Muhammad Ayaz Mustufa1,2, Munir Ahmed Sheikh3, Ijaz-Ul-Haque Taseer4, Syed Jamal Raza5, Muhammad Sohail Arshad4, Tasleem Akhter6, Ghazala Mohyuddin Arain7, Sultana Habibullah8, Sohail Safdar4, Rukhsana Firdous9, Muhammad Adnan10. 1. PMRC Specialized Research Center on Child Health, National Institute of Child Health, Karachi, Pakistan. ayazbukero@gmail.com. 2. 5th Floor, PMRC Specialized Research Center on Child Health, National Institute of Child Health, Karachi, 75500, Pakistan. ayazbukero@gmail.com. 3. PMRC Research Center, Liaquat University of Health and Medical Sciences, Jamshoro, Hyderabad, Pakistan. 4. PMRC Research Center, Nishtar Medical College, Multan, Pakistan. 5. PMRC Specialized Research Center on Child Health, National Institute of Child Health, Karachi, Pakistan. 6. PMRC Research Center, Khyber Medical College, Peshawar, Pakistan. 7. PMRC Research Center, Punjab Medical College, Faisalabad, Pakistan. 8. PMRC Research Center, Dow University of Health Sciences, Karachi, Pakistan. 9. PMRC Research Center, Bolan Medical College, Quetta, Pakistan. 10. PMRC Research Center, FJMC, Lahore, Pakistan.
Abstract
BACKGROUND: Considering the fact that Pakistan is amongst the countries with very high neonatal mortality rates, we conducted a research study to determine the possible causes and characteristics of neonates presenting dead to the emergency department of tertiary public health care facilities of Pakistan using verbal autopsies. METHODS: A descriptive case series study was conducted in emergency department/pediatrics ward/neonatal ward/nursery unit of ten tertiary care public health facilities, situated in seven major cities of Pakistan from November, 2011 to June, 2013. Precoded verbal autopsy proforma was used to collect information regarding cause of death, family narratives and other associated risks accountable for pathway to mortality. RESULTS: We identified 431 neonates presenting dead to the emergency department (238 males and 193 females). Sepsis (26.7%), birth asphyxia (18.8%) and persistent pulmonary arrest (17.2%) were main primary causes of brought death. Around 72% brought dead neonates were referred from doctors/health care facilities and more than 28% caregivers mentioned that they were not informed about the diagnosis/ailment of their deceased newborn. CONCLUSIONS: Findings of our study suggest that infectious disease remains the main primary cause of neonatal mortality. Underweight in newborns (64%) was estimated as a leading associated risk. Delays in referrals to respective health care facility enlightened the concern of sub-standard prerequisites of neonatal care that could be one of the major contributing risk factor of high mortality rates.
BACKGROUND: Considering the fact that Pakistan is amongst the countries with very high neonatal mortality rates, we conducted a research study to determine the possible causes and characteristics of neonates presenting dead to the emergency department of tertiary public health care facilities of Pakistan using verbal autopsies. METHODS: A descriptive case series study was conducted in emergency department/pediatrics ward/neonatal ward/nursery unit of ten tertiary care public health facilities, situated in seven major cities of Pakistan from November, 2011 to June, 2013. Precoded verbal autopsy proforma was used to collect information regarding cause of death, family narratives and other associated risks accountable for pathway to mortality. RESULTS: We identified 431 neonates presenting dead to the emergency department (238 males and 193 females). Sepsis (26.7%), birth asphyxia (18.8%) and persistent pulmonary arrest (17.2%) were main primary causes of brought death. Around 72% brought dead neonates were referred from doctors/health care facilities and more than 28% caregivers mentioned that they were not informed about the diagnosis/ailment of their deceased newborn. CONCLUSIONS: Findings of our study suggest that infectious disease remains the main primary cause of neonatal mortality. Underweight in newborns (64%) was estimated as a leading associated risk. Delays in referrals to respective health care facility enlightened the concern of sub-standard prerequisites of neonatal care that could be one of the major contributing risk factor of high mortality rates.
Entities:
Keywords:
autopsy; child health services; early childhood; emergency department use; neonatal mortality
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