Pediatric death audit with special emphasis on autopsy at the University of Uyo Teaching Hospital, Uyo, Nigeria: a 6-year review
Keywords:
Paediatric autopsies, Autopsy, Pediatric death audit
Abstract
Background and Objectives: Paediatric autopsies are useful in the establishment of diagnosis, quality assurance and research. They are relevant in guiding genetic counseling and helping families that are grieving. Despite these uses and applications, autopsy rates have declined globally. This study was undertaken to identify the autopsy rate in the Department of Paediatrics at the University of Uyo Teaching Hospital (UUTH), Uyo, Nigeria.
Materials and Methods: The current report is a descriptive, cross-sectional and retrospective review of all the deaths among the hospitalized children from 1st January 2009 to 31st December 2014. Relevant information was extracted from case files of all in-patient deaths during the period under review.
Results: A total of 772 paediatric deaths were recorded during the period under review, of which 453 (58.7%) were males and 319 (41.3%) were females. Two hundred and twelve [212 (37.5%)] deaths occurred within 24 hours of admission. No autopsy was conducted (0%) on any of the cases.
Conclusion: Despite the importance, paediatric autopsies are not routinely performed in this centre, and in many others. This should not be the case. Paediatric autopsy rates can be improved by making consistent autopsy requests by the attending clinicians. Advocacy and enlightenment campaigns should be conducted at facility and community levels to educate everyone concerned about the benefits of paediatric autopsies.
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References
1. Kotabagi RB, Charati SC, Jayachandar D. Clinical autopsy vs medicolegal autopsy. Med J Armed Forces India 2005;61:258‑263. Available online: http://medind.nic.in/maa/t05/i3/maat05i3p258.pdf. Accessed: 24. July. 2015.
2. Law M, Stromberg P, Meuten D, Cullen J. Necropsy or Autopsy? It’s All About Communication! Veterinary Pathology 2012; 49(2): 271-272. DOI: 10.1177/0300985811410722. [PubMed]
3. Kaschula ROC. The Pediatric Autopsy in Africa. Arch Pathol Lab Med 2013; 137 (6): 756–766; Available online: http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2011-0589-RA. Accessed: 26. July. 2015. DOI: 10.5858/arpa.2011-0589-RA. [PubMed]
4. Kumar P, Taxy J, Angst DB, Mangurten HH. Autopsies in children: are they still useful? Arch Pediatr Adolesc Med 1998 Jun;152(6):558- 63. Available online: http://archpedi.jamanetwork.com/article.aspx?articleid=189612. Accessed: 25. July. 2015. DOI: 10.1001/archpedi.152.6.558.
5. Ekanem VJ, Vhriterhire CO. Relevance of clinical autopsy in medical practice in Sub‑Saharan Africa. Sahel Medical Journal 2015 Apr-Jun; 18 (2): 49-56. Available online: http://www.smjonline.org/temp/SahelMedJ18249-539545_145914.pdf . Accessed: 25. July. 2015. DOI: 10.4103/1118-8561.160795.
6. Cox JA, Lukande RL, Lucas S, Nelson AM, Van Marck E, Colebunders R. Autopsy Causes of Death in HIV-Positive Individuals in Sub-Saharan Africa and Correlation with Clinical Diagnoses. AIDS Rev. 2010 Oct-Dec;12(4):183-94. Available online: http://www.aidsreviews.com/files/2010_12_4_183-194.pdf. Accessed: 23. July. 2015.
7. Cox JA, Lukande RL, Kateregga A, Mayanja-Kizza H, Manabe YC, Colebunders R. Autopsy acceptance rate and reasons for decline in Mulago Hospital, Kampala, Uganda. Trop Med Int Health 2011 Aug; 16 (8): 1015 - 18. Available online: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02798.x/epdf . Accessed: 23. July. 2015. DOI:10.1111/j.1365-3156.2011.02798.x.
8. Lishimpi K, Chintu C, Lucas S, Mudenda V, Kaluwaji J, Story A, Maswahu D, Bhat G, Nunn AJ, Zumla A. Necropsies in African children: consent dilemmas for parents and guardians. Arch Dis Child 2001;84:463–67. Available online: http://adc.bmj.com/content/84/6/463.full.pdf. Accessed: 23. July. 2015. [PubMed]
9. Tette E, Yawson AE, Tettey Y. Clinical utility and impact of autopsies on clinical practice among doctors in a large teaching hospital in Ghana. Glob Health Action 2014; 7: 23132 - http://dx.doi.org/10.3402/gha.v7.23132. Available online: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3914029/pdf/GHA-7-23132.pdf. Accessed: 20. July. 2015.
10. Yawson AE, Tette E, Tettey Y. Through the lens of the clinician: autopsy services and utilization in a large teaching hospital in Ghana. BMC Research Notes 2014; 7:943:1-6. Available online: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307638/pdf/13104_2014_Article_3450.pdf. Accessed: 25. July. 2015. DOI: 10.1186/1756-0500-7-943.
11. Burton JL. The history of the autopsy. In Burton JL and Rutty GN(eds): The Hospital Autopsy. 3rd Ed. Hodder Arnold London 2010:1 - 10.
12. Gordijn SJ, Erwich JJ, Khong TY. Value of the perinatal autopsy: critique. Pediatr Dev Pathol. 2002 Sep - Oct;5(5):480-8. Accessed: 24. July. 2015. DOI: 10.1007/s10024-002-0008-y. [PubMed]
13. Feinstein JA, Ernst LM, Ganesh J, Feudtner C. What New Information Pediatric Autopsies Can Provide: A Retrospective Evaluation of 100 Consecutive Autopsies Using Family-Centered Criteria. Arch Pediatr Adolesc Med. 2007 Dec;161(12):1190-6. Accessed: 22. July. 2015. DOI:10.1001/archpedi.161.12.1190.
14. Lundberg GD. Low-Tech Autopsies in the Era of High-Tech Medicine: Continued Value for Quality Assurance and Patient Safety. JAMA 1998 Oct 14; 280(14): 1273 - 4. Accessed: 22. July. 2015. DOI: doi:10.1001/jama.280.14.1273. [PubMed]
15. Peres LC. Review of pediatric autopsies performed at a university hospital in Ribeirão Preto, Brazil. Arch Pathol Lab Med 2006 Jan;130(1):62‑8. Available online: http://www.archivesofpathology.org/doi/pdf/10.1043/1543-2165%282006%29130%5B62%3AROPAPA%5D2.0.CO%3B2. Accessed: 26. July. 2015.
16. Khong TY. A review of perinatal autopsy rates worldwide, 1960s to 1990s. Paediatr Perinat Epidemiol 1996 Jan;10:97‑105. Accessed: 22. July. 2015. DOI: 10.1111/j.1365-3016.1996.tb00030.x.
17. World Health Organization. Health and the Millennium Development Goals. Geneva: World Health Organization 2005: 82. [PubMed]
18. Adappa R, Paranjothy S, Roberts Z, Cartlidge PH. Perinatal and infant autopsy. Arch Dis Child Fetal Neonatal Ed 2007 Jan;92:F49‑50. Available online: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2675313/pdf/F49.pdf. Accessed: 22.July.2015. DOI: 10.1136/adc.2005.091447.
19. Scottish Programme for Clinical Effectiveness in Reproductive Health. Scottish Perinatal and Infant Mortality and Morbidity Report 2001. Edinburgh: SPCERH; 2002: 80.
20. Brodlie M, Laing IA, Keeling JW, McKenzie KJ. Ten years of neonatal autopsies in tertiary referral centre: retrospective study. BMJ. 2002 Mar 30;324(7340):761‑3. Available online: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC100315/pdf/761.pdf. Accessed: 22.July.2015.
21. Turnbull A, Osborn M, Nicholas N. Hospital autopsy: Endangered or extinct? J Clin Pathol 2015;0:1–4. Available online: http://jcp.bmj.com/content/early/2015/05/08/jclinpath-2014-202700.full.pdf+html. Accessed: 31. July. 2015. DOI:10.1136/jclinpath-2014-202700.
22. Korle-Bu Teaching Hospital . Annual report 2010, Accra, Ghana: Korle – Bu Teaching Hospital. Korle-Bu Teaching Hospital, 2011.
23. Gohill R, Nkanza NK, Bhagwandeen SB, Naik KG. A review of autopsies at the University Teaching Hospital, Lusaka, 1975. Med J Zambia. 1979 Apr-May;13(2):28–32. PMID: 263368. Accessed: 26. July. 2015. [PubMed]
24. Eke FU, Frank-Briggs A, Ottor J. Childhood Mortality In Port Harcourt, Nigeria. Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology, 2001; Vol. 2, No. 2 (July-Dec 2001): Available online: http://www.anilaggrawal.com/ij/vol_002_no_002/papers/paper003.html. Accessed: 20. July. 2015.
25. Nwafor CC, Abali C, Nnoli MA. Childhood Mortality in Federal Medical Centre Umuahia, South Eastern Nigeria. Oman Med J. 2014 Sep; 29(5):320-4. Accessed: 22. July. 2015. DOI: 10.5001/omj.2014.87.
26. Ugiagbe EE, Osifo OD. Postmortem examinations on deceased neonates: A rarely utilized procedure in an African referral center. Pediatr Dev Pathol 2012 Jan-Feb;15:1‑4. Accessed: 22. July.2015. DOI: http://dx.doi.org/10.2350/10-12-0952-OA.1.
27. Akang EE, Asinobi AO, Fatunde OJ, Pindiga HU, Okpala JU Abiola AO, et al. Childhood mortality in Ibadan: An autopsy study. Niger J Paediatr 1992;19:30‑6.
28. Ayoola OO, Orimadegun AE, Akinsola AK, Osinusi K. A five‑year review of childhood mortality at the University College Hospital, Ibadan. West Afr J Med. 2005 Apr-Jun;24(2):175‑9. [PubMed]
29. Oluwasola AO, Fawole OI, Otegbayo JA, Ayede IA, Ogun GO, Ukah CO, Bamigboye AE. Trends in clinical autopsy rate in a Nigerian tertiary hospital. Afr J Med Med Sci. 2007 Sep; 36(3):267-72. PMID: 18390067. Accessed: 26. July. 2015. [PubMed]
30. Abdulkareem FB, Elesha SO, Banjo AA. Prospective autopsy study of childhood mortality in Lagos, Nigeria (1993‑1994). Nig Qt J Hosp Med. 1996;6:88‑95.
31. Ekanem VJ, Gerry IE. Attitude of Nigerian resident doctors towards clinical autopsy. Niger Postgrad Med J. 2007 Mar;14(1):8‑11. [PubMed]
32. Rosenbaum GE, Burns J, Johnson J, Mitchell C, Robinson M, Truog RD. Autopsy consent practice at US teaching hospitals: results of a national survey. Arch Intern Med. 2000 Feb 14;160(3):374‑80. Accessed: 22. July.2015. DOI:10.1001/archinte.160.3.374. [PubMed]
33. Start RD, Brain SG, McCulloch TA, Angel CA. Analysis of necropsy requests behaviour of clinicians. J Clin Pathol 1996; 49: 29-33. Available online : http://jcp.bmj.com/content/49/1/29.full.pdf. Accessed 31. July. 2015.
34. Mudenda V, Lucas S, Shibemba A, O'Grady J, Bates M, Kapata N, Schwank S, Mwaba P, Atun R, Hoelscher M, Maeurer M, Zumla A. Tuberculosis and Tuberculosis/HIV/AIDS–Associated Mortality in Africa: The Urgent Need to Expand and Invest in Routine and Research Autopsies. J Infect Dis. 2012; S1-S7. Available online : http://jid.oxfordjournals.org/content/early/2012/03/21/infdis.jir859.full.pdf+html. Accessed 31. July. 2015. DOI: 10.1093/infdis/jir859.
35. Mittleman RE, Davis JH, Kasztl W, Graves WM Jr. Practical approach to investigative ethics and religious objections to the autopsy. J Forensic Sci. 1992 May;37(3):824‑9. [PubMed]
36. Gatrad AR. Muslim customs surrounding death, bereavement, postmortem examinations, and organ transplants. BMJ. 1994;309:521‑523. Accessed: 31. July. 2015. DOI: http://dx.doi.org/10.1136/bmj.309.6953.521.
37. Rispler‑Chaim V. The ethics of postmortem examinations in contemporary Islam. J Med Ethics 1993;19:164‑8. [PubMed]
38. Charlton R. Autopsy and medical education: a review. J R Soc Med 1994; 87: 232-236. Available online: http://jme.bmj.com/content/19/3/164.full.pdf+html . Accessed: 31. July.2015. doi:10.1136/jme.19.3.164.
39. Zumla A, Huggett J, Dheda K, Green C, Kapata N, Mwaba P. Trials and tribulations of an African-led research and capacity development programme: the case for EDCTP investments. Trop Med Int Health. 2010 Apr;15(4):489–94. Accessed: 30.July.2015. DOI: 10.1111/j.1365-3156.2010.02479.x. [PubMed]
2. Law M, Stromberg P, Meuten D, Cullen J. Necropsy or Autopsy? It’s All About Communication! Veterinary Pathology 2012; 49(2): 271-272. DOI: 10.1177/0300985811410722. [PubMed]
3. Kaschula ROC. The Pediatric Autopsy in Africa. Arch Pathol Lab Med 2013; 137 (6): 756–766; Available online: http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2011-0589-RA. Accessed: 26. July. 2015. DOI: 10.5858/arpa.2011-0589-RA. [PubMed]
4. Kumar P, Taxy J, Angst DB, Mangurten HH. Autopsies in children: are they still useful? Arch Pediatr Adolesc Med 1998 Jun;152(6):558- 63. Available online: http://archpedi.jamanetwork.com/article.aspx?articleid=189612. Accessed: 25. July. 2015. DOI: 10.1001/archpedi.152.6.558.
5. Ekanem VJ, Vhriterhire CO. Relevance of clinical autopsy in medical practice in Sub‑Saharan Africa. Sahel Medical Journal 2015 Apr-Jun; 18 (2): 49-56. Available online: http://www.smjonline.org/temp/SahelMedJ18249-539545_145914.pdf . Accessed: 25. July. 2015. DOI: 10.4103/1118-8561.160795.
6. Cox JA, Lukande RL, Lucas S, Nelson AM, Van Marck E, Colebunders R. Autopsy Causes of Death in HIV-Positive Individuals in Sub-Saharan Africa and Correlation with Clinical Diagnoses. AIDS Rev. 2010 Oct-Dec;12(4):183-94. Available online: http://www.aidsreviews.com/files/2010_12_4_183-194.pdf. Accessed: 23. July. 2015.
7. Cox JA, Lukande RL, Kateregga A, Mayanja-Kizza H, Manabe YC, Colebunders R. Autopsy acceptance rate and reasons for decline in Mulago Hospital, Kampala, Uganda. Trop Med Int Health 2011 Aug; 16 (8): 1015 - 18. Available online: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02798.x/epdf . Accessed: 23. July. 2015. DOI:10.1111/j.1365-3156.2011.02798.x.
8. Lishimpi K, Chintu C, Lucas S, Mudenda V, Kaluwaji J, Story A, Maswahu D, Bhat G, Nunn AJ, Zumla A. Necropsies in African children: consent dilemmas for parents and guardians. Arch Dis Child 2001;84:463–67. Available online: http://adc.bmj.com/content/84/6/463.full.pdf. Accessed: 23. July. 2015. [PubMed]
9. Tette E, Yawson AE, Tettey Y. Clinical utility and impact of autopsies on clinical practice among doctors in a large teaching hospital in Ghana. Glob Health Action 2014; 7: 23132 - http://dx.doi.org/10.3402/gha.v7.23132. Available online: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3914029/pdf/GHA-7-23132.pdf. Accessed: 20. July. 2015.
10. Yawson AE, Tette E, Tettey Y. Through the lens of the clinician: autopsy services and utilization in a large teaching hospital in Ghana. BMC Research Notes 2014; 7:943:1-6. Available online: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307638/pdf/13104_2014_Article_3450.pdf. Accessed: 25. July. 2015. DOI: 10.1186/1756-0500-7-943.
11. Burton JL. The history of the autopsy. In Burton JL and Rutty GN(eds): The Hospital Autopsy. 3rd Ed. Hodder Arnold London 2010:1 - 10.
12. Gordijn SJ, Erwich JJ, Khong TY. Value of the perinatal autopsy: critique. Pediatr Dev Pathol. 2002 Sep - Oct;5(5):480-8. Accessed: 24. July. 2015. DOI: 10.1007/s10024-002-0008-y. [PubMed]
13. Feinstein JA, Ernst LM, Ganesh J, Feudtner C. What New Information Pediatric Autopsies Can Provide: A Retrospective Evaluation of 100 Consecutive Autopsies Using Family-Centered Criteria. Arch Pediatr Adolesc Med. 2007 Dec;161(12):1190-6. Accessed: 22. July. 2015. DOI:10.1001/archpedi.161.12.1190.
14. Lundberg GD. Low-Tech Autopsies in the Era of High-Tech Medicine: Continued Value for Quality Assurance and Patient Safety. JAMA 1998 Oct 14; 280(14): 1273 - 4. Accessed: 22. July. 2015. DOI: doi:10.1001/jama.280.14.1273. [PubMed]
15. Peres LC. Review of pediatric autopsies performed at a university hospital in Ribeirão Preto, Brazil. Arch Pathol Lab Med 2006 Jan;130(1):62‑8. Available online: http://www.archivesofpathology.org/doi/pdf/10.1043/1543-2165%282006%29130%5B62%3AROPAPA%5D2.0.CO%3B2. Accessed: 26. July. 2015.
16. Khong TY. A review of perinatal autopsy rates worldwide, 1960s to 1990s. Paediatr Perinat Epidemiol 1996 Jan;10:97‑105. Accessed: 22. July. 2015. DOI: 10.1111/j.1365-3016.1996.tb00030.x.
17. World Health Organization. Health and the Millennium Development Goals. Geneva: World Health Organization 2005: 82. [PubMed]
18. Adappa R, Paranjothy S, Roberts Z, Cartlidge PH. Perinatal and infant autopsy. Arch Dis Child Fetal Neonatal Ed 2007 Jan;92:F49‑50. Available online: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2675313/pdf/F49.pdf. Accessed: 22.July.2015. DOI: 10.1136/adc.2005.091447.
19. Scottish Programme for Clinical Effectiveness in Reproductive Health. Scottish Perinatal and Infant Mortality and Morbidity Report 2001. Edinburgh: SPCERH; 2002: 80.
20. Brodlie M, Laing IA, Keeling JW, McKenzie KJ. Ten years of neonatal autopsies in tertiary referral centre: retrospective study. BMJ. 2002 Mar 30;324(7340):761‑3. Available online: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC100315/pdf/761.pdf. Accessed: 22.July.2015.
21. Turnbull A, Osborn M, Nicholas N. Hospital autopsy: Endangered or extinct? J Clin Pathol 2015;0:1–4. Available online: http://jcp.bmj.com/content/early/2015/05/08/jclinpath-2014-202700.full.pdf+html. Accessed: 31. July. 2015. DOI:10.1136/jclinpath-2014-202700.
22. Korle-Bu Teaching Hospital . Annual report 2010, Accra, Ghana: Korle – Bu Teaching Hospital. Korle-Bu Teaching Hospital, 2011.
23. Gohill R, Nkanza NK, Bhagwandeen SB, Naik KG. A review of autopsies at the University Teaching Hospital, Lusaka, 1975. Med J Zambia. 1979 Apr-May;13(2):28–32. PMID: 263368. Accessed: 26. July. 2015. [PubMed]
24. Eke FU, Frank-Briggs A, Ottor J. Childhood Mortality In Port Harcourt, Nigeria. Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology, 2001; Vol. 2, No. 2 (July-Dec 2001): Available online: http://www.anilaggrawal.com/ij/vol_002_no_002/papers/paper003.html. Accessed: 20. July. 2015.
25. Nwafor CC, Abali C, Nnoli MA. Childhood Mortality in Federal Medical Centre Umuahia, South Eastern Nigeria. Oman Med J. 2014 Sep; 29(5):320-4. Accessed: 22. July. 2015. DOI: 10.5001/omj.2014.87.
26. Ugiagbe EE, Osifo OD. Postmortem examinations on deceased neonates: A rarely utilized procedure in an African referral center. Pediatr Dev Pathol 2012 Jan-Feb;15:1‑4. Accessed: 22. July.2015. DOI: http://dx.doi.org/10.2350/10-12-0952-OA.1.
27. Akang EE, Asinobi AO, Fatunde OJ, Pindiga HU, Okpala JU Abiola AO, et al. Childhood mortality in Ibadan: An autopsy study. Niger J Paediatr 1992;19:30‑6.
28. Ayoola OO, Orimadegun AE, Akinsola AK, Osinusi K. A five‑year review of childhood mortality at the University College Hospital, Ibadan. West Afr J Med. 2005 Apr-Jun;24(2):175‑9. [PubMed]
29. Oluwasola AO, Fawole OI, Otegbayo JA, Ayede IA, Ogun GO, Ukah CO, Bamigboye AE. Trends in clinical autopsy rate in a Nigerian tertiary hospital. Afr J Med Med Sci. 2007 Sep; 36(3):267-72. PMID: 18390067. Accessed: 26. July. 2015. [PubMed]
30. Abdulkareem FB, Elesha SO, Banjo AA. Prospective autopsy study of childhood mortality in Lagos, Nigeria (1993‑1994). Nig Qt J Hosp Med. 1996;6:88‑95.
31. Ekanem VJ, Gerry IE. Attitude of Nigerian resident doctors towards clinical autopsy. Niger Postgrad Med J. 2007 Mar;14(1):8‑11. [PubMed]
32. Rosenbaum GE, Burns J, Johnson J, Mitchell C, Robinson M, Truog RD. Autopsy consent practice at US teaching hospitals: results of a national survey. Arch Intern Med. 2000 Feb 14;160(3):374‑80. Accessed: 22. July.2015. DOI:10.1001/archinte.160.3.374. [PubMed]
33. Start RD, Brain SG, McCulloch TA, Angel CA. Analysis of necropsy requests behaviour of clinicians. J Clin Pathol 1996; 49: 29-33. Available online : http://jcp.bmj.com/content/49/1/29.full.pdf. Accessed 31. July. 2015.
34. Mudenda V, Lucas S, Shibemba A, O'Grady J, Bates M, Kapata N, Schwank S, Mwaba P, Atun R, Hoelscher M, Maeurer M, Zumla A. Tuberculosis and Tuberculosis/HIV/AIDS–Associated Mortality in Africa: The Urgent Need to Expand and Invest in Routine and Research Autopsies. J Infect Dis. 2012; S1-S7. Available online : http://jid.oxfordjournals.org/content/early/2012/03/21/infdis.jir859.full.pdf+html. Accessed 31. July. 2015. DOI: 10.1093/infdis/jir859.
35. Mittleman RE, Davis JH, Kasztl W, Graves WM Jr. Practical approach to investigative ethics and religious objections to the autopsy. J Forensic Sci. 1992 May;37(3):824‑9. [PubMed]
36. Gatrad AR. Muslim customs surrounding death, bereavement, postmortem examinations, and organ transplants. BMJ. 1994;309:521‑523. Accessed: 31. July. 2015. DOI: http://dx.doi.org/10.1136/bmj.309.6953.521.
37. Rispler‑Chaim V. The ethics of postmortem examinations in contemporary Islam. J Med Ethics 1993;19:164‑8. [PubMed]
38. Charlton R. Autopsy and medical education: a review. J R Soc Med 1994; 87: 232-236. Available online: http://jme.bmj.com/content/19/3/164.full.pdf+html . Accessed: 31. July.2015. doi:10.1136/jme.19.3.164.
39. Zumla A, Huggett J, Dheda K, Green C, Kapata N, Mwaba P. Trials and tribulations of an African-led research and capacity development programme: the case for EDCTP investments. Trop Med Int Health. 2010 Apr;15(4):489–94. Accessed: 30.July.2015. DOI: 10.1111/j.1365-3156.2010.02479.x. [PubMed]
CITATION
DOI: 10.17511/ijpr.2015.i04.04
Published: 2015-12-31
How to Cite
IJEZIE Echey, OKPOKOWURUK, Frances Sam, & NWAFOR, Chukwuemeka Charles. (2015). Pediatric death audit with special emphasis on autopsy at the University of Uyo Teaching Hospital, Uyo, Nigeria: a 6-year review. Pediatric Review: International Journal of Pediatric Research, 2(4), 52-59. https://doi.org/10.17511/ijpr.2015.i04.04
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Original Article
Copyright (c) 2015 Author (s). Published by Siddharth Health Research and Social Welfare Society
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