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

Pattern and Magnitude of Treatment Delay among TB Patients in Five States in Southern Nigeria

Prompt diagnosis and early treatment of Tuberculosis (TB) cases is an important strategy in TB prevention and control. Thus; passive case finding of TB suspects; sputum examination for diagnosis; and prompt treatment using Directly Observed Treatment Short Course (DOTS) are key elements in the national guideline for TB control programme. The aim of this study is to determine the time interval between diagnosis of smear-positive TB cases and the commencement of treatment in DOTS facilities in southern Nigeria. The study was carried out in 20 healthcare facilities supported by TB Control Assistance Program (TB-CAP) involved in TB management in southern Nigeria; which comprised tertiary; secondary; and primary healthcare facilities including public and private facilities. Data were collected through review of clients' and facility records covering July-September 2009. Data collected were sociodemographic characteristics; sputum-smear result; date of diagnosis; and date of commencement of treatment. Data were analyzed using SPSS version 15.0 software. Of the total 2;507 TB suspects examined for Acid-Fast Bacillus (AFB); 323 were diagnosed to be Sputum-Smear-Positive (SS+ve); However; 269 new smear positive cases were commenced on treatment within the period; thus 54 (17.0) of the new SS+ve cases defaulted initially. One hundred and two (38) of them commenced TB treatment within 3 days of smear examination for diagnosis; while 59 (22) commenced 4-6 days after diagnosis. The study revealed significant delay in commencement of TB treatment for most new smear positive TB cases in southern Nigeria and underlines the need to further explore factors responsible for delay in commencement of TB treatment following diagnosis