Open Access Research article

Burden of childhood diseases and malnutrition in a semi-urban slum in southern India

Rajiv Sarkar1, Prabhu Sivarathinaswamy1, Bhuvaneshwari Thangaraj1, Kulandaipalayam Natarajan Chella Sindhu1, Sitara Swarna Rao Ajjampur1, Jayaprakash Muliyil2, Vinohar Balraj2, Elena N Naumova13, Honorine Ward14 and Gagandeep Kang1*

Author affiliations

1 Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, 632004, India

2 Community Health Department, Christian Medical College, Vellore, Tamil Nadu, 632002, India

3 Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA, 02155, USA

4 Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, 02111, USA

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Citation and License

BMC Public Health 2013, 13:87  doi:10.1186/1471-2458-13-87

Published: 30 January 2013



India has seen rapid unorganized urbanization in the past few decades. However, the burden of childhood diseases and malnutrition in such populations is difficult to quantify. The morbidity experience of children living in semi-urban slums of a southern Indian city is described.


A total of 176 children were recruited pre-weaning from four geographically adjacent, semi-urban slums located in the western outskirts of Vellore, Tamil Nadu for a study on water safety and enteric infections and received either bottled or municipal drinking water based on their area of residence. Children were visited weekly at home and had anthropometry measured monthly until their second birthday.


A total of 3932 episodes of illness were recorded during the follow-up period, resulting in an incidence of 12.5 illnesses/child-year, with more illness during infancy than in the second year of life. Respiratory, mostly upper respiratory infections, and gastrointestinal illnesses were most common. Approximately one-third of children were stunted at two years of age, and two-thirds had at least one episode of growth failure during the two years of follow up. No differences in morbidity were seen between children who received bottled and municipal water.


Our study found a high burden of childhood diseases and malnutrition among urban slum dwellers in southern India. Frequent illnesses may adversely impact children’s health and development, besides placing an additional burden on families who need to seek healthcare and find resources to manage illness.

Children; Morbidity; Incidence; Slum; Longitudinal study; India