Unnatural childhood deaths in two tertiary care hospitals in Sri Lanka: a retrospective study

Unnatural mortality in children is a global issue that varies widely from country to country and within the regions of a country. Natural deaths are usually disease-related, but unnatural deaths (UD) are due to various external factors, which are usually preventable. This study aims to identify the risk factors for UD and its proportion, for which preventive measures can be adopted. UD in children reported to two tertiary care hospitals (National Hospital Kandy and Provincial General Hospital Kegalle) in Sri Lanka from 1st January 2020 to 31st December 2023 were analyzed. The study sample consisted of 333 deaths, of which the majority were natural. There were 237 (71.17.%) natural deaths and 96 (28.9%) UD. Among UD, 67.7% (65) were male children. Accidental deaths were higher than suicides. Out of suicidal deaths, 88.2% were due to hanging and 5.8% by drowning. Road traffic accidents (RTA) were the most common cause (48.4%) for accidental deaths, followed by falls, train accidents and drowning. The teenage group had sustained 72.2% of unnatural deaths out of all deaths. RTA, drowning and hanging were accountable for the majority of UD in Sri Lanka. Appropriate measures must be adopted to overcome these preventable deaths.