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

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 serves at least three states of the federation between 1996 and 2005? 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 in the MDG period. Results: Out of 10,451 paediatric admissions, 1320 (12.6%) died but only 1225 were studied. The male-to-female ratio was 1.4:1. Although the yearly mortality rate ranged from 10.7% to 14.9%, however the overall mortality rate for the pre-MDG period was similar to that obtained during the MDG-period (p = 0.135) Most deaths (69.1%) occurred within 48 hours of hospitalization. Of the 1225 mortalities, 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 the 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. HIV/AIDS (p = 0.046) became commoner as a result of the HIV pandemic while severe malaria (p = 0.041) became less common as causes of death during the same period. Conclusion: Childhood mortality rate remained high over the ten-year period studied. The causes of the deaths were mostly infectious and other preventable conditions. The utilization of specific target-oriented interventions IMCI and primary health care may reduce the childhood deaths before 2015.