Coroner autopsy study of homicides in Rivers State of Nigeria: 11-year review.

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.

Review of population based coroners autopsy findings in Rivers state of Nigeria.

BACKGROUND: Sudden deaths are common findings in Rivers state of Nigeria. The victims of such deaths are subjects, of coroners' autopsies, and the records there from constitute important sources of epidemiological data. AIMS: To determine the pattern, causes and demographic features of all deaths reported to the coroner for medico legal autopsies in Rivers state of Nigeria. MATERIALS AND METHODS: Retrospective descriptive study on reports of coroner autopsies carried out between January 2000 and December 2010 in different mortuaries located across Rivers state was undertaken. The autopsies were unlimited and standardized. Information analyzed were: gender, age, circumstances of death and, autopsy-defined cause of death. RESULTS: Of the 1987 cases reviewed, 83.4% were males. The age range was 2 weeks to 98 years with a mean of, 31.7 years. The peak age range was 21-30 years with 46.5%. The manners of deaths in descending order include: homicides with 50.5%, accidents with 32%, sudden natural deaths with 14.1%, maternal deaths with 2.6% and suicides with 0.8%. Males were most affected in homicidal death with average male:female ratio of 12.4:1. Gunshots constituted the commonest means of homicidal deaths, with 67.9% while decapitation was the least with 0.1%. The commonest cause of accidental death was, road traffic accident with 63.6%. Cardiovascular system pathologies were the commonest causes of natural deaths with 46.1%. Illegal abortions with 41.1% were the commonest causes of maternal, deaths and all suicidal cases were committed by hanging. CONCLUSIONS: Homicides were by far the commonest findings of medico legal autopsies, followed by accidental and natural deaths respectively while suicides were the least in Rivers state of Nigeria. Firearms were the, most frequently used weapons for homicides and road traffic accidents remain the major causes of accidental deaths while cardiovascular system pathologies account for the highest proportion of sudden natural deaths and suicides are committed by hanging. Males within the productive age, brackets of 20-49 years are more affected by sudden deaths of all manners.

Forensic medicine in the Rivers State of Nigeria: experience in four rural general hospitals.

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.

A prospective study of coroner's autopsies in University College Hospital, Ibadan, Nigeria.

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.