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To the Editor : The article 'Where do children die and what are the causes?', which appeared in the April 2016 issue of the SAMJ, provides an overview of the causes of death in under-5 children in the Metro West geographical service area of the Western Cape for 2011. It highlights the proportion of under-5 deaths from congenital abnormalities (obvious structural abnormalities), which are particularly prevalent in early neonatal mortality - a close third (9.6%) of in-hospital deaths after hypoxia (10.0%) and immaturity (40.6%) according to the Perinatal Problem Identification Programme (PPIP) data. In the Local Mortality Surveillance System in-hospital data, congenital abnormalities are ranked as the second (13.5%) cause of early neonatal death after prematurity (35.8%).

Contribution of congenital disorders to under-5 mortality