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Uruguayan Medical Journal

ISSN: 1688-0390

Vol.23 - Nº 4 - Dic. 2007

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Postneonatal household death 10 years after: Montevideo, 2006

Rev Med Urug 2007; 23: 242-250
Full text (spanish) |  Full text (spanish) (New windows, pdf) | Abstract


Introduction: studies carried out at national level in 1996 evidenced a high prevalence of postneonatal deaths without medical assistance. Infant mortality rate decreased in the following 10 years at the expense of the postneonatal component. Within the new epidemiological framework, we aim to find out whether the attributes of postneonatal household death have changed.

Objectives: 1. To learn about postneonatal household death in Montevideo in 2006, describing some of the features of the affected population and their environment. 2.

To learn about the causes of these deaths and the diagnostic procedures used. 3. To Compare the new results with those corresponding to 1996.

Method: a descriptive, retrospective study was conducted for all postneonatal household deaths occurring in Montevideo in 2006. Death certificates, police reports, autopsy reports and anatomopathological studies were used as research sources. The form used for the collection of data in the present study was the same one used in 1996. The initial cause of death was revised in those cases where Anatomopathological Reports were available.

Results: In 2006, there were 84 postneonatal deaths in Uruguay, 39 (0.46%) of which were household deaths.

Most infant deaths were male (0.64%). Average death age was 3 months fifteen days. Female and male weight/age ratios were obtained in 34 cases: eight of which were equal to or lower than percentile 5. Except for malnutrition and preterm birth, in most cases (0.67%) there was no pathological history. Six of them carried known diseases and a further seven presented respiratory complications in the week prior to death. In terms of season distribution, winter prevailed (0.36%). Almost all deaths were natural deaths and certified by a forensic doctor. In 24 out of 38 deaths complementary anatomopathological studies were re- quired. Judicial autopsy findings, anatomopathological studies and pediatric history reveal the main cause of death are respiratory infections (0,42%).

Most deaths occurred (FR=0,56) in three police districts of Montevideo, characterized by low socioeconomic indicators. Upon comparing new results to those obtained in 1996, we found proportional household postneonatal deaths remained constant, the same as the deceased?s profile.

Conclusions: 1. Household death still represents almost 50% of infant mortality in the postneonatal term in Montevideo, it is a significant public health issue and it is avoidable. 2. It occurs in neighborhoods with low socio- economic level. The deceased?s profile is the same as that of 1996. 3. Forensic doctors who certify these deaths have evidenced a change in attitude, showing a tendency to request more anatomopathological studies and to avoid attributing deaths to incidental autopsy findings. 4. Information regarding causes of death is not enough. This could be reverted by systematically requesting the neces sary complementary studies, especially anatomopathologi cal studies and verbal autopsies, as well as by organizing multidisciplinary committees to discuss the issue.