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Infant morbidity in an Indian slum birth cohort
  1. Beryl Primrose Gladstone (berylg{at}cmcvellore.ac.in)
  1. Christian Medical College, India
    1. Jayaprakash Muliyil (princi{at}cmcvellore.ac.in)
    1. Christian Medical College, India
      1. Shabbar Jaffar (shabbar.jaffar{at}lshtm.ac.uk)
      1. London School of Hygiene and Tropical Medicine, United Kingdom
        1. Jeremy G. Wheeler (jeremy.wheeler{at}pfizer.com)
        1. London School of Hygiene and Tropical Medicine, United Kingdom
          1. Andrea M. LeFevre (andrea.lefevre{at}lshtm.ac.uk)
          1. London School of Hygiene and Tropical Medicine, United Kingdom
            1. Miren Iturriza-Gomara
            1. Health Protection Agency, United Kingdom
              1. James J. Gray (jim.gray{at}hpa.org.uk)
              1. Health Protection Agency, India
                1. Anuradha Bose (abose{at}cmcvellore.ac.in)
                1. Christian Medical College, India
                  1. Mary K. Estes (mestes{at}bcm.tmc.edu)
                  1. Baylor College of Medicine, United States
                    1. David W. G. Brown (david.brown{at}hpa.org.uk)
                    1. Health Protection Agency, United Kingdom
                      1. Gagandeep Kang (gkang{at}cmcvellore.ac.in)
                      1. Christian Medical College, India

                        Abstract

                        Objective To establish incidence rates, clinic referrals, hospitalizations, mortality rates and baseline determinants of morbidities 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 hospitalization. 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 to 5 months), male sex, cold/wet season and household involved in 'beedi'work. The rate (95% CI) of hospitalization, 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.

                        • India
                        • birth cohort
                        • gastrointestinal infections
                        • morbidity
                        • respiratory infections

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