High morbidity and low mortality--the experience of urban preschool children in Kerala.

This study was undertaken to estimate the morbidity pattern in children under 3 years in urban Kerala. Two cohorts of 111 and 74 children were selected from contrasting areas in Trivandrum city, capital of Kerala, by systematic sampling. Morbidity information on each child was gathered for one year through weekly visits and recording of symptoms by trained investigators. The results showed: 1. very high incidence rates of all illness groups studied, with peak incidence being observed in the first 6 months and the lowest in the third year; 2. up to six times greater risk for many disease groups in the more environmentally deprived area; 3. no significant differences in risk between sexes; 4. no seasonal variation. We conclude that despite low infant and child mortality levels, morbidity load in Kerala, for 0-3-year-old children is very high and this is directly related to the quality of the environment.