An audit of paediatric mortality patterns in a Nigerian teaching hospital

BACKGROUND: The 4(th) millennium development goals (2002) reported that sub-Saharan Africa countries including Nigeria have a persistently high childhood mortality rates in-spite of all the preventive and interventional measures to reduce this ugly trend. PATIENTS AND METHODS: Childhood mortality data was obtained from the medical records department and post-mortem records of the pathology departments over a 5-year period from January 2007 to December 2011. The selection criteria include all case notes with mortality records involving children admitted into the paediatrics department through the labour ward and the obstetrics theater, children emergency unit (CHER), paediatric out-patient clinic. RESULTS: A total of 12,442 children were admitted during this period. Of this, 711 paediatric deaths were documented accounting for 17.5%. The male to female mortality ratio was 1.4:1. The age range was from birth to 17 years. Neonatal deaths accounted for the most common cause of death constituting 344 (48.4%) of all deaths. Among the neonatal mortality patterns, severe birth asphyxia/perinatal asphyxia was the most common cause of early neonatal deaths accounting for 97 (28.2%). Septicaemia accounted for the most frequent cause of infant mortality accounting for 28 (21.8%). Among the under-5 age group, severe malaria constituted the most common cause of death accounting for 52 (36.6%) cases while malignancy topped the list of 5-17 years mortality rate constituting 15 (15.4%) cases. CONCLUSION: Perinatal and neonatal deaths constitute the vast majority of death in our environment with most of the deaths resulting from severe birth asphyxias, prematurity. Again in the post-neonatal period, infections and other preventable diseases constitute the most common cause of death in children of under age group of five years. Above 5 years childhood malignancies constitutes the highest mortality pattern.