Mortality Pattern and Factors Influencing Mortality Among Under-Five Children Admitted in Selected Hospitals in Ibadan

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.

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-fives 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. Data were analyzed using descriptive statistics, Chi-square test and logistic regression at P<0.05.

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. Neonatal deaths were mainly due to sepsis (32.2%), perinatal asphyxia (26.5%), prematurity (14.4%), and meconium aspiration syndrome (4.5%). Among post-neonates, it was malaria (25.7%), bronchopneumonia (16.3%), gastroenteritis (12.4%), sepsis (10.1%) and anaemia (5.9%). Malaria (35.2%), anaemia (11.2%), measles (10.8%), gastroenteritis (7.8%) and bronchopneumonia (6.6%) were the main causes of deaths among children aged 12-59 months. Immunisation history was significantly associated with mortality (p<0.05). Children from inner core areas (81.9%) were 2 times more likely to die compared with children from the elite areas (OR = 2.0, 95% CI = 1.5, 2.7).

Under-five mortality was mostly caused by 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.

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