Patterns of Unnatural Deaths during Insurgency in Maiduguri, Borno State, North-Eastern Nigeria: A Ten-Year Retrospective Review

Abstract

Background: Unnatural death refers to premature death against the course of nature which results from homicides, accidents and suicides. The prevalence is rising worldwide and is considered one of the commonest causes of mortality. Among all the unnatural deaths in the western world, fire-arm death constitutes most of the cases and accounting for 4.43 deaths per 100,000 annually. In Nigeria, there is a paucity of data on unnatural deaths despite the rising incidence of deaths due to insurgency, banditry, kidnapping, political and ethnic crises, that prompted the need for this study. Method: The study was a hospital-based, ten-year retrospective survey. Non-probability purposive sampling method was used from three selected hospitals in Borno State. All cases of unnatural deaths from the mortuary logbooks from 2009-2018 available were recorded along with the deceased demography. The results were analyzed using Microsoft Excel, 2010 and were displayed in a frequency table, bar charts and pie chart. Results: There were 1,029(4.9%) cases of unnatural deaths during the study period (2009-2018). The unnatural death frequency peaked in 2014 with 260 (25%) cases. Gunshot death was the commonest and accounted for 387 (38%) cases. Road traffic accident and bomb blast were 2nd and 3rd with 291 (28%) and 196 (19%) cases respectively. Males were more affected than females by a ratio of 4:1. The age ranges were between 3 to 75 years. The commonest age group involved was 21-30 (34%) years. Most of the unnatural deaths occurred in urban [715 (69%)] than rural areas [(314 (31%)] cases respectively. Conclusion: The study has highlighted an increased incidence of unnatural deaths in Borno state due to insurgency with gunshot fatality being the commonest cause of death. To the best of our knowledge, this is the first report of unnatural deaths during the civil unrest in Borno state. We suggest a community-based study to effectively plan for mitigation and prevention of unnatural death in Nigeria.