Comparative analyses of childhood deaths in Sagamu, Nigeria: implications for the fourth MDG

Abstract

Background. The fourth Millennium Development Goal (MDG) aims at reducing childhood deaths in the developing world by 2015.
Objective. 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.
Method. 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.
Results. 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 (p=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 (p=0.298) and measles (p=0.927) as causes of death before and during the MDG periods. HIV/AIDS (p=0.046) became more common as a result of the HIV pandemic, while severe malaria (p=0.041) became less common as a cause of death during the same period.
Conclusion. 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.