Morbidity due to Infections in Preschool Children from Urban Low Income Households

Abstract

Respiratory infection, diarrhea and fever are three common infections in underfive children; there are substantial differences in the reported prevalence and ranking of these three morbidities between studies and surveys. Seasonal and year to year variation in prevalence of morbidity and impact of health care on the duration and severity of infection has not been explored. A large scale mixed longitudinal study of under-five children from urban low income households was carried out to document year to year and seasonal variations in the prevalence and type of morbidity and utilization of health care for morbidity and their impact on duration and severity of morbidity. Between January 2012 and Dec 2015 a total of 3888 pre-school children were investigated and 74636 observations were made; prevalence of morbidity was 10.3% (range 7.2%-11.6%). Prevalence of morbidity was higher between July and October. Respiratory infection was the most common and diarrhea was the least common illness in children. Over years there was a rise in the respiratory illness because of increase in construction activity in the study area. There was a fall in diarrhoeal diseases after construction of water supply and drainage system. Majority of the households accessed health care; as a result duration of illness was short and severe morbidity was rare. Improvement in environmental hygiene can result in reduction in morbidity. Access to health care reduces duration and severity of infection.

Nutrition morbidity interactions in pre-school children

“…Majority (92.6%) of the educated urban low- and middle-income parents, therefore, accessed healthcare within three days after illness. As a result, most illnesses were mild or moderate and the duration of illness was relatively short 22 . Utilization of available healthcare within three days after illness might have played a role in limiting the duration, severity of illness and deterioration in nutritional status during illness and convalescence.…”

Nutritional status of Indian pre-school children and WHO nutrition targets for 2025

“…The increase in underweight rates between 3-5 months might be due to introduction of animal milk and increase in morbidity due to infections. 28,29 The further rise in underweight and stunting rates between 6-11 months might be due to late introduction, inadequate quantity, frequency and low-calorie density of complementary feeds as well as increase in morbidity due to infections. [28][29][30][31][32][33] Increase in the underweight and stunting rates between 12-23 months could be the result of inadequate energy intake when children shift to household diet.…”

“…28,29 The further rise in underweight and stunting rates between 6-11 months might be due to late introduction, inadequate quantity, frequency and low-calorie density of complementary feeds as well as increase in morbidity due to infections. [28][29][30][31][32][33] Increase in the underweight and stunting rates between 12-23 months could be the result of inadequate energy intake when children shift to household diet. In India, the habitual family diets have relatively low-calorie density; infants have small stomach capacity and need to be fed 5-6 times a day to meet their food requirements.…”

“…In India, the habitual family diets have relatively low-calorie density; infants have small stomach capacity and need to be fed 5-6 times a day to meet their food requirements. [28][29][30][31][32][33] Nutrition education has a major role to play in improving infant and young child feeding practices thereby preventing rise in stunting and under-weight rates. Low birthweight children grow along a lower growth trajectory as compared to normal birthweight children; when their weight or length are compared to WHO standards they are misclassified as stunted and under-weight.…”