Introduction: Annual child mortality rates in India have decreased between 1.7% and 2.3% in the last two decades. Still, the United Nations (UN) estimates that about 2.35 million (M) children died in India in 2005. This corresponds to over 20% of the world's under-five deaths, more than any other country. Children illness requires more frequent hospital care and younger children are more vulnerable to mortality. This study was, therefore, undertaken to evaluate the morbidity pattern in hospitalized children less than twelve years with all disease in a regional hospital of hilly region of India.

Methods: This was a hospital data based retrospective observational study carried out from August 2016 to July 2017. Hospitalized children were enrolled for the study and evaluated for morbid events leading to hospitalization.
Results: A total of 1068 patients were admitted in the pediatric ward of the hospital within the period under review. Out of these boys constituted 62.26% (n=665) boys and 37.73% (n=403) girls with boys to girls preponderance ratio of 1.65:1. The age group less than 5 years constituted the main chunk with total 784 (73.40%) admissions. Seasonal variation in admission rate was also documented with maximum 378 (35.39%) children admitted during hot weather season (July-Sept). Among morbidities respiratory tract infection was the leading cause with 300 (28.08%) patients followed by patients with gastrointestinal diseases 214 (20.03%). It was found that febrile seizures were quite prevalent in this region with 81 (7.58%) admissions.  

Conclusion: Research on morbidity is rather scanty. Yet it is very important and useful indicator of the health status of the people. The concept morbidity has more than one meaning. The findings indicate that there is a need to improve utilization of primary health care services including the vital MCH services for better child health and survival.

1. Annual Report 2010-11 Ministry of Health and Family Welfare. Department of Health and Family Welfare, 2011.
2. International Institute for Population Sciences (IIPS) National Family Health Survey (NFHS-2) 1998-99.International Institute for Population Sciences (IIPS), Mumbai, India, 1999.
3. Ministry of Home affairs SRS Bulletin. Sample Registration System, Registrar General, Ministry of Home affairs, Government of India, New Delhi. 2008;43:1
4. UN Population Division. World Population Prospects (2008 revision). [June 14, 2010]. http://esa.un.org/peps/peps_interpolated-data.htm.
5. Rajaratnam JK, Marcus JR, Flaxman AD, Wang H, Levin-Rector A, Dwyer L, et al. Neonatal , post neonatal, childhood, and under-5 mortality for 187 countries, 1970-201: a systematic analysis of progress towards the Millenium Development Goal 4. Lancet 2010; 357:1988–2008.
6. UNICEF, WHO, Bank W UN Population Division. Child Survival and Health - estimates developed by the Inter-agency Group for Child Mortality Estimation (IGME). [September 13, 2010]. http://www.childinfo.org/mortality.html.
7. Lakshmi J. A., Khyrunnisa Begum, Saraswathi G. & Jamuna Prakash. Influence of Nutrition and Environment on Morbidity Profile of Indian Preschool Children. Mal J Nutr. 11(2): 121-132, 2005.
8. Sudarshan MK, Parasuramalu BG, Gangaboriah. An epidemiological survey of diarrhoea among children in Karnataka region of Kaveri Basin. Indian Journal of Community Medicine, 1995, XX (1-4): 41 – 45.
9. Schachner LA, Hansen RG. Preface In: Pediatric Dermatology, Schachner LA, Hansen RG (eds). Edinburgh, Churchill Livingstone, 1995: IX.
10. Bhansali K.M., Mathur G.M., Sharma R. — A study of morbidity pattern in pre-school children. Indian JPaediatrics. 46: 13-19, 1979.
11. Paramita S., Nina P., Benjamin A.I. — Epidemiological correlates of under-nutrition in Under-5 years childrenin an urban slum of Ludhiana. Health and Population: Perspectives and Issues. 33 (1), 1-9, 2010.
12. Panda P., Benjamin, A.I., & Zachariah, P. — Health status of under-fives in a Ludhiana slum. Health and Population– Perspectives and Issues. 16 (3&4), 133-141, 1993.
13. Venketesh S, Bansal RD. A longitudinal study of Morbidity among under-five Children in a Semi-Urban Area, Ind J Comm Med. 1986; 11:11-20.
14. Tondon BN, Sahai A, Balaji LN, Vardhan VA. Morbidity Pattern and Cause Specific Mortality during infancy in ICDS Projects J Trop Pediatr. 1987; 33:190-193.
15. Vander Berg BJ, Yerushalmy J. Studies on convulsive disorders in young children. I. The incidence of febrile and nonfebrile convulsions by age and other factors. Pediatr Res. 1969; 3:298–304.
16. Shinnar S. Febrile Seizures and Mesial Temporal Sclerosis. Epilepsy Curr. 2003; 3: 115–118.
17. Pal R, Dahal S, Pal S. Prevalence of bronchial asthma in Indian children. Indian J Community Med. 2009; 34(4):310‐316. doi:10.4103/0970-0218.58389.
18. Tyagi BB, Aswal RS, Haroon AS. Morbidity Patterns amongst Hospitalized Patients in a Secondary Care Hospital of Dehradun, Uttarakhand State, India. J Gen
    Pract Med Diagn. 2015; 1:003.

Ravinder Singh

Medical Officer, Dermatology DR RKGMC Hamirpur H.P India