Respiratory infections in children are up: National Family Health Survey

Adult morbidities rose and child malnutrition worsened in four years

India’s latest National Family Health Survey (NFHS) has recorded a grim picture of public health in the country. While several indicators such as mothers getting institutional help during deliveries and awareness about risk factors are improving, health parameters looked worse in 2019-20 as compared to 2015-16.

A serious cause for concern is the prevalence of acute respiratory illnesses, which has increased among children in most states. Of the 22 states for which data was released, the eight most populous states – Andhra Pradesh, Bihar, Gujarat, Karnataka, Kerala, Maharashtra, Telangana and West Bengal – are analysed here.

Six of these eight states saw a rise in child respiratory infections in the four-year period. In Kerala, nearly 3 per cent of children had respiratory illness in 2019-20, up from 0.4 per cent in 2015-16.

The reason partly lies in child nutrition, which has either stayed at levels of 2015-16 or worsened since.

Five out of the eight states had more stunted children under five in 2019-20 than before. Stunting means having low height for a particular age, and it is associated with hampering of cognitive abilities in childhood. And three out of the eight saw a rise in wasting (low weight for a particular height) among children under five.

Though its impact is considered to be short-term than stunting, wasting makes a child more susceptible to infections, and is associated with increased child mortality.

India’s epidemiological transition began after economic liberalisation boosted urbanisation, and low prevalence of healthy habits catapulted the rise of “lifestyle-induced” diseases. Developed states tend to have a higher prevalence of such non-communicable diseases than nutritional diseases, which are higher in relatively underdeveloped states.

Nearly one in four men had a pre-diabetic condition, or had diabetes, as recorded by the 2019-20 survey. And about one in five had hypertension and blood pressure-related ailments. These are all conditions that can lead to complications in the event of a Covid-19 infection.

Data from the Department of Health and Family Welfare, released in October, showed the stark difference. Without co-morbidities, 0.2 per cent of Covid-19 patients below the age of 45 died. But with ailments such as these, the case fatality rate rose to 8.8 per cent.

Even for seriously ill Covid-19 patients above the age of 60, when immune responses are weaker, those with co-morbidities have a higher chance of dying (one in four) than those without (one in 20).

Data as released in October; Eight major states, data available for 22; Small, hilly, and Northeastern states have been left out of analysis for now
 

Source: National Family Health Survey – 5, 2019-20, Phase – 1; Department of Health and Family Welfare