n South African Journal of Child Health - Comparative analyses of childhood deaths in Sagamu, Nigeria : implications for the fourth MDG




The fourth Millennium Development Goal (MDG) aims at reducing childhood deaths in the developing world by 2015.

To examine the pattern of childhood deaths in a Nigerian tertiary hospital which served at least three states of the federation between 1996 and 2015.
A retrospective study of paediatric deaths between January 1996 and December 2005. Subjects admitted in the pre-MDG period were compared with those admitted during the MDG period.
Of 10 451 paediatric patients admitted, 1 320 (12.6%) died but only 1 225 were studied. The male-to-female ratio was 1.4:1. Although the yearly mortality rate ranged from 10.7% to 14.9%, the overall mortality rate for the pre-MDG period was similar to that for the MDG period (=0.135). Most deaths (69.1%) occurred within 48 hours of hospitalisation. Of the 1 225 patients who died, 57.3% were neonates. These neonatal deaths were commonly due to prematurity (34.6%), perinatal asphyxia (30.8%) and septicaemia (24.8%), while severe anaemia was the most common cause of death among infants (20.1%) and toddlers (25.1%). Severe malaria, severe anaemia, and tetanus formed 33.3% of all deaths among children older than 5 years. There was no significant difference in the role of prematurity (=0.298) and measles (=0.927) as causes of death before and during the MDG periods. HIV/AIDS (=0.046) became more common as a result of the HIV pandemic, while severe malaria (=0.041) became less common as a cause of death during the same period.
The childhood mortality rate remained high over the 10-year study period. The deaths were mostly caused by infectious and other preventable conditions. The utilisation of specific target-orientated interventions, such as integrated management of childhood illnesses (IMCI), and primary health care may reduce the number of childhood deaths before 2015.


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