Infant morbidity in an Indian slum birth cohort
B P Gladstone1, J P Muliyil, S Jaffar
1Department of Community Health, Christian Medical College, Vellore, India.
Insights
Infants in an Indian slum experienced significant illness, particularly respiratory and gastrointestinal issues, for about one-fifth of their first year. Key risk factors included young age, male sex, and household work.
Area of Science:
- Pediatric Health
- Epidemiology
- Global Health
Background:
- Infant morbidity poses a significant public health challenge in resource-limited settings.
- Understanding disease patterns and determinants is crucial for targeted interventions.
Purpose of the Study:
- To determine incidence rates of various illnesses and hospitalizations among infants in a South Indian urban slum.
- To identify baseline determinants associated with infant morbidity.
Main Methods:
- A community-based birth cohort study was conducted with twice-weekly surveillance.
- 452 newborns were recruited and followed through infancy in Vellore, South India.
Main Results:
- Infants experienced approximately 12 illness episodes per year, spending one-fifth of their infancy sick.
- Respiratory (7.4/child-year) and gastrointestinal (3.6/child-year) illnesses were most common.
- Hospitalization rates were 0.28/child-year, primarily for respiratory and gastrointestinal conditions.
Conclusions:
- A high burden of respiratory and gastrointestinal illness affects infants in this urban slum.
- Younger age, male sex, cold/wet season, and household beedi work were identified as significant risk factors for increased morbidity.
Objective:
To establish incidence rates, clinic referrals, hospitalisations, mortality rates and baseline determinants of morbidity among infants in an Indian slum.
Design:
A community-based birth cohort with twice-weekly surveillance.
Setting:
Vellore, South India.
Subjects:
452 newborns recruited over 18 months, followed through infancy.
Main Outcome Measures:
Incidence rates of gastrointestinal illness, respiratory illness, undifferentiated fever, other infections and non-infectious morbidity; rates of community-based diagnoses, clinic visits and hospitalisation; and rate ratios of baseline factors for morbidity.
Results:
Infants experienced 12 episodes (95% confidence interval (CI) 11 to 13) of illness, spending about one fifth of their infancy with an illness. Respiratory and gastrointestinal symptoms were most common with incidence rates (95% CI) of 7.4 (6.9 to 7.9) and 3.6 (3.3 to 3.9) episodes per child-year. Factors independently associated with a higher incidence of respiratory and gastrointestinal illness were age (3-5 months), male sex, cold/wet season and household involved in beedi work. The rate (95% CI) of hospitalisation, mainly for respiratory and gastrointestinal illness, was 0.28 (0.22 to 0.35) per child-year.
Conclusions:
The morbidity burden due to respiratory and gastrointestinal illness is high in a South Indian urban slum, with children ill for approximately one fifth of infancy, mainly with respiratory and gastrointestinal illnesses. The risk factors identified were younger age, male sex, cold/wet season and household involvement in beedi work.
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