The present study reviews 876 consecutive coroner's autopsies performed in the Department of Pathology, University College Hospital, Ibadan over a two-year period (1 February 1991 to 31 January 1993). The hospital autopsy rate during the study period was 36.2%, and 62.5 per cent of these post-mortems were medico-legal cases. The most common indications for coroner's autopsies were sudden natural deaths (55.6%), followed by accidental deaths (35.3%). The proportions of maternal (4.3%), homicidal (3.1%) and suicidal (0.3%) deaths were much lower. The male to female ratio was 1.7 to 1. Ninety-one (10.4%) of the cases fell within the paediatric age group and the peak age incidence for these cases was in the 5-14 years age group. The remaining 785 (89.6%) cases were adults and the peak age incidence for these cases was in the fourth decade of life. The most common cause of sudden natural death was cardiovascular disease, of which hypertension constituted the majority of cases. Other major causes of sudden death included pneumonia, meningitis, typhoid fever and neoplastic diseases. Road traffic accidents accounted for 78 per cent of accidental deaths followed by falls (13.3%) and burns (4.6%). Abortions, post-partum haemorrhage and eclampsia were the major causes of maternal deaths in the present study. Homicidal deaths were eight times more frequent in male than female victims and the commonest mode of death was gunshot injuries. Suicidal deaths remain extremely uncommon in African patients, as confirmed by our study.
As most developing countries, including Nigeria, grapple with economic crisis, poor human capital development and high levels of income inequality, violent crimes - especially homicides - continue to be a cause for concern. We studied the pathology and demographic distribution of homicides in Rivers State of Nigeria expecting that the findings would be useful in formulating preventive strategies. Reports of homicide autopsies in the state for 11 years were retrospectively scrutinized for age, gender, type of weapon, site of injury, circumstances, mechanisms and causes of death. The data were analyzed using SPSS version 17. Homicides constituted 50.5% of the medicolegal autopsies. Although the overall male:female ratio was 12.4 : 1, there was variation with weapon. Deaths by firearm had the highest male:female ratio of 24.6 : 1. The mean and peak ages were 29.2 ± 11.4 and 21-30 years, respectively, while the range was 1 to 96 years. Firearms were the most common weapons, at 68.9%, hemorrhagic shock and head injuries at 61.5% and 28.2% respectively were the most common mechanisms and causes of death. Armed robbery incidents were the most common circumstances, while the head was the most common site of injury at 48.8%. The homicide rate is high in our environment and most homicides are committed during armed robberies using firearms. Improving medical care and providing emergency medical services will reduce cases of deaths from homicides, most of which occur due to manageable hemorrhagic shock. Increasing the drive towards controlling illegal arms acquisition and possession will reduce the present carnage in the state.
A retrospective study of 375 consecutive medicolegal cases seen in four peripheral general hospitals in the Rivers State of Nigeria over a five-year period (March 1984 to February 1989) was undertaken. The most common indications for forensic medical consultation were assaults (78.6%) using clubs, sticks, fists and machetes as weapons, road traffic accidents (9.1%) and sexual offences (7.7%). The proportions of accidental deaths (4.3%), homicidal deaths (2.9%), sudden natural deaths (0.5%), maternal deaths (0.5%) and suicidal deaths (0.3%) were much lower. The male-to-female ratio was 1.4 to 1. The patients' ages ranged from 10 months to 75 years, with a mean of 31.6 years. Twenty-three cases (6.1%) were children, while the remaining 352 cases (93.9%) were adults. The study showed that for those cases which do come to the pathologist's attention, forensic personnel and laboratory services are inadequate in the peripheral parts of Nigeria. The study also highlighted the possible range of medicolegal problems of which the medical practitioner should be aware, even if he is practising in the rural non-urbanized areas of Nigeria. The study shows that not all deaths are registered in Nigeria.
Aero-disaster, though rare in Port Harcourt, is posing a serious problem in Nigeria in recent times. Various agencies should be established to adequately control mass disasters in Nigeria. Adequate maintenance of aircraft and strict observation and enforcement of aviation laws may drastically reduce the frequency of accidents and subsequent deaths.
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