Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with H...Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.展开更多
Introduction: The greatest effect of maternal mortality is renowned in children aged 2 - 5 months whose mothers had died. Children whose mothers died due to maternal complications were likely to record a higher mortal...Introduction: The greatest effect of maternal mortality is renowned in children aged 2 - 5 months whose mothers had died. Children whose mothers died due to maternal complications were likely to record a higher mortality in infancy compared to children of surviving mothers. Motherless children mostly suffer a lot due to lack of day-to-day care, isolation, lack of motivation as well as economic cost associated with mother’s death. Thus, the purpose of this study was to ascertain the lives of children whose mothers passed away during childbirth at the Sagnarigu Municipality. Methods: This quantitative cross-sectional study was carried out at the Sagnarigu Municipal. The study recruited 297 respondents. To assess the effects of maternal death on the lives of children, families that experienced maternal death were assessed. The number of pregnancies experienced by the deceased woman, pregnancy-related complaints experienced, determinants of maternal death, number of children alive, and their standard of living were assessed with the aid of a structured questionnaire. Results: The data showed that negligence, illiteracy, poor road access, poverty, ignorance, delays in recognizing the problem, delays in making appropriate decisions, delays in the health facility, delays in giving the appropriate treatments, and traditional beliefs were some of the factors that led to maternal death in the Sagnarigu Municipality. Conclusion: The study concluded that determinants of maternal death in the Sagnarigu Municipal included the following;negligence, illiteracy, poverty, and delays in recognizing the problem. The study findings also demonstrated that the effects of maternal death on children are diverse and cut across different areas of a child’s life including livelihood sustenance, healthcare, education, and emotional and psychological development.展开更多
Introduction: The United Nations Sustainable Development Goals (SDGs) aim to decrease the global maternal mortality ratio to below 70 per 100,000 live births and eliminate preventable deaths of newborns and children u...Introduction: The United Nations Sustainable Development Goals (SDGs) aim to decrease the global maternal mortality ratio to below 70 per 100,000 live births and eliminate preventable deaths of newborns and children under the age of five in all countries by 2030. The pediatric department at Spécialisé Mère-Enfant Blanche Gomes Hospital (HSMEBG) is divided into two sectors, one catering to children aged one month to four years and the other dedicated to children aged five to 17 years. According to department records, over the past three years, there has been an average of 1050 hospitalizations per year, with an average duration of five days. Objectives: This study aims to describe the socio-demographic characteristics of children who died while in the pediatrics department of the HSMEBG and analyze the factors associated with their deaths. Methodology: A retrospective analytical cross-sectional study was conducted, collecting data over a three-year period, covering the years 2019, 2020 and 2021. Data were collected from medical records of deceased children using Excel software version 2016, and statistical calculations and logistic regression were performed using Epi info software version 7.2.5.0. Results: During the three years of operation, the pediatric department at HSMEBG recorded 3060 new admissions, of which 271 resulted in death, representing an overall frequency of 8.8%. December and January had the highest mortality rates, accounting for 15.5% and 12.5%, respectively. Out of the 271 recorded deaths, 143 (52.77%) occurred in children under the age of one, and 230 (84.87%) occurred in children under the age of five. The average age at death was 2.4 years, ranging from one month to 17 years. The sex ratio was 1. More than half of the deaths (51.66%) occurred during the night, and 165 (60.89%) sought medical help more than three days after the onset of symptoms. Weekend deaths accounted for nearly half (45.7%) of the cases. Upon admission, slightly over half of the children (55.72%) had impaired consciousness, 219 (80.81%) presented with respiratory distress, and 194 (71.59%) had a fever. The average time from admission to administering the first medication was 72 minutes. Respiratory infections were the leading cause of death, accounting for 83 (30.26%) cases, followed by severe forms of malaria (anemic and neurological) at 23.25%. Among the 271 recorded deaths, 33 (12.18%) received no treatment before their demise, and 136 (50.18%) died within the first 24 hours of hospitalization. The average duration of hospitalization for patients who spent less than 24 hours was 15 hours, while those who died after the 24th hour had an average hospital stay of five days, ranging from one to 41 days. Children under the age of five who were admitted with impaired consciousness had roughly double the risk of dying compared to those without this condition (p = 0.001). Conclusion: The overall mortality rate in the pediatric department at HSMEBG is 8.8%. Acute respiratory infections are the primary cause of death. Improving this rate necessitates reducing consultation and treatment durations.展开更多
This article addresses the need for anticipatory guidance about death and death education with young children. Children often experience the death of an immediate family member before the age of ten. This number incre...This article addresses the need for anticipatory guidance about death and death education with young children. Children often experience the death of an immediate family member before the age of ten. This number increases if one considers the loss of friends, pets, and other loved ones. However, children experience a death with little or no anticipatory guidance or knowledge about death. Anticipatory guidance can assist the child in having a better understanding of a death when it occurs. Talking about death with children can be difficult for adults. However, it is important to address the topic and realize the impact anticipatory guidance in relation to death can have in assisting with childhood bereavement, anticipatory grief, and anticipatory adaptation. By providing anticipatory education related to death symptoms such as grief, anger, and/or fear, regressive or aggressive behaviors can be prevented or lessened when a death occurs. Age appropriate developmental levels for understanding the concept of death, resources for death education, and literature that can be used for death education are presented. Any resource used for death education with children should be carefully reviewed by the adult for its appropriateness prior to its use.展开更多
Background: Malaria is the most widespread parasitic disease and remains a public health priority worldwide. The severe form is fatal if not treated early and appropriately. The aim was to carry out a descriptive and ...Background: Malaria is the most widespread parasitic disease and remains a public health priority worldwide. The severe form is fatal if not treated early and appropriately. The aim was to carry out a descriptive and analytical study of the factors associated with mortality during severe malaria in children attending emergency departments in Dakar, Senegal. Methods: This is a prospective, observational and analytical study conducted over a 6-month period (July 1 to December 31, 2022), focusing on children hospitalized for severe malaria according to WHO severity criteria. Results: A total of 403 patients were hospitalized, including 78 cases of severe malaria (19.35%). Males predominated (60.26%) (sex ratio 1.51). The average age was 6.56 years [8 months - 14 years], with the [5 - 10 years] age group the most represented (40.26%). The average consultation time was 5.33 days (1 - 19 days). The main reasons for consultation were fever (70.51%), vomiting (24.35%) and convulsions (14.10%). Biological signs of severity were severe anemia (17.95%), renal failure (6.4%) and hypoglycemia (3.85%). Thrombocytopenia was noted in 52.56% of patients, including 32.05% of severe cases (sis in 61.41% of cases. Hyponatremia was noted in 39.74% of cases and hyperkalemia in 2 patients. Artesunate was the main drug used (93.59% of cases). Mortality was estimated at 1.5%. Factors leading to death were coma (P < 0.01), respiratory distress (P Conclusion: Malaria is still a public health problem, with a high mortality rate in emergency departments. Reducing this mortality rate requires effective management of the factors associated with death.展开更多
When it comes to the death,it can be gruesome or be dolente.However,the death also can be warm and be a new start of life.It is because we regard the death from different perspective that we show different attitude to...When it comes to the death,it can be gruesome or be dolente.However,the death also can be warm and be a new start of life.It is because we regard the death from different perspective that we show different attitude to the death.The novel The Great Blue Yonder which described the experience of the little protagonist died as a ghost wandering in the mortal world interpreted the death by fairy tale.In his wandering trip,he experience not only tears but also laughter.The more important experience he realized was that he took a new look at love and comprehended the significance of life.Because of the dislocation between narrative perspective and narrative contents,the abnormal narrative perspective owns the unique artistic charm.This thesis aims to interpret the Great Blue Yonder by taking the abnormal narrative perspective as the point of view from the dual narrative perspective of the ghosts and the children.The abnormal narrative perspective is endowed with the unique aesthetic effect because of its own aesthetic properties.It will make a great fresh aesthetic feast to readers.展开更多
AIM: To evaluate the accuracy of a tool developed to predict timing of death following withdrawal of life support in children. METHODS: Pertinent variables for all pediatric deaths(age ≤ 21 years) from 1/2009 to 6/20...AIM: To evaluate the accuracy of a tool developed to predict timing of death following withdrawal of life support in children. METHODS: Pertinent variables for all pediatric deaths(age ≤ 21 years) from 1/2009 to 6/2014 in our pediatric intensive care unit(PICU) were extracted through a detailed review of the medical records. As originally described, a recently developed tool that predicts timing of death in children following withdrawal of life support(dallas predictor tool [DPT]) was used to calculate individual scores for each patient. Individual scores were calculated for prediction of death within 30 min(DPT30) and within 60 min(DPT60). For various resulting DPT30 and DPT60 scores, sensitivity, specificity and area under the receiver operating characteristic curve were calculated.RESULTS: There were 8829 PICU admissions resulting in 132(1.5%) deaths. Death followed withdrawal of life support in 70 patients(53%). After excluding subjects with insufficient data to calculate DPT scores, 62 subjects were analyzed. Average age of patients was 5.3 years(SD: 6.9), median time to death after withdrawal oflife support was 25 min(range; 7 min to 16 h 54 min). Respiratory failure, shock and sepsis were the most common diagnoses. Thirty-seven patients(59.6%) died within 30 min of withdrawal of life support and 52(83.8%) died within 60 min. DPT30 scores ranged from-17 to 16. A DPT30 score ≥-3 was most predictive of death within that time period, with sensitivity = 0.76, specificity = 0.52, AUC = 0.69 and an overall classification accuracy = 66.1%. DPT60 scores ranged from-21 to 28. A DPT60 score ≥-9 was most predictive of death within that time period, with sensitivity = 0.75, specificity = 0.80, AUC = 0.85 and an overall classification accuracy = 75.8%.CONCLUSION: In this external cohort, the DPT is clinically relevant in predicting time from withdrawal of life support to death. In our patients, the DPT is more useful in predicting death within 60 min of withdrawal of life support than within 30 min. Furthermore, our analysis suggests optimal cut-off scores. Additional calibration and modifications of this important tool could help guide the intensive care team and families considering DCD.展开更多
Purposes: The purpose of this study was to determine the pattern of mortality in children’s Federal District. Knowledge of the epidemiology of injuries is essential for planning, implementation and evaluation of prev...Purposes: The purpose of this study was to determine the pattern of mortality in children’s Federal District. Knowledge of the epidemiology of injuries is essential for planning, implementation and evaluation of preventive measures. Methods: We analyzed the forensic examination documents of all children under 12 years sent to the IML-DF, during 2010. The data analyzed included age, gender, cause of death (i.e.natural or external), mechanism of death (traffic accident, asphyxia, firearm injuries, poisoning, heat injuries) and the medical cause of death. Results: A large number of children (n = 123 total;n = 71 males, n = 52 females) were examined in the IML-DF, Brasília, Brazil. Mean age was 37.96 months, with a median of 12 months, and 21% of children were younger than 1 month. There were 62 cases (33 males and 29 female) classified as natural deaths. The average age for natural deaths was 18.72 months. Most cases of natural death occurred in the first year of life (n = 50), being prevalent in the first month of life (n = 24). Among the 62 cases analyzed, six were stillborns, 13 suffered intrauterine fetal distress (e.g. placental insufficiency, prematurity and meconium aspiration), 36 had lung problems (e.g. Acute respiratory distress syndrome (ARDS), bronchopneumonia, pulmonary hemorrhage, interstitial pneumonitis and infant respiratory distress syndrome (IRDS)), five had neurologicalproblems (e.g. hydrocephalus, hydranencephaly,convulsive seizures and meningitis) and two had undetermined cause of death. There were also isolated cases of heart disease, leukemia, diabetic ketoacidosis, peritonitis causedby acute appendicitisand amniotic bandsyndrome. There were 61 cases of deaths from external causes, as a consequence of the following: blunt instrument, firearm, physical agent (i.e.heat), physicochemical agent (i.e.asphyxia) and chemical agent (i.e.poisoning). Conclusions: The profile of deaths from external causesin this developing country follows a trend similar to trends reported in the literature for other developing countries. The majority of deaths are accidental, with traffic accidents being the most frequent cause, followed by asphyxia (i.e.aspiration of gastric contents and drownings). Sporadic cases of poisoning, injuries from firearms, accidents and fires also occur.展开更多
文摘Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.
文摘Introduction: The greatest effect of maternal mortality is renowned in children aged 2 - 5 months whose mothers had died. Children whose mothers died due to maternal complications were likely to record a higher mortality in infancy compared to children of surviving mothers. Motherless children mostly suffer a lot due to lack of day-to-day care, isolation, lack of motivation as well as economic cost associated with mother’s death. Thus, the purpose of this study was to ascertain the lives of children whose mothers passed away during childbirth at the Sagnarigu Municipality. Methods: This quantitative cross-sectional study was carried out at the Sagnarigu Municipal. The study recruited 297 respondents. To assess the effects of maternal death on the lives of children, families that experienced maternal death were assessed. The number of pregnancies experienced by the deceased woman, pregnancy-related complaints experienced, determinants of maternal death, number of children alive, and their standard of living were assessed with the aid of a structured questionnaire. Results: The data showed that negligence, illiteracy, poor road access, poverty, ignorance, delays in recognizing the problem, delays in making appropriate decisions, delays in the health facility, delays in giving the appropriate treatments, and traditional beliefs were some of the factors that led to maternal death in the Sagnarigu Municipality. Conclusion: The study concluded that determinants of maternal death in the Sagnarigu Municipal included the following;negligence, illiteracy, poverty, and delays in recognizing the problem. The study findings also demonstrated that the effects of maternal death on children are diverse and cut across different areas of a child’s life including livelihood sustenance, healthcare, education, and emotional and psychological development.
文摘Introduction: The United Nations Sustainable Development Goals (SDGs) aim to decrease the global maternal mortality ratio to below 70 per 100,000 live births and eliminate preventable deaths of newborns and children under the age of five in all countries by 2030. The pediatric department at Spécialisé Mère-Enfant Blanche Gomes Hospital (HSMEBG) is divided into two sectors, one catering to children aged one month to four years and the other dedicated to children aged five to 17 years. According to department records, over the past three years, there has been an average of 1050 hospitalizations per year, with an average duration of five days. Objectives: This study aims to describe the socio-demographic characteristics of children who died while in the pediatrics department of the HSMEBG and analyze the factors associated with their deaths. Methodology: A retrospective analytical cross-sectional study was conducted, collecting data over a three-year period, covering the years 2019, 2020 and 2021. Data were collected from medical records of deceased children using Excel software version 2016, and statistical calculations and logistic regression were performed using Epi info software version 7.2.5.0. Results: During the three years of operation, the pediatric department at HSMEBG recorded 3060 new admissions, of which 271 resulted in death, representing an overall frequency of 8.8%. December and January had the highest mortality rates, accounting for 15.5% and 12.5%, respectively. Out of the 271 recorded deaths, 143 (52.77%) occurred in children under the age of one, and 230 (84.87%) occurred in children under the age of five. The average age at death was 2.4 years, ranging from one month to 17 years. The sex ratio was 1. More than half of the deaths (51.66%) occurred during the night, and 165 (60.89%) sought medical help more than three days after the onset of symptoms. Weekend deaths accounted for nearly half (45.7%) of the cases. Upon admission, slightly over half of the children (55.72%) had impaired consciousness, 219 (80.81%) presented with respiratory distress, and 194 (71.59%) had a fever. The average time from admission to administering the first medication was 72 minutes. Respiratory infections were the leading cause of death, accounting for 83 (30.26%) cases, followed by severe forms of malaria (anemic and neurological) at 23.25%. Among the 271 recorded deaths, 33 (12.18%) received no treatment before their demise, and 136 (50.18%) died within the first 24 hours of hospitalization. The average duration of hospitalization for patients who spent less than 24 hours was 15 hours, while those who died after the 24th hour had an average hospital stay of five days, ranging from one to 41 days. Children under the age of five who were admitted with impaired consciousness had roughly double the risk of dying compared to those without this condition (p = 0.001). Conclusion: The overall mortality rate in the pediatric department at HSMEBG is 8.8%. Acute respiratory infections are the primary cause of death. Improving this rate necessitates reducing consultation and treatment durations.
文摘This article addresses the need for anticipatory guidance about death and death education with young children. Children often experience the death of an immediate family member before the age of ten. This number increases if one considers the loss of friends, pets, and other loved ones. However, children experience a death with little or no anticipatory guidance or knowledge about death. Anticipatory guidance can assist the child in having a better understanding of a death when it occurs. Talking about death with children can be difficult for adults. However, it is important to address the topic and realize the impact anticipatory guidance in relation to death can have in assisting with childhood bereavement, anticipatory grief, and anticipatory adaptation. By providing anticipatory education related to death symptoms such as grief, anger, and/or fear, regressive or aggressive behaviors can be prevented or lessened when a death occurs. Age appropriate developmental levels for understanding the concept of death, resources for death education, and literature that can be used for death education are presented. Any resource used for death education with children should be carefully reviewed by the adult for its appropriateness prior to its use.
文摘Background: Malaria is the most widespread parasitic disease and remains a public health priority worldwide. The severe form is fatal if not treated early and appropriately. The aim was to carry out a descriptive and analytical study of the factors associated with mortality during severe malaria in children attending emergency departments in Dakar, Senegal. Methods: This is a prospective, observational and analytical study conducted over a 6-month period (July 1 to December 31, 2022), focusing on children hospitalized for severe malaria according to WHO severity criteria. Results: A total of 403 patients were hospitalized, including 78 cases of severe malaria (19.35%). Males predominated (60.26%) (sex ratio 1.51). The average age was 6.56 years [8 months - 14 years], with the [5 - 10 years] age group the most represented (40.26%). The average consultation time was 5.33 days (1 - 19 days). The main reasons for consultation were fever (70.51%), vomiting (24.35%) and convulsions (14.10%). Biological signs of severity were severe anemia (17.95%), renal failure (6.4%) and hypoglycemia (3.85%). Thrombocytopenia was noted in 52.56% of patients, including 32.05% of severe cases (sis in 61.41% of cases. Hyponatremia was noted in 39.74% of cases and hyperkalemia in 2 patients. Artesunate was the main drug used (93.59% of cases). Mortality was estimated at 1.5%. Factors leading to death were coma (P < 0.01), respiratory distress (P Conclusion: Malaria is still a public health problem, with a high mortality rate in emergency departments. Reducing this mortality rate requires effective management of the factors associated with death.
文摘When it comes to the death,it can be gruesome or be dolente.However,the death also can be warm and be a new start of life.It is because we regard the death from different perspective that we show different attitude to the death.The novel The Great Blue Yonder which described the experience of the little protagonist died as a ghost wandering in the mortal world interpreted the death by fairy tale.In his wandering trip,he experience not only tears but also laughter.The more important experience he realized was that he took a new look at love and comprehended the significance of life.Because of the dislocation between narrative perspective and narrative contents,the abnormal narrative perspective owns the unique artistic charm.This thesis aims to interpret the Great Blue Yonder by taking the abnormal narrative perspective as the point of view from the dual narrative perspective of the ghosts and the children.The abnormal narrative perspective is endowed with the unique aesthetic effect because of its own aesthetic properties.It will make a great fresh aesthetic feast to readers.
基金Supported by Health Resources and Services Administration,NO.234-2005-37011C
文摘AIM: To evaluate the accuracy of a tool developed to predict timing of death following withdrawal of life support in children. METHODS: Pertinent variables for all pediatric deaths(age ≤ 21 years) from 1/2009 to 6/2014 in our pediatric intensive care unit(PICU) were extracted through a detailed review of the medical records. As originally described, a recently developed tool that predicts timing of death in children following withdrawal of life support(dallas predictor tool [DPT]) was used to calculate individual scores for each patient. Individual scores were calculated for prediction of death within 30 min(DPT30) and within 60 min(DPT60). For various resulting DPT30 and DPT60 scores, sensitivity, specificity and area under the receiver operating characteristic curve were calculated.RESULTS: There were 8829 PICU admissions resulting in 132(1.5%) deaths. Death followed withdrawal of life support in 70 patients(53%). After excluding subjects with insufficient data to calculate DPT scores, 62 subjects were analyzed. Average age of patients was 5.3 years(SD: 6.9), median time to death after withdrawal oflife support was 25 min(range; 7 min to 16 h 54 min). Respiratory failure, shock and sepsis were the most common diagnoses. Thirty-seven patients(59.6%) died within 30 min of withdrawal of life support and 52(83.8%) died within 60 min. DPT30 scores ranged from-17 to 16. A DPT30 score ≥-3 was most predictive of death within that time period, with sensitivity = 0.76, specificity = 0.52, AUC = 0.69 and an overall classification accuracy = 66.1%. DPT60 scores ranged from-21 to 28. A DPT60 score ≥-9 was most predictive of death within that time period, with sensitivity = 0.75, specificity = 0.80, AUC = 0.85 and an overall classification accuracy = 75.8%.CONCLUSION: In this external cohort, the DPT is clinically relevant in predicting time from withdrawal of life support to death. In our patients, the DPT is more useful in predicting death within 60 min of withdrawal of life support than within 30 min. Furthermore, our analysis suggests optimal cut-off scores. Additional calibration and modifications of this important tool could help guide the intensive care team and families considering DCD.
文摘Purposes: The purpose of this study was to determine the pattern of mortality in children’s Federal District. Knowledge of the epidemiology of injuries is essential for planning, implementation and evaluation of preventive measures. Methods: We analyzed the forensic examination documents of all children under 12 years sent to the IML-DF, during 2010. The data analyzed included age, gender, cause of death (i.e.natural or external), mechanism of death (traffic accident, asphyxia, firearm injuries, poisoning, heat injuries) and the medical cause of death. Results: A large number of children (n = 123 total;n = 71 males, n = 52 females) were examined in the IML-DF, Brasília, Brazil. Mean age was 37.96 months, with a median of 12 months, and 21% of children were younger than 1 month. There were 62 cases (33 males and 29 female) classified as natural deaths. The average age for natural deaths was 18.72 months. Most cases of natural death occurred in the first year of life (n = 50), being prevalent in the first month of life (n = 24). Among the 62 cases analyzed, six were stillborns, 13 suffered intrauterine fetal distress (e.g. placental insufficiency, prematurity and meconium aspiration), 36 had lung problems (e.g. Acute respiratory distress syndrome (ARDS), bronchopneumonia, pulmonary hemorrhage, interstitial pneumonitis and infant respiratory distress syndrome (IRDS)), five had neurologicalproblems (e.g. hydrocephalus, hydranencephaly,convulsive seizures and meningitis) and two had undetermined cause of death. There were also isolated cases of heart disease, leukemia, diabetic ketoacidosis, peritonitis causedby acute appendicitisand amniotic bandsyndrome. There were 61 cases of deaths from external causes, as a consequence of the following: blunt instrument, firearm, physical agent (i.e.heat), physicochemical agent (i.e.asphyxia) and chemical agent (i.e.poisoning). Conclusions: The profile of deaths from external causesin this developing country follows a trend similar to trends reported in the literature for other developing countries. The majority of deaths are accidental, with traffic accidents being the most frequent cause, followed by asphyxia (i.e.aspiration of gastric contents and drownings). Sporadic cases of poisoning, injuries from firearms, accidents and fires also occur.
