Trauma unit admissions at the Ugandan National Referral Hospital: a descriptive study

Background: Injuries are a neglected epidemic globally accounting for 9% global deaths; 1.7 times that of HIV, TB and malaria combined. Trauma remains overlooked with key research and data focusing on infectious diseases, yet Uganda has one of the highest rates of traumatic injury. We described demographics of patients admitted to Mulago Hospital's Shock Trauma Unit within the Emergency Department. Methods: This was a retrospective record review Trauma Unit admission from July 2012 to December 2015. Information collected included: age, sex, time of admission, indication for admission and mechanism of trauma. Results: 834 patient records were reviewed. The predominant age group was 18-35 with majority of patients being male. 54% of patients presented during daytime with 46% admitted in the evening hours or overnight. Mechanism of injury was documented in 484 cases. The most common mechanism was Road Traffic Accident (67.4%), followed by assault (12.8%) and mob violence (5.6%). The most common indication for admission was traumatic brain injury (84.5%), followed by hemodynamic instability (20.0%) and blunt chest injury (6.1%). Conclusion: There's a significant burden of high-acuity injury particularly among males with RTAs as the leading cause of admission associated with Traumatic Brain Injury as main admission indication

Referral conditions for severe road traffic injuries and their influence on the occurrence of hospital deaths in Benin

Road traffic accidents are the leading cause of death by trauma. Delays in in first aid due, inter alia, to the long time to transfer traffic accident victims to hospital and the lack of pre-hospital emergency care, contribute to the increase in hospital mortality. This study aims to analyse the referral conditions for severe road traffic injuries and to assess their effect on the occurrence of hospital deaths in Benin. This is an analytical prospective cohort study conducted in road accident victims with a severe injury. Four groups of factors were studied: referral conditions, sociodemographic and victim-specific characteristics, factors related to the accident environment, and factors related to health services. A top-down binary stepwise logistic regression was the basis for the analyses. Nine point eight percent of severe trauma patients died after hospital admission (7.0-13.5). Associated factors were referral time greater than 1 hour (RR=5.7 [1.5-20.9]), transport to hospital by ambulance (RR=4.8 [1.3-17.3]) and by the police or fire department (RR=7.4 [1.8- 29.7]), not wearing protective equipment (RR=4.5 [1.4-15.0]), head injuries (RR=34.8 [8.7-139.6]), and no upper extremity injuries (RR=20.1 [2.3-177.1]). To reduce the risk of hospital death in severe road traffic injuries, it is important to ensure rapid and medicalized referral of severe trauma patients in Benin.

Self-assessed competencies of nurses at an emergency department in Ghana

Introduction: The nature and scope of emergency nursing exposes nurses to a wide array of patient populations with rapidly changing and unexpected clinical conditions, sophisticated logistics and procedures. Hence, emergency centre (EC) nurses ought to be ready to face diverse clinical challenges and deliver care to patients in a timely cost-effective manner and with the needed competence. The current study aimed at examining the self assessed competencies of nurses, and comparing ratings among certified emergency nurses (ENs) and general nurses (GNs) working at an EC of a tertiary hospital in Ghana. Methods: A descriptive cross-sectional quantitative study was carried out among 109 conveniently sampled nurses. Participants evaluated their perceived competencies on a validated instrument under five domains, namely: diagnostic function (DF), administering and monitoring therapeutic interventions (AMTI), effective management of rapidly changing situations (EMRCS), organisational and work load competency (OWLC), and the helping role (HR). Descriptive and inferential data analyses were by SPSS version 25. Results: Participants generally had good competencies in the performance of emergency nursing procedures. Highest scores were obtained in OWLC (median score of 83.3%) while EMRCS recorded the least scores (median score of 57.9%). With the exception of the DF domain (p=0.166), ENs perceived themselves as significantly more competent than their counterpart GNs in 4 (OWLC, HR, AMTI, EMRCS) out of the five studied domains (p < 0.05). Discussion: Specialist training enhances nurses' perceived competences in emergency nursing procedures. This reiterates the need for regular theory and practice-based education for GNs on intermediate and advanced procedures as they prepare to enrol in specialist programmes. As nurses take on expanded professional roles in this emerging nursing specialty in low- and middle-income countries, it is important the needed capacity is developed to adequately address the needs of patients and families that require services in ECs

Prévalence des accidents d'exposition au sang et facteurs associés chez les professionnels de santé à l'hôpital de zone de Menontin, Bénin

Introduction: Les accidents d'exposition au sang (AES) constituent une réelle préoccupation pour les professionnels de santé à cause de la gravité des affections qu'ils engendrent. La présente étude a été menée pour évaluer la fréquence des accidents d'exposition au sang (AES) au sein du personnel de l'hôpital de zone de Mènontin et les facteurs qui lui sont associés. Méthode d'étude : Enquête descriptive transversale et analytique incluant 90 agents de santé. Le recueil des données a été fait sur la base d'un questionnaire anonyme et de deux grilles d'observation. Le questionnaire a été remis à chaque agent de santé volontaire après explication des objectifs de l'étude. Une visite de tous les services a été réalisée pour compléter les grilles d'observation. Résultats : L'âge moyen de notre échantillonnage est de 37 ans ± 10. Les femmes ont représentées dans 70% de notre échantillonnage et le sexe ratio est de 0,42.Les infirmiers (32,2%), les techniciens de laboratoire (25,56%) et les aidessoignants (16,7%) étaient les classes professionnelles plus représentées. La fréquence des AES chez les professionnels de santé à l'hôpital de zone de Mènontin est de 40%. Les types d'AES les plus fréquents sont les piqures (44,4%), les projections sur muqueuse (25%) et les coupures (16,7%).le sang a été impliqué dans 86,11% des cas. Les mécanismes de survenue des AES répertoriés étaient essentiellement le recapuchonnage (66,7%) et l'élimination de déchets (25%). L'absence de formation sur les AES et de port de gants influence significativement la survenue des AES. Les AES n'ont pas été déclarés dans 66,7% des cas. Les mesures de prévention et de prise en charge des AES sont inexistantes au sein de l'hôpital de zone de Mènontin. Conclusion : Des séances de sensibilisation du personnel sur les risques liés aux AES s'imposent en vue de leur prévention

Injury Patterns and Mortality Rates of Motorcycle-Related Head Injuries in Kenya

Background: Motorcycles are an emerging means of public transportation in many developing countries and has a poor safety record when compared to other road users. Subsequently; motorcycle injuries have been on the rise and head injuries are the leading cause of death; severe injury and disability globally.Objectives: To determine the injury patterns and mortality rate of motorcycle-related head injuries. Design: A retrospective descriptive study. Setting: Moi Teaching and Referral Hospital Subjects: All motorcycle-related head injuries from the year 2010 to 2013. Results: One hundred and fourteen files were reviewed. The study sample was predominantly male (n=106; 93%) with a mean age of 30.2 years (SD=14.01). More than half of the patients sustained skull fractures and intra-cranial haemorrhage (n=68; 59.6%). About 9.6% (n=11) of the patients succumbed to their injuries out of which 63.6% (n=7) sustained severe head injuries. There was a significant association between helmet use and the mortality rate of patients (?2=5.684; p=0.017). The use of helmets also had an influence on the type of injury sustained (p=0.004) as patients not wearing helmets sustained more serious injuries such as skull fractures; intra-cranial bleeding; cerebral oedema and diffuse axonal injuries.Conclusion: There is a relationship between helmet use; the type of injury sustained and the mortality rate of the patients. Hence; the need for public education programmes on motorcycle safety and helmet use to curb the negative impact of motorcycle-related injuries on the society and economy

A Survey of Commercial Drivers' Perception on the Causes of Road Traffic Accidents in Nigeria

Background: Road traffic accident is a multifactorial phenomenon that affects victims to different degrees depending on the type of accident. The aim of this study was to study commercial driver's attitude and their perceived causes of accidents on Nigerian roads.Methodology: A cross-sectional study of commercial drivers from various motor parks in a Nigerian urban city was carried out using questionnaires. Every volunteer was asked to complete a questionnaire that revealed patient demographics; age; education level; time of accident and perceived cause(s) of the accident. All participants were males and licensed drivers.Results : Drivers in the age range of 38 - 47 years (n = 174; 46.77) were mostly involved in road traffic accidents. Road accidents were much more prevalent on rural roads than on urban roads. Majority of the drivers (n = 198; 53) had secondary level of education; while 112 drivers (30) had primary level of education. One hundred and eight drivers (29.03) believed the accidents were as a result of the road. 21.24 (79) stated that the time of the day; which could be in the daylight; dusk or at night; could influence road traffic accidents.Conclusions : The drivers perceived that the nature of the road; time and weather are some of the major contributory factors to road accidents. However; it was deduced from the study? that behavioral patterns on the road; violation of traffic rules and driving under the influence of alcohol were the major contributory factors in commercial drivers' involvement in vehicular accidents

Profie and Economic Impact of Motorcycle Injuries Treated at a University Referral Hospital in Kigali; Rwanda

Background: Motorcycle injuries constitute a major public health problem in developing countries; leading to significant disability and straining healthcare resources. We aim to present the basic epidemiology of motorcycle injuries presenting to an urban referral hospital in Rwanda and to evaluate patient outcomes and associated costs arising from injuries sustained on motorcycles. Methods: We conducted a retrospective cross-sectional study of motorcycle injury patients presenting to Kigali Teaching University Hospital from January-December; 2011. Patients were identified through review of ward registers and trauma registries and stratified into 3 groups based upon length of stay. A representative sample of 269 patients was randomly selected from each group for financial analysis. Data were collected from patient medical; police; and financial records as well as patient interviews. Cost analysis was based upon the standard road accident cost conceptual framework. Data were collected using Epi data 3.1; Excel and analyzed using SPSS 16. Results: A total of 269 motorcycle accident files were examined. Males were more affected than females with sex ratio F:M;1:6.72.Youths were more involved in motorcycle accident (53.2) than other age group(16-30 years) .The majority of Motorcycles victims were motorcyclists; (30.86); businessmen (20.45) and students (11.53). Motorcycle-vehicle (41.61) was the fist cause of motorcycle injuries then motorcycle-pedestrian (30.86). Helmet use was 92.75. Head injuries and fractures were the predominant diagnoses (82.15). About 46.7 had pre-hospital care. The mean hospital stay was 15.43 days; and 38.3 spent more than 15 days in hospitalization. Permanent disability was confirmed in 11.5 (n=31); and mortality was 10.4 (n=28). The total economic cost was estimated at US$1;236;207.31 with 39.40 (US$487;030.30) due to loss of labor and 21.76 due to direct medical costs (US$269;000.84). Conclusions: Motorcycle injuries create a substantial disability and cost burden in Kigali; Rwanda. Prevention and early treatment should be promoted to decrease the morbidity and financial burden

Epidemiology and Pattern of Road Traffic Injuries in Ngaoundere; Cameroon: a Retrospective Hospital Based Study Prior to the Implementation of a Formal Trauma Registry

Low income countries are disproportionately affected by injuries. Most injury related death and disabilities occur as the result of road traffic accidents. This study aims at analysing the epidemiology and pattern of road traffic related injuries in a semi-urban area in the northern part of Cameroon where no such data existed before.This hospital based retrospective analysis was conducted over a period of five years in a level III institution in the Adamaoua region of Cameroon. The records of all patients received in the emergency department of Ngaoundere hospital after a road traffic related injury were reviewed for epidemiological variables; type of vehicle involved; nature and severity of injuries; modalities of management and outcome. A total of 1257 victims of road traffic injuries could be analyzed. Their ages ranged from 2 to 84 years and males were more affected than females. Almost 60 of victims were motorcycle users. Each patient sustained a mean of 1.3 lesions. The head and lower limbs were the most affected body parts. The most frequent lesions were soft tissue injuries and bone fractures; involving mostly the lower limb. Most injuries were of minor or moderate severity and the admission rate was 28. A total of 79 patients (6.3) were reported dead. Most of them sustained a head injury. The massive presence of motorcycles in the Adamaoua region seems to influence the pattern of road traffic injuries. A more comprehensive system of capturing injury cases needs to be developed in Ngaoundere

Patterns of Injury at Two University Teaching Hospitals in Rwanda: Baseline Injury Epidemiology Using the Rwanda Injury Registry

Introduction: Globally; more worldwide deaths in 2010 could be attributed to injuries than the total number of deaths from infection with AIDS; tuberculosis; and malaria combined; with a disproportionate number of these deaths occurring in low- and middle-income countries. Yet; worldwide research and plans for prevention of injuries are far below other world health problems; especially in developing countries. Methods: A 31-item; 2-page registry form was adapted from regional trauma registries for use in Rwanda to collect data at the two main university referral hospitals in Kigali and Butare. Beginning in 2011; registrars recorded demographics; pre-hospital care; initial physiology; early interventions; and disposition of injured patients who met our selection criteria. Inpatient 30-day discharge status; mortality; and complications were abstracted from patient charts; ward reports and operating room logs. Descriptive analysis was used to evaluate patterns of injury and basic injury epidemiology at the two study hospitals from August 1; 2011-January 31; 2013. Results: A total of 3599 patients were registered from August 1; 2011 to January 31; 2013. Patients were predominantly male; and road traffic crashes were the leading cause of injury overall; contributing to a greater proportion of injuries in the more urban capital than the smaller city of Butare. The majority of patients were admitted to the hospital. All variables evaluated except for the percentage of injuries acquired via a penetrating mechanism showed statistically signifiant differences at an alpha signifiance level of 0.05; illustrating that the trauma population presenting at the two hospitals may be quite different. Conclusion: The Rwanda Injury Registry indicates a high burden of road traffic injuries in a predominantly working age male population over an eighteen-month period. This information can be useful in expanding injury surveillance programs and hopefully implementing population-based prevention programs

A 20 Year Retrospective Analysis of Medicolegal Deaths in a Tertiary Hospital Setting in Nigeria

Objective: To determine and classify the various types of medicolegal deaths as seen at University of Benin Teaching Hospital (UBTH); Benin City; Nigeria.Materials and Methods: This is a retrospective study of all the medicolegal deaths seen in the Department of Histopathology; (UBTH; Benin City over a 20 year period (January 1990-December 2009) as recorded in the autopsy registers of the department.Result: A total of 5035 autopsies were done during the period; 89 of which were coroner cases. Four thousand; four hundred and eighty-one coroner cases representing 12.5 of all bodies received by the mortuary during the period were studied. The male to female ratio was 1.9:1; with an overall mean age of 38.3 years. The ages ranged from 1 day to 101 years with a peak incidence in the 25-44 years age group. A total of 553 children and 3928 adults were involved. The commonest indication for coroner's autopsy was sudden unexpected natural deaths (SUNDs) which accounted for 65.5 of the cases. Other causes of death were accidents; homicide; suicide; and undetermined causes representing 28.6; 5.0; 0.5; and 0.4; respectively. Commonest cause of SUND was cardiovascular diseases with complications of hypertension being the most common CVS disease (26.9). Road traffic accident was the commonest form of accident causing death (88.7). Public enlightenment and health education about routine medical screening will help to reduce causes of natural deaths.Conclusion: This study shows the pattern of medicolegal autopsies in UBTH and this preliminary data will provide a baseline for future research and help in formulating policies to help in reduction of preventable causes of death

The Impact of Seat-belts in Limiting the Severity of Injuries in Patients Presenting to a University Hospital in the Developing World

Road traffic injuries are major public health problems and a leading cause of death and injury around the world. Approximately 1.2 million people are killed each year in road crashes worldwide; with up to 50 million more injured. Over 95 of these deaths and injuries occur in the low- and middle-income countries of the world. The aim of this study is to evaluate the impact of the use of seat-belts in reducing the severity of injuries from road traffic crashes and to determine the compliance and awareness of the importance of the use of seat-belts among Nigerian motorists. Patients and Methods: The injury patterns and outcome of care in 140 patients who were seen at the emergency department of our tertiary hospital were evaluated. Initial care and resuscitation was carried out on all patients using the advanced trauma life support protocol. Results: A total of 81 (57) patients used seat-belts; while 59 (42.1) did not. Nineteen (13.6) patients died as a result of their injuries; 4 (21.1) of these had used seat-belts; while 15 (79) had not ( P = 0.001). The mortality rate of 79 for patients who did not use seat-belt was statistically significant. Conclusions: The seat-belt is an effective safety tool that not only saves lives; but also significantly reduces the severity of the injury that a vehicle occupant may have sustained if they were not wearing the device. More public enlightenment is needed to increase the awareness and compliance of use of seat-belts among Nigerian motorists. for patients who did not use seat-belt was statistically significant. Conclusions: The seat-belt is an effective safety tool that not only saves lives; but also significantly reduces the severity of the injury that a vehicle occupant may have sustained if they were not wearing the device. More public enlightenment is needed to increase the awareness and compliance of use of seat-belts among Nigerian motorists

An Observational Study of Road Safety around Selected Primary Schools in Ibadan Municipality; Oyo State; Southwestern Nigeria

"Background/ Objective: Child pedestrians have been identified as vulnerable road users. Although walking as a means of transport has health and other benefits; it exposes children to the risk of road traffic injuries. This study was conducted to assess the availability of road safety features around government-owned primary schools in Ibadan municipality. Materials and Methods: A multistage sampling technique was used to select 46 of the 74 schools in the study area. Some (11) of the selected schools were sited within the same premises and shared a common entrance; thus a total of 35 school premises were eventually observed. Trained research assistants observed the school environment around the selected schools for road safety features such as location of schools; presence of ""school""; ""child crossing"" and ""speed limit"" road signs; and presence of traffic calming devices (road bumps or zebra crossing). Results: Five (14) of the schools were located on major roads and eight (23) had road signs indicating that a school was nearby. Seven (20) had road bumps close to the school; 15 (43) had a warden who assisted children to cross; and none had a zebra crossing. Five (14) schools had pedestrian sidewalks. Conclusions: The study revealed that the environment around a number of the observed schools in the municipality compromised the pupils' road safety. The local government; school authorities; parents; and road safety professionals need to institute definite measures to enhance the road safety environment around schools in the municipality."

Motor Traffic Injuries (MTIs) in Sub-Saharan Africa (SSA)

"Introduction: Motor traffic injuries are recognized as a major public health problem in developing countries. MTIs continue to cause morbidity; mortality and disability in Sub Saharan Africa (SSA). Objectives: To describe the magnitude of MTI's in SSA and to find the magnitude of morbidity and mortality caused by MTI's. Methodology: The World Health Organization (WHO); PUBMED and EMBASE database were used to identify documents and articles on MTIs in SSA and its effects. The literature review was supplemented by document review and interviews with a key informant in one region of Tanzania to determine the magnitude of morbidity and mortality associated with MTIs in Tanzania. Results: The mortality rate due to MTIs in Lower and Middle Income Countries(LMIC's) including SSA is about 20 per 100;000 population while in High Income Countries(HIC's) is about 10.3 per 100;000 population. MTI's also represent the ninth leading cause of Disability Adjusted Life Years (DALY's) lost and it is forecasted by WHO to be the third leading cause of DALY's lost by 2020. Total number of reported accidents in Kilimanjaro region in 2008 was 906 while in 2009 it was 1;125 accounting for an increase of 24. The total mortality reported in 2008 was 147 and 202 in 2009 with an increase of 37. The total morbidity was 622 in 2008 and 933 in 2009 accounting for a 50increase. Discussion: The high mortality rate in SSA of about 20 per 100;000 populations is contributed mainly by human factors with the major being reckless driving and negligence of drivers; pedestrians and passengers. Morbidity and mortality due to MTI's is increasing gradually over time as seen from the Kilimanjaro documents. The burden of MTI morbidity and mortality is predicted to rise by 80in SSA and fall by 30in HIC's by 2020. Conclusion et recommendations: MTI is still a public health problem in LMIC's. Measures to improve human factors in causing MTA are urgently required in order to reverse the trend. I hereby conclude with the motto by the National Road Safety Council of Tanzania which says ""Road safety is NO ACCIDENT"" and that ""Road safety is for sharing""."

Motor Traffic Injuries in Sub-Saharan Africa

Introduction: Motor traffic injuries are recognized as a major public health problem in developing countries. MTIs continue to cause morbidity; mortality and disability in Sub Saharan Africa (SSA). Objectives: To describe the magnitude of MTI's in SSA and to find the magnitude of morbidity and mortality caused by MTI's. Methodology:The World Health Organization (WHO); PUBMED and EMBASE databases were used to identify documents and articles on MTIs in SSA and its effects. The literature review was supplemented by document review and interviews with a key informant in one region of Tanzania to determine the magnitude of morbidity and mortality associated with MTI's in Tanzania. Results: The mortality rate due to MTI's in Lower and Middle Income Countries (LMIC's) including SSA is about 20 per 100;000 population while in High Income Countries(HIC's) it is about 10.3 per 100;000 population. MTI's also represent the ninth leading cause of Disability Adjusted Life Years (DALY's) lost and are forecasted by WHO to be the third leading cause of DALY's lost by 2020. Total number of reported accidents in Kilimanjaro region in 2008 was 906 while in 2009 it was 1;125 accounting for an increase of 24. The total mortality reported in 2008 was 147 and 202 in 2009 with an increase of 37The total morbidity was 622 in 2008 and 933 in 2009 accounting for a 50increase. Discussion: The high mortality rate in SSA of about 20 per 100;000 population is contributed mainly by human factors with the major being reckless driving and negligence of drivers; pedestrians and passengers. Morbidity and mortality due to MTI's is increasing gradually over time as seen from the Kilimanjaro documents. The burden of MTI morbidity and mortality is predicted to rise by 80in SSA and fall by 30in HIC's by 2020

Pre-Hospital and In-Hospital Management of Non-Fatal Road Traffic Injuries in Khartoum State: A Case Study

Abstract:Road traffic injuries are a major global public health concern. Millions of disabilities and death occur every year around the whole world. Low and middle income countries suffer more from road traffic injuries;subsequent complications and deaths. Studies have shown that these deaths could be prevented and injured persons would receive proper pre-hospital management and prompt ambulance services. This case study was conducted in three main hospitals in Khartoum State. The aim of the study was to explore pre-hospital and early hospital management provided to road traffic victims. One hundred seventy sixinjured persons were explored in this study. The study revealed that 53 (30) of the respondents had received first aid at the scene of the accident. Most victims arrived to hospitals with private cars in less than five hours. In hospitals; they were seen by doctors who were in charge. They received medical care such as sedation procedures to stop bleeding. Poor; delayed and incomplete pre-hospital or in-hospital management were the main findings of this study

Preparedness for Mass Casualties of Road Traffic Crashes in Uganda: Assessing the Surge Capacity of Highway General Hospitals

In Uganda; increase in human and vehicular populations against a non-expanding road infrastructure; breakdown in enforcement of traffic regulations and poor vehicle quality contribute to the high rate of casualties from road traffic crashes on highways; with over 2000 deaths per year. Highway hospitals should be the vanguard of preparedness to manage mass surgical casualties; to minimize road crash mortality. Objectives: To determine the capacity of Uganda's highway hospitals to manage mass surgical casualties. Methods: A descriptive; cross-sectional study of emergency surgical services of ten key highway general hospitals. Results: The hospitals had adequate capacity to manage uncomplicated solitary cases of injury. However; they had severe shortage of essential surgical equipment (9.6of expected). Staffing was poor (64.3of the recommended) and the staff lacked the life-saving surgical skills needed in a frontline hospital. There was perennial shortage of essential supplies e.g. blood; surgical gloves; intravenous fluids; oxygen and medicines. There was inadequate space for emergency surgery and only few staff members reside within easy reach for quick mobilization. Overall surge capacity was rated at below 50of what is required. Conclusion: Ugandan highway hospitals lack the technical and infrastructural capacity to handle mass casualties resulting from road traffic crashes. Surge capacity is below 50of that required to manage mass casualties. Recommendations: The key recommendations of this paper are: re-organisation of the outpatient departments to cater for mass emergency surgical cases; deployment of qualified surgeons in highway hospitals; training of hospital staff in life-saving surgical skills; targeted supervision of highway hospitals; training of managers in disaster preparedness; and improved funding for highway hospitals. THEME TWO: HOSPITALS

Mortality and Cause of Death in Abuth; Zaria: 1999-2005

Background: Accurate mortality statistics are needed for policy formulation; implementation and monitoring of health intervention that are aimed at improving the health status of the people. Mortality level is one of the indicators of the quality of life and status of health of a population. However; accurate collection; collation; analysis and interpretation of such data is poorly organised in developing nations; including Nigeria leading to a gap in health policy formulation; implementation and monitoring. Therefore; policies and strategies for disease prevention are based on empirical evidence rather than on data primarily collected to formulate disease specific interventions.Though; hospital data have inherent deficiency in its use to design prevention. However; when accurately generated and adequately managed would provide both qualitative and quantitative information on morbidity and mortality if not for the entire society at least for a segment of the population utilizing it. We implemented a system of death certification to determine causes and pattern of mortality in Ahmadu Bello University Teaching Hospital; Zaria Methods: From May 1999 to November 2005; all case folders of deceased patients were retrieved from the central library of health information management department of the hospital; case folders of deceased patients are required to have in them a completed IFMCCD(International Form of Medical Certification of Cause of Death). All case folders of deceased patients after relevant information were extracted by the staff of health management information department; were passed on to the staff of department of Community Medicine directly involved in this study. The completed cause of death certificates received in the department of Community Medicine (between May 1999 and November 2005); were examined. Coding rules were employed to select the appropriate code for those certificates that were incorrectly completed. The underlying cause of death as identified from the correctly completed IFMCCDS is coded according to ICD-10. Results: For the period under study; there were 4019 deaths: 2212 males and 1807 females. Total of 2914 (72.5) deaths were certified; using the IFMCCD of which 1641 of them were males and 1273 females and formed the basis of this analysis. Coverage rates ranges from 56.2in 2001 to 85in 1999. The proportion of garbage codes ranges from 0to 2.4while the three leading causes of death are HIV infection; road traffic accident (RTA); and cardiovascular diseases among the ten. The time-trend of the leading causes of death show RTA maintaining steady upward climb while malaria; septicemia; PEM; sepsis in the neonatal period shows unsteady fluctuation. Conclusion: This study assessed the pattern of mortality and causes of death in ABU Teaching Hospital; Zaria; it also provided information on leading causes of death