| dc.description.abstract | Overall Under-Five Mortality Rate (U5MR) is reportedly high in Nigeria. Statistics on U5MR in
Nigeria are mainly derived from data obtained from community-based surveys and teaching
hospital records. There are few reports on childhood mortality from secondary health institutions
where many deaths are known to occur. This study was therefore designed to determine the
mortality pattern and factors influencing mortality among under-five children admitted in
selected hospitals in Ibadan.
A review of records of deaths and admissions occurring in under-five children between January
2005 and December 2009 was conducted in three purposively selected mission and state
hospitals in Ibadan. A total of 19,203 under-five children were admitted within the period under
review. Records of all the 2146 under-five children that died and an equal number of children
admitted but recovered which were matched for age and sex were reviewed using a structured
chart review form. Information collected included age, place of residence, parents’ occupation
and causes of death. Data were analyzed using descriptive statistics, Chi-square test and logistic
regression at P<0.05. Results were compared with the World Health Organisation mortality rate
standard of < 40/1000 admission.
The mean ages for neonates, post-neonates and children aged 12-59 months were 8.5 ± 5.5 days,
6.1 ± 3.1 months and 26.4 ± 13.1 months respectively. Many of the deaths (47.4%) occurred
within 24 hours of hospitalisation. Overall U5MR was 111.8/1000 admissions. Annual trend in
mortality rate was 107.6/1000 in year 2005, 95.7/1000 in 2006, 96.5/1000 in 2007, 127.1/1000 in
2008 and 128.7/1000 in 2009. Mortality rate per 1000 admissions was highest (132.3/1000)
among post-neonates, followed by neonates (88.2/1000) and children aged 12-59 months
(52.5/1000). Neonatal deaths were mainly due to sepsis (32.2%), perinatal asphyxia (26.5%),
prematurity (14.4%), and meconium aspiration syndrome (4.5%). Malaria (25.7%) was the
predominant cause of death among post-neonates followed by bronchopneumonia (16.3%),
gastroenteritis (12.4%), sepsis (10.1%) and anaemia (5.9%). Malaria (35.2%), anaemia (11.2%),
measles and post measles complications (10.8%), gastroenteritis (7.8%) and bronchopneumonia
(6.6%) were the main causes of deaths among 12-59 months. Immunisation history was
significantly associated with mortality (p<0.05). Children from highly congested areas (81.9%)
were 2 times more likely to die compared with children from the suburban areas (OR = 2.0, 95%
CI = 1.5, 2.7). U5MR was significantly more among children whose father were engaged in
unskilled works (OR=2.0, 95% CI=0.3, 0.7). Children were at higher risk of dying during rainy
season than in the dry season (OR=2.3, 95% CI=0.5, 0.8).
Under-five mortality rate was higher than the World Health Organisation standard over the five
year review period and the deaths were mostly caused by infections and preventable conditions.
Advocacy and public enlightenment for the adoption of immunisation services and timely
presentation to hospitals are needed to reduce the prevalence of under-five mortality. | en_US |
