Sudden infant death syndrome/unexplained infant deaths in Sri Lanka

Sudden Infant Death Syndrome (SIDS), also known as 'unexplained deaths under one year', is rarely reported in Sri Lanka as a cause of post-neonatal mortality. The aim of this study was to assess the opinion of paediatricians and pathologists regarding the reasons for this rarity. Members of the Colleges of Paediatricians, Pathologists and Forensic Pathologists who met the inclusion criteria were selected as the study population. A brief self-administered questionnaire was used for data collection. Results were analysed using standard statistical methods. The sample consisted of 50 paediatricians, 15 histopathologists and seven forensic pathologists with a mean career span of 26.3 years. SIDS was reportedly diagnosed by only nine (12.5%) of the respondents while the other 63 (87.5%) have never encountered SIDS during their careers. Of the nine doctors, three (33.3%) based their diagnosis on autopsy findings but histological and toxicological studies had not been performed. The other six doctors (66.6%) relied on clinical history alone. Twenty-five doctors (34.7%) believed that keeping babies under close adult supervision was the reason SIDS is so rare in Sri Lanka. Twenty paediatricians (40%) and four histopathologists (26.7%) agreed with this view while five forensic pathologists (71.4%), believed the reason was under-diagnosis. In conclusion, the majority of doctors believe the most likely reason for the rarity of SIDS in Sri Lanka is that babies are kept under close adult supervision, in comparison with developed countries. By contrast, most forensic pathologists are of the opinion that SIDS is under-diagnosed.