients (306 admitted) reported a mortality rate of 23.4 percent, with shock (35.0 percent), sepsis (24.3 percent), and acute respiratory distress (24.3 percent) as the leading proximate causes of death ^[6]. Vlasic et al.'s Tanzanian paediatric cohort of 133 children reported in-hospital mortality of 22.6 percent, with burn severity independently associated with all three studied outcomes ^[12]. Wondifraw et al.'s meta-analysis of 18 Sub-Saharan-African paediatric studies estimated the prevalence of poor treatment outcomes at 15.99 percent (95% CI 11.32 to 20.66 percent), driven by age under five (pooled OR 8.57), TBSA above 20 percent (pOR 10.59), flame mechanism (pOR 3.87), and malnutrition (pOR 3.26) ^[13].

Survival has shifted the long-term yardstick to quality of life. Mustehsan and colleagues' systematic review of HRQoL among LMIC burn survivors found consistently markedly impaired scores, most compromised in physical-functioning and psychological-wellbeing domains, with greater burn severity and socioeconomic factors as key predictors and rehabilitation interventions producing moderate-to-large standardised effects (Cohen's d 1.51 to 3.81) ^[11]. Christie et al. document bloodstream-infection rates of 18.8 percent (46 of 245) in South African paediatric burn patients, with 56 percent of pathogens multi-drug-resistant — a concrete LMIC-specific complication surface that compounds the mortality gap ^[44].

Special Considerations

Paediatric LMIC. Children in LMICs carry a disproportionate share of the global paediatric burn burden, with Sub-Saharan Africa the highest-incidence region and scald the dominant mechanism [12, 13]. Meng and colleagues' systematic review of paediatric burn contractures in low- and lower-middle-income countries describes a recurrent sequence: timely access to primary care is challenging, and children with deep burns often fail to receive specialised care until months or years post-injury, producing hypertrophic scar and joint or soft-tissue contracture ^[27]. Fanstone et al. cataloguing global contracture risk factors found that 76 percent of 102 papers were from HICs and only 15 examined risk factors with statistical comparisons; LMIC papers included socioeconomic and health-system factors among the risks, but these were rarely considered in HIC publications ^[26]. Jain et al. add the regional layer: across 167 patients in Middle East, Russia, and South Asia outreach camps, South Asia showed higher TBSA and greater prevalence of lower-limb contractures, and 35 percent of patients had bilateral contractures, with 43 percent having multiple anatomical contractures ^[25].

Women, scald, and self-immolation. Cleary et al.'s systematic review of self-immolation found that prevalence of self-immolation is significantly higher in some Middle Eastern and Central Asian Islamic countries than in Western countries, that self-immolation typically occurs among females either as an attempted suicide or an act of protest, and that drivers include marital and familial conflict, male-dominated culture, mental-health disorders, and economic and social factors ^[23]. Rezaeian et al. report that evidence suggests sex trafficking is especially high in India, Pakistan, and Bangladesh, where diverse types of burning are also prevalent among young females ^[40].

Conflict, refugee, and displaced populations. Buyukbese Sarsu et al.'s comparative analysis showed that flame and blast burns were severe and fatal in more paediatric Syrian victims than Turkey residents due to the severity of war-inflicted wounds and the living conditions at the refugee camps and tent cities ^[24]. Egelko et al.'s EXTRACCT clinical-practice guideline reviews current best practice for management of burn wounds in low-resource conflict settings ^[39].

HIC equity disparities. Inequity does not stop at HIC borders. Locke et al.'s county-level New England analysis associated higher burn-injury incidence with lower per-capita income, higher poverty rates, and older housing stock — readily available US Census variables predicted burn incidence at the county level ^[32]. Alden et al.'s elderly-scald series found that most patients receiving inpatient care for tap-water scalds were on government-assistance income, and that socio-economic factors play a significant role in these injuries ^[34]. Ruest et al., comparing pre-pandemic and 2020 pandemic-period paediatric-ED visits across 40 US sites (741,418 injury visits total), observed significant differences in burn-visit composition by race and ethnicity (p<0.05 and p=0.01), with higher proportions of White and non-Hispanic patients during the COVID-19 disruption period, a signal that household-exposure patterns shifted across racial and ethnic groups during the pandemic ^[33].

Non-governmental and capacity-building infrastructure. Fabia and colleagues catalogued 27 unique NGOs working in burn care in African countries plus 14 global NGOs, and noted challenges including frequent shifts in geographical regions supported, lack of collaboration among organisations, availability of public information, and austere environments ^[28]. Argenta et al. note that the burden of burn injury falls predominantly on the world's poor, with LMICs accounting for 96 percent of burn injuries — a different point-estimate for the same gradient ^[42]. Wall et al.'s bibliometric analysis observed that LMICs remain drastically underrepresented in health research, with African countries producing less than 1 percent of global output, and that nearly a quarter of papers on burns in LMICs had both first and senior authors from HICs; they argue that the maximum benefit of HIC-LMIC collaborations is achieved when LMICs play an active role in leading the research ^[29]. Ghosh et al.'s programme in Jamshedpur, India, documented growing community awareness of burn prevention and steady increase in water-as-first-aid use as evidence of a feasible local prevention model ^[36].

Controversies and Evidence Gaps

Do HIC-developed protocols transfer. Purcell et al. emphasise that in HICs, early surgical intervention has been shown to improve survival, but in their Malawian paediatric cohort improved survival in the early-excision cohort (≤5 days) was not seen — surgery as a whole improved survival, but the early-excision-protocol specifically did not, when applied without HIC-level supportive infrastructure ^[15]. The Forjuoh review explicitly calls for continuous evaluation of promising interventions and those with unknown efficacy in LMICs, along with testing of HIC-effective interventions in LMIC settings before adoption ^[4].

Prevention evidence is thin. Rybarczyk et al., having identified only 11 manuscripts on prevention of burn injuries in LMICs after screening 12,568 abstracts, found that the majority of these demonstrated reductions in hazardous behaviours, incidence, morbidity, and mortality using educational programmes; the original research base is nonetheless lacking and further studies of preventative efforts tailored to LMIC populations are needed, grounded in population-based epidemiology with meaningful end points ^[1]. Atiyeh et al. observe that many health authorities, agencies, corporations, and even medical personnel in LMICs consider injury prevention to have a lower priority than disease prevention, and that prevention programmes consequently fail to receive deserved government funding ^[3].

Methodological gap on burden estimation. Spronk et al. demonstrated that for the same registry data, choice of method heavily influences the non-fatal burden of disease expressed in YLDs, with the highest-method estimate roughly an order of magnitude above the lowest across the GBD, Injury-VIBES, and INTEGRIS-burns methods ^[31] (specific per-100,000 ranges are in the Epidemiology section). The Global Burden of Disease point estimates are therefore one of three plausible answers, not a settled number.

Research authorship and the LMIC-led-research gap. Wall et al.'s bibliometric analysis quantifies the underrepresentation of LMIC-led burn research and frames it as a methodological gap as well as an equity gap ^[29].

Contracture risk-factor evidence is sparse and HIC-skewed. Fanstone et al.'s global review found that only 15 of 102 included contracture-risk-factor papers used statistical comparisons of outcomes, and only 3 of those were from LMICs — the population that experiences the highest burden has the thinnest evidence base on the most common late complication ^[26].

Scarce LMIC-specific cost data. Lowin et al. found an almost complete lack of cost-focused burns research in Nepal despite a high incidence and limited infrastructure for management and prevention — a representative gap across LMICs ^[46].

References

[1] Rybarczyk et al. "Prevention of burn injuries in low- and middle-income countries: A systematic review." Burns : journal of the International Society for Burn Injuries 2016. PMID: 27161088. https://pubmed.ncbi.nlm.nih.gov/27161088/ [2] Peck et al. "The correlation between burn mortality rates from fire and flame and economic status of countries." Burns : journal of the International Society for Burn Injuries 2013. PMID: 23768720. https://pubmed.ncbi.nlm.nih.gov/23768720/ [3] Atiyeh et al. "Burn prevention mechanisms and outcomes: pitfalls, failures and successes." Burns : journal of the International Society for Burn Injuries 2009. PMID: 18926639. https://pubmed.ncbi.nlm.nih.gov/18926639/ [4] Forjuoh et al. "Burns in low- and middle-income countries: a review of available literature on descriptive epidemiology, risk factors, treatment, and prevention." Burns : journal of the International Society for Burn Injuries 2006. PMID: 16777340. https://pubmed.ncbi.nlm.nih.gov/16777340/ [5] Peck et al. "Burns and fires from non-electric domestic appliances in low and middle income countries Part I. The scope of the problem." Burns : journal of the International Society for Burn Injuries 2008. PMID: 18206314. https://pubmed.ncbi.nlm.nih.gov/18206314/ [6] Forbinake et al. "Mortality analysis of burns in a developing country: a CAMEROONIAN experience." BMC public health 2020. PMID: 32819340. https://pubmed.ncbi.nlm.nih.gov/32819340/ [7] Jacobs et al. "An Analysis of Factors Associated with Burn Injury Outcomes in Low- and Middle-Income Countries." The Journal of surgical research 2021. PMID: 32892143. https://pubmed.ncbi.nlm.nih.gov/32892143/ [8] Potokar et al. "A comprehensive, integrated approach to quality improvement and capacity building in burn care and prevention in low and middle-income countries: An overview." Burns : journal of the International Society for Burn Injuries 2020. PMID: 32616426. https://pubmed.ncbi.nlm.nih.gov/32616426/ [9] Hodgins et al. "Comparing rich and poor: burn prevention in Wales, Pakistan, India, Botswana and Zambia." Burns : journal of the International Society for Burn Injuries 2011. PMID: 21872400. https://pubmed.ncbi.nlm.nih.gov/21872400/ [10] Ahuja et al. "Changing trends of an endemic trauma." Burns : journal of the International Society for Burn Injuries 2009. PMID: 19427125. https://pubmed.ncbi.nlm.nih.gov/19427125/ [11] Mustehsan et al. "Health-related quality of life in burn survivors from low-and middle-income countries: A systematic review and targeted comparative analysis of rehabilitation interventions." Burns : journal of the International Society for Burn Injuries 2026. PMID: 41855789. https://pubmed.ncbi.nlm.nih.gov/41855789/ [12] Vlasic et al. "A Characterization of Pediatric Burn Injury Patients Presenting to a Zonal Referral Hospital in Northern Tanzania." Journal of burn care & research : official publication of the American Burn Association 2026. PMID: 41025520. https://pubmed.ncbi.nlm.nih.gov/41025520/ [13] Wondifraw et al. "Treatment outcomes of burn injury and its associated factor among children in Sub-Saharan Africa: a systematic review and meta-analysis." BMC pediatrics 2025. PMID: 40604717. https://pubmed.ncbi.nlm.nih.gov/40604717/ [14] Botman et al. "Access to Burn Care in Low- and Middle-Income Countries: An Assessment of Timeliness, Surgical Capacity, and Affordability in a Regional Referral Hospital in Tanzania." Journal of burn care & research : official publication of the American Burn Association 2022. PMID: 34643726. https://pubmed.ncbi.nlm.nih.gov/34643726/ [15] Purcell et al. "The Effect of Surgical Intervention on Pediatric Burn Injury Survival in a Resource-Poor Setting." The Journal of surgical research 2020. PMID: 32335395. https://pubmed.ncbi.nlm.nih.gov/32335395/ [16] Puri et al. "Comparative Analysis of Early Excision and Grafting vs Delayed Grafting in Burn Patients in a Developing Country." Journal of burn care & research : official publication of the American Burn Association 2016. PMID: 23816999. https://pubmed.ncbi.nlm.nih.gov/23816999/ [17] Wood et al. "Water First Aid Is Beneficial In Humans Post-Burn: Evidence from a Bi-National Cohort Study." PloS one 2016. PMID: 26808839. https://pubmed.ncbi.nlm.nih.gov/26808839/ [18] Wright et al. "Human model of burn injury that quantifies the benefit of cooling as a first aid measure." The British journal of surgery 2019. PMID: 31441049. https://pubmed.ncbi.nlm.nih.gov/31441049/ [19] Alomar et al. "Knowledge, attitude, and belief regarding burn first aid among caregivers attending pediatric emergency medicine departments." Burns : journal of the International Society for Burn Injuries 2016. PMID: 27161087. https://pubmed.ncbi.nlm.nih.gov/27161087/ [20] Phuyal et al. "Burns in Nepal: a participatory, community survey of burn cases and knowledge, attitudes and practices to burn care and prevention in three rural municipalities." BMJ open 2020. PMID: 32114463. https://pubmed.ncbi.nlm.nih.gov/32114463/ [21] Michael et al. "Differences in burn injury knowledge among reproductive-age women attending an urban and a semi-rural hospital in Northwest Nigeria: A cross-sectional study." Burns : journal of the International Society for Burn Injuries 2024. PMID: 39127575. https://pubmed.ncbi.nlm.nih.gov/39127575/ [22] Banerjee et al. "A systematic review of epidemiological patterns and proposed interventions to address pediatric burns in Nigeria." African health sciences 2020. PMID: 33163068. https://pubmed.ncbi.nlm.nih.gov/33163068/ [23] Cleary et al. "Drivers and consequences of self-immolation in parts of Iran, Iraq and Uzbekistan: A systematic review of qualitative evidence." Burns : journal of the International Society for Burn Injuries 2021. PMID: 31928787. https://pubmed.ncbi.nlm.nih.gov/31928787/ [24] Buyukbese Sarsu et al. "Mortality risk factors in war-related pediatric burns: A comparative study among two distinct populations." Burns : journal of the International Society for Burn Injuries 2018. PMID: 29551449. https://pubmed.ncbi.nlm.nih.gov/29551449/ [25] Jain et al. "Across borders, over time: epidemiology of post-burn injury patterns and late sequelae presenting to surgical outreach camps across three geographical regions." Medicine, conflict, and survival 2026. PMID: 41693647. https://pubmed.ncbi.nlm.nih.gov/41693647/ [26] Fanstone et al. "Global perspectives on risk factors for major joint burn contractures: A literature review." Burns : journal of the International Society for Burn Injuries 2024. PMID: 37977897. https://pubmed.ncbi.nlm.nih.gov/37977897/ [27] Meng et al. "Pediatric burn contractures in low- and lower middle-income countries: A systematic review of causes and factors affecting outcome." Burns : journal of the International Society for Burn Injuries 2020. PMID: 31813620. https://pubmed.ncbi.nlm.nih.gov/31813620/ [28] Fabia et al. "Efforts to catalogue non-governmental organizations with a role in global burn relief." Burns : journal of the International Society for Burn Injuries 2020. PMID: 32165028. https://pubmed.ncbi.nlm.nih.gov/32165028/ [29] Wall et al. "Who tells the story of burns in low-and-middle income countries? - A bibliometric study." Burns : journal of the International Society for Burn Injuries 2023. PMID: 35787966. https://pubmed.ncbi.nlm.nih.gov/35787966/ [30] Roberson et al. "Lessons Learned From Implementation and Management of Skin Allograft Banking Programs in Low- and Middle-Income Countries: A Systematic Review." Journal of burn care & research : official publication of the American Burn Association 2020. PMID: 32504535. https://pubmed.ncbi.nlm.nih.gov/32504535/ [31] Spronk et al. "Comparison of three different methods to estimate the burden of disease of burn injuries in Western Australia." Burns : journal of the International Society for Burn Injuries 2020. PMID: 32593481. https://pubmed.ncbi.nlm.nih.gov/32593481/ [32] Locke et al. "Socioeconomic factors and the incidence of hospitalized burn injuries in New England counties, USA." Burns : journal of the International Society for Burn Injuries 1990. PMID: 2257069. https://pubmed.ncbi.nlm.nih.gov/2257069/ [33] Ruest et al. "The impact of COVID-19 on patterns of burns evaluated in pediatric emergency departments." Burns : journal of the International Society for Burn Injuries 2026. PMID: 41447904. https://pubmed.ncbi.nlm.nih.gov/41447904/ [34] Alden et al. "Tap water scalds among seniors and the elderly: socio-economics and implications for prevention." Burns : journal of the International Society for Burn Injuries 2007. PMID: 17478044. https://pubmed.ncbi.nlm.nih.gov/17478044/ [35] Davies et al. "How much do parents know about first aid for burns?." Burns : journal of the International Society for Burn Injuries 2013. PMID: 23347890. https://pubmed.ncbi.nlm.nih.gov/23347890/ [36] Ghosh et al. "Domestic burns prevention and first aid awareness in and around Jamshedpur, India: strategies and impact." Burns : journal of the International Society for Burn Injuries 2000. PMID: 10925182. https://pubmed.ncbi.nlm.nih.gov/10925182/ [37] Spiwak et al. "Creation of a standardized burn course for Low Income Countries: meeting local needs." Burns : journal of the International Society for Burn Injuries 2014. PMID: 24685348. https://pubmed.ncbi.nlm.nih.gov/24685348/ [38] Borg et al. "Surgical training for burns care in low-income countries: A literature review and critical appraisal." Burns : journal of the International Society for Burn Injuries 2022. PMID: 35941027. https://pubmed.ncbi.nlm.nih.gov/35941027/ [39] Egelko et al. "Explosive Weapons Trauma Care Collective (EXTRACCT) Blast Injury Clinical Practice Guideline: Burn Management in Low-Resource Settings." World journal of surgery 2026. PMID: 41578417. https://pubmed.ncbi.nlm.nih.gov/41578417/ [40] Rezaeian et al. "The frequency of burns among the victims of sex trafficking in some lower-middle-income countries." Burns : journal of the International Society for Burn Injuries 2017. PMID: 27524437. https://pubmed.ncbi.nlm.nih.gov/27524437/ [41] Sanane et al. "Comparing burn wound for under-five children between rural and urban areas in Dodoma Region: understanding caregiver supervision, household hazards, and children's risk behaviours on the burn wound." BMC pediatrics 2026. PMID: 41645110. https://pubmed.ncbi.nlm.nih.gov/41645110/ [42] Argenta et al. "Burn Management in the Developing World: International Volunteerism." Clinics in plastic surgery 2017. PMID: 28888312. https://pubmed.ncbi.nlm.nih.gov/28888312/ [43] Potokar et al. "The development of the Delivery Assessment Tool (DAT) to facilitate quality improvement in burns services in low-middle income countries." Burns : journal of the International Society for Burn Injuries 2022. PMID: 34903404. https://pubmed.ncbi.nlm.nih.gov/34903404/ [44] Christie et al. "Insights into bloodstream infections in South African paediatric burn patients: implications for antimicrobial stewardship." BMC infectious diseases 2025. PMID: 40087547. https://pubmed.ncbi.nlm.nih.gov/40087547/ [45] Tevlin et al. "Education in burns: Lessons from the past and objectives for the future." Burns : journal of the International Society for Burn Injuries 2017. PMID: 28408146. https://pubmed.ncbi.nlm.nih.gov/28408146/ [46] Lowin et al. "A Structured Review to Assess the Current Status of Cost-Based Burns Research in Nepal." Journal of burn care & research : official publication of the American Burn Association 2021. PMID: 32780811. https://pubmed.ncbi.nlm.nih.gov/32780811/