News article

Acute infections burden in Indian children under age five

Posted:  Wednesday, June 29, 2016

Prevalence and risk factors of acute infections in Indian children

About a quarter of the global burden of acute infectious diseases is borne by Indian children. The most commonly observed acute infections in children under five years of age are those of the eyes, ears, and skin; but the burden of other infections remains unknown. In a study published in the journal Indian Journal of Child Health, the burden of childhood infections and the associated risk factors in the Indian scenario were studied .

A systematic literature review yielded 10 relevant PubMed articles published between 2000 and 2014, on risk factors associated with infections among under-5 Indian children (except acute respiratory and diarrhoeal diseases). Details on prevalence and risk factors for eye, ear, and skin infections; fever; sepsis; Helicobacter pylori infection; and Staphylococcus aureus carriage in healthy children were collected.

The meta-analysis indicated that the pooled prevalence of infections between 2002 and 2013 was found to be 18.42 (95% confidence interval: 9.30–30.62). Cases of skin, eye, and other infections ranged between 3.7% and 50.8%, with 1.7 episodes per child year being contributed to by ear and skin infections. Children from rural areas showed a higher prevalence of infections compared to those from urban areas.

The significant risk factors for infections were young age of the child, malnutrition, improper breastfeeding, low socio-economic status, animal rearing near household, unhygienic conditions, seasonal variations; and mothers’ illiteracy, for independent morbidities. Ear infections in children aged 3–5 months were positively associated with cold season, female sex, tobacco-based occupation in household, presence of nasal symptoms, and passive smoking.

However, the study has significant limitations. The aetiology of disease with specific strains of an infectious agent; role of vaccination; impact of nutritional deficiencies; role of home environment and association with co-morbidities were not assessed. Few studies on morbidities in under-five children were found outside PubMed but not included in the meta-analysis. This may have contributed to biased results.

In conclusion, the most common infections in Indian children under five years of age are those of the eye, followed by the skin. Rural children are more vulnerable to infectious morbidities than those from urban areas. More evidence is required to elucidate the role of immunisation, malnutrition, and associated co-morbidities, to establish their role in childhood infections.

News Source: Ganguly E, Sharma PK, Bunker CH. Burden of acute infections (except respiratory and diarrheal) and its risk factors among under-five children in India: A systematic review and meta-analysis. Indian journal of child health. 2016 Jan;3(1):1.