Epidemiology, seasonality, and geospatial distribution of burn injuries in southern Mozambique: a six-year hospital-based study

• Six years of burn injury epidemiology in southern Mozambique are presented. • Children make up most burn admissions, with over half occurring <5 years. • Scalds predominate in early childhood, while flame burns increase with age. • Burn severity increased over time without parallel system capacity gains. • Targeted household prevention and expanded regional burn care are needed. Burn injuries are a major global public health challenge. Across the sub-Saharan region, the burden and mortality from burn injury are disproportionately high, yet there is inadequate data from Mozambique to guide country-specific service expansion. This study describes the epidemiology, clinical, and temporal patterns of burn injury in southern Mozambique. This retrospective, cross-sectional chart review examined adult and pediatric burn injuries treated at a major referral center in southern Mozambique from January 2017 to December 2022. Analyses included chi-square tests, one-way ANOVA with post-hoc comparisons, linear trend tests, seasonal analyses, and multinomial logistic regression to assess associations between etiology and patient/temporal characteristics. Geospatial visualization was performed using QGIS. A total of 1299 patients were analyzed. Geospatial mapping showed broad catchment with clustering around Maputo city. A large majority of the study population were children ≤14 years (72.7%), and scald injury was the most common mechanism (71.7%). However, flame injuries increased with age, and adjusted models revealed a 5% higher relative risk of sustaining a flame burn with each additional year of age. Etiology was strongly associated with age, sex, location of occurrence, and year. Mean TBSA increased during the study period. Burn injuries in this setting are overwhelmingly pediatric, predominantly domestic, and strongly age-associated in mechanism. Taken with increasing burn severity over time, there is an urgent need for targeted prevention strategies and expanded burn treatment capacity in southern Mozambique.