Autopsy acceptance rate and reasons for decline in Mulago Hospital, Kampala, Uganda

Objective
To determine the autopsy acceptance rate and reasons for decline at Mulago Hospital, Kampala, Uganda.
Methods
The next of kin of patients who died in a combined infectious diseases and gastro-enterology ward of Mulago Hospital were approached to answer a questionnaire concerning characteristics of their deceased relative. During the interview their consent was asked to perform a complete autopsy. If autopsy was declined, the next of kin were asked to provide their reason for the decline.
Results
Permission to perform an autopsy was requested in 158 (54%) of the 290 deaths that occurred during the study period. In 60 (38%) cases autopsy was accepted. Fifty-nine autopsies were performed. For 82% of refusals a reason was listed; mainly 'not wanting to delay the burial' (58%), 'no use to know the cause of death' (16%) and 'being satisfied with the clinical cause of death' (10%).
Conclusion
The autopsy rate achieved under study conditions was 38% compared to rates of 5% in Mulago Hospital over the past decade. Timely request and rapid performance of autopsies appear to be important determinants of autopsy acceptance. A motivated team of pathologists and clinicians is required to increase autopsy acceptance.