Analysis of neonatal deaths in Sri Lanka from 2002 to 2006

Abstract

INTRODUCTION AND OBJECTIVES: To describe the causes, timing and distribution of neonatal deaths in Sri Lanka from 2002 to 2006. METHODS: Information on all neonatal deaths occurred from 2002 to 2006 (5 calendar years) in the entire country was obtained from the Registrar Generals' Department. Place of death and age at death were retrieved. Causes of death documented as 429 different diagnoses according to the ICD-10 classification were reclassified into clinically relevant and meaningful categories. Results: A total of 14,487 neonatal deaths occurred during the 5-year period with a mean of 2897.4 deaths per year; of which 8159 (56.32%) were males. One third of them (4904) died within 24 hours of life and 11,318 (78.12%) were early neonatal deaths. Number of deaths gradually decreased with increasing age. Colombo district reported 3334 (23.0%) deaths. Prematurity and related complications were the cause for 4603 (31.77%) deaths whereas 2389 (16.49%) deaths were due to infections. Proportion of deaths due to infections has gradually decreased from 20.23% in 2002 to 11.84% in 2006. Congenital anomalies contributed to 12.63% (1830) deaths and the majority of those deaths (1389-9.59%) were due to congenital heart diseases. Birth asphyxia had caused 1349 (7.93%) neonatal deaths. Tsunami wave in 2004 has led to 36 (0.25%) neonatal deaths. CONCLUSIONS: Preventable causes such as prematurity, infections and congenital heart diseases are still leading causes of neonatal deaths in Sri Lanka. Targeted healthcare reforms are urgently needed to address these issues.