Health Policy 96 (2010) 226–230 Contents lists available at ScienceDirect Health Policy journal homepage: www.elsevier.com/locate/healthpol Determinants of childhood burns in rural Bangladesh: A nested case–control study Saidur R. Mashreky a,b,* , Aminur Rahman a , Tabassum F. Khan c , Leif Svanström b , Fazlur Rahman a,b a Centre for Injury Prevention and Research, Bangladesh (CIPRB), Bangladesh b Department of Public Health Science, Karolinska Institutet, Sweden c Centre for Medical Education, Bangladesh article info Keywords: Burn Risk factors Prevention Bangladesh Low income country Case–control study abstract Background: Burn is one of the major causes of childhood illnesses in Bangladesh and is the third leading cause of illness of 1- to 4-year-old children. Rural children are more at risk compared to urban-dwelling children. Objective: The study was designed to identify the risk factors of childhood burn in rural Bangladesh. Methods: This nested case–control study was conducted in rural Bangladesh. The study population was children of less than 10 years old in three sub-districts of Bangladesh. Results: Children of families who did not have a household with a separate kitchen, a com- mon occurrence in rural areas, were at significantly higher risk of burn (OR 1.65; 95% CI 1.22–2.24). A kitchen without a door was also found to create a more hazardous environ- ment compared to a kitchen with a door. The traditional kerosene lamp (kupi bati) was found to be one of the major determinants of childhood burn in rural Bangladesh (OR 3.16; 95% CI 1.58–6.35). No use or restricted use of kupi bati significantly reduces the risk of child- hood burn. Children of nuclear families were at significantly higher risk of burn compared to combined families. Conclusion: Cooking in an open place and use of the traditional kerosene lamp are the major determinants of childhood burn in rural Bangladesh. A combined family environment reduces the risk of childhood burn. Childhood burn can be reduced by prohibiting use of kupi bati and limiting children’s access to the cooking area. Promoting combined family could be an initiative of childhood burn prevention program. © 2010 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Burns are one of the most devastating injuries in the world [1]. Children are the most vulnerable group as they have limited perception of dangerous situations and lim- ited ability to react promptly and properly [2]. The survival * Corresponding author at: Centre for Injury Prevention and Research Bangladesh (CIPRB), Epidemiology, Lake Road-15, New DOHS, Mohakhali, Dhaka1206, Bangladesh. Tel.: +880 28861258; fax: +880 28861499. E-mail address: mashreky@ciprb.org (S.R. Mashreky). of burn patients has markedly improved with the advance- ment of medical care, however in terms of morbidity and disability it still remains a huge public health problem all over the world [3]. It remains a major cause of uninten- tional injuries in many of the high income countries [3–6]. In Africa and many of the South-Asian countries, includ- ing India, Pakistan, Nepal, Sri Lanka and Afghanistan, burn injuries have emerged as a major public health issue [7–14]. About 173,000 children are burnt every year in Bangladesh and among them 3400 children become per- manently disabled [15,16]. Childhood burn was ranked as the fifth leading cause of childhood illness among 1- to 17- 0168-8510/$ – see front matter © 2010 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.healthpol.2010.02.004