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Trajectory of cause of death among brought dead neonates in tertiary care public facilities of Pakistan: A multicenter study

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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.

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Acknowledgements

All the authors are thankful to PMRC for providing funds. The project was Conducted under PMRC grant no.4-17-1/09/RDC/Multicenter/Verbal Autopsy/NICH.

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Authors and Affiliations

  1. PMRC Specialized Research Center on Child Health, National Institute of Child Health, Karachi, Pakistan

    Muhammad Ayaz Mustufa & Syed Jamal Raza

  2. PMRC Research Center, Liaquat University of Health and Medical Sciences, Jamshoro, Hyderabad, Pakistan

    Munir Ahmed Sheikh

  3. PMRC Research Center, Nishtar Medical College, Multan, Pakistan

    Ijaz-ul-Haque Taseer, Muhammad Sohail Arshad & Sohail Safdar

  4. PMRC Research Center, Khyber Medical College, Peshawar, Pakistan

    Tasleem Akhter

  5. PMRC Research Center, Punjab Medical College, Faisalabad, Pakistan

    Ghazala Mohyuddin Arain

  6. PMRC Research Center, Dow University of Health Sciences, Karachi, Pakistan

    Sultana Habibullah

  7. PMRC Research Center, Bolan Medical College, Quetta, Pakistan

    Rukhsana Firdous

  8. PMRC Research Center, FJMC, Lahore, Pakistan

    Muhammad Adnan

  9. 5th Floor, PMRC Specialized Research Center on Child Health, National Institute of Child Health, Karachi, 75500, Pakistan

    Muhammad Ayaz Mustufa

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  1. Muhammad Ayaz Mustufa
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  2. Munir Ahmed Sheikh
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  7. Ghazala Mohyuddin Arain
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  11. Muhammad Adnan
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Correspondence to Muhammad Ayaz Mustufa.

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Mustufa, M.A., Sheikh, M.A., Taseer, IuH. et al. Trajectory of cause of death among brought dead neonates in tertiary care public facilities of Pakistan: A multicenter study. World J Pediatr 13, 57–62 (2017). https://doi.org/10.1007/s12519-016-0063-5

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  • DOI: https://doi.org/10.1007/s12519-016-0063-5

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