Pediatric “brought in dead”: Analysis of the characteristics and probable causes in a Nigerian tertiary hospital

Background: Information obtained from the “brought in dead” (BID) cases is important in understanding the challenges in seeking health care and help in policy making. Objective: This study was conducted to describe the characteristics of children presenting to Enugu State University Teaching Hospital (ESUTH), Enugu as BID and probable causes of death. Materials and Methods: This descriptive study was conducted in the Children Emergency Room (CHER) of ESUTH. Information from all cases of BID children presenting to the CHER of ESUTH between May 2016 and April 2020 was recorded in a register after the confirmation of death. A probable diagnosis was made by verbal autopsy. Data were entered and analyzed with Statistical Package for Social Sciences (SPSS) version 20 (Chicago, IL). Results were presented as tables, bar chart, and prose. Results: There were 124 cases of BID, accounting for 2.2% of the total presentations and 43.1% of the mortalities. Their ages ranged from one month to 192 months, with a median age of 12 months. Majority (61, 49.2%) of the dead children were infants. There was an almost equal sex distribution with 63 males and a male-to-female ratio of 1:1. Probable causes of death included acute gastroenteritis (AGE), severe anemia, sepsis, acute encephalitic syndrome, and aspiration. None of the cases was referred from a health facility. There was a bimodal peak for the annual presentation (January and October). Most of the presentations were during the day (86, 69.4%). None of the parents gave consent for autopsy. Conclusion: The rate of children dying before receiving health care in our hospital is high; there is an urgent need for continuous mass mobilization within the communities to improve the health-seeking behaviors, and also to teach them to recognize danger signs in children.