. 2024 Nov 12;24:3121. doi: 10.1186/s12889-024-20090-y

Table 6.

Highlights of findings emerged from the present study on the illnesses of Diarrhoea, Fever and ARI in Northeast India,2019–21

Known about the illnesses (Diarrhoea, Fever & ARI) in India & Northeast from previous studies	New emerging points from our study about the illnesses (Diarrhoea, Fever & ARI) in the 8 states of Northeast India
• A study using NFHS-4 (2015–16) data revealed that the north-east region as a reference, those from north, central and east regions were more likely to suffer from ARI. Comorbidity, sex, age and nutritional status of children were significantly associated with the prevalence of ARI [51] • It is found that among children in northeast India, the overall incidence of fever remains more or less unchanged but that of cough and diarrhoea have declined considerably during 2004–05 to 2011–12.Girls are less likely to have suffered from diarrhea than the boys; age has a significant effect on the risk of children suffering from fever and cough, toilet and having access to improved sources of drinking water lower the risk of childhood morbidities [27] • In a multicounty study including India, using NFHS4 data it was found that children who were given the measles vaccine were less likely to suffer from Diarrhoea and ARI in India [52] • Using NFHS-4 data, the study results suggests that most districts situated in India’s north and central regions had higher chances of ARI and diarrhoea and cases of diarrhoea may reduce with the improved toilet facilities, female children are less prone to ARI and Diarrhoea; stunted and wasted children are more susceptible to Diarrhoea only; young women with low education level are more likely to have children down with both the diseases, Hindu and ST have less while SC children have more chances of being sick with ARI and diarrhoea [20] • Using NFHS-4 data, the prevalence of diarrhoea and ARI was 13.8% and 3.4% among children in India. Association was observed between exclusive breastfeeding with Diarrhoea and ARI [53] • Using NFHS-4 data, prevalence of diarrhoea in India among under 5 children is higher in rural areas, not staying in Pacca house, living with unimproved sanitation facilities, belonging to under privileged community, children of younger mothers and “poor’ households [16] • Using NFHS-5 data (2019–21) a study on spatial clustering of diarrhoea in India among children under 5 years found that the Prevalence of diarrhoea in Meghalaya (10.5%), is third highest in India, with an increase in children’s age as well as mother's age the prevalence of the diarrhoea decreases. prevalence is more among male children than females, Underweight children have a greater risk of suffering from diarrhoea diseases, the odds of children living in a pucca house are less likely to suffer from diarrhoea. rich economic status reduces the risk of such morbid conditions [2]	*From NFHS-5 (2019–21) data revealed* About Diarrhoea • Prevalence of diarrhoea in Meghalaya (10%), Tripura (6%), Assam, Arunachal Pradesh, Sikkim, Manipur lied (5–5.5%), Mizoram (4.3%) and least in Nagaland (3.4%) and overall northeast it is 6% • Among northeast states and age wise prevalence, Sikkim has the highest prevalence (18.4%) of diarrhoea among children of less than 6 months, Meghalaya has highest prevalence of diarrhoea for children of age-group 6–12 months and 1–2 years while Arunachal Pradesh has highest rate of diarrhoea among 2–5 years children • In comparison to the children of less than 6 months, the odds of diarrhoea among 6 to 12 months children were 2.18 times more and for 1–2 years children are 96% higher and for 2 to 5 years it is 39 percent higher • The odds of diarrhoea was higher among children born in cesarean delivery than not cesarean delivery • The vaccinations like BCG, DPT and Rota virus was found to have insignificant effect on diarrhoea in northeast states *About Fever* • A higher prevalence of fever was observed in Meghalaya (23%) and lowest in Arunachal Pradesh (9%) • Among all age groups of children (less than 6 months,6 to 12 months,1–2 year and 2to 5 years) in northeast Indian states, the prevalence is highest in Meghalaya • Compared to 1st birth order children, the 4 plus birth order children has more than 2 times higher odds of fever • The programme factors like BCG and DPT was insignificant, however the Rota virus vaccination lowers the odds of fever among children • The odds of fever were higher for the children born out of cesarean delivery than not born out of it *About ARI* • Higher prevalence of ARI was observed in Meghalaya (4.8%) followed by Assam (2.5%), Arunachal Pradesh (2.1%) while Mizoram and Sikkim it is less than 1 percent • Among all age groups of children (less than 6 months,6 to 12 months,1–2 year and 2 to 5 years) in northeast Indian states, the prevalence of ARI is highest in Meghalaya • The odds of ARI were higher for the children born out of cesarean delivery than not born out of it • In comparison to the children of less than 6 months, the odds of ARI among 6 to 12 months children and for 1–2 years children are higher • The vaccinations like BCG, DPT was insignificantly affecting the ARI, however, there is lower odds of ARI among the children who were given Rota virus than those who were not given

Known about the illnesses (Diarrhoea, Fever & ARI) in India & Northeast from previous studies

New emerging points from our study about the illnesses (Diarrhoea, Fever & ARI) in the 8 states
of Northeast India

• A study using NFHS-4 (2015–16) data revealed that the north-east region as a reference, those from north, central and east regions were more likely to suffer from ARI. Comorbidity, sex, age and nutritional status of children were significantly associated with the prevalence of ARI [51]

• It is found that among children in northeast India, the overall incidence of fever remains more or less unchanged but that of cough and diarrhoea have declined considerably during 2004–05 to 2011–12.Girls are less likely to have suffered from diarrhea than the boys; age has a significant effect on the risk of children suffering from fever and cough, toilet and having access to improved sources of drinking water lower the risk of childhood morbidities [27]

• In a multicounty study including India, using NFHS4 data it was found that children who were given the measles vaccine were less likely to suffer from Diarrhoea and ARI in India [52]

• Using NFHS-4 data, the study results suggests that most districts situated in India’s north and central regions had higher chances of ARI and diarrhoea and cases of diarrhoea may reduce with the improved toilet facilities, female children are less prone to ARI and Diarrhoea; stunted and wasted children are more susceptible to Diarrhoea only; young women with low education level are more likely to have children down with both the diseases, Hindu and ST have less while SC children have more chances of being sick with ARI and diarrhoea [20]

• Using NFHS-4 data, the prevalence of diarrhoea and ARI was 13.8% and 3.4% among children in India. Association was observed between exclusive breastfeeding with Diarrhoea and ARI [53]

• Using NFHS-4 data, prevalence of diarrhoea in India among under 5 children is higher in rural areas, not staying in Pacca house, living with unimproved sanitation facilities, belonging to under privileged community, children of younger mothers and “poor’ households [16]

• Using NFHS-5 data (2019–21) a study on spatial clustering of diarrhoea in India among children under 5 years found that the Prevalence of diarrhoea in Meghalaya (10.5%), is third highest in India, with an increase in children’s age as well as mother's age the prevalence of the diarrhoea decreases. prevalence is more among male children than females, Underweight children have a greater risk of suffering from diarrhoea diseases, the odds of children living in a pucca house are less likely to suffer from diarrhoea. rich economic status reduces the risk of such morbid conditions [2]

From NFHS-5 (2019–21) data revealed

About Diarrhoea

• Prevalence of diarrhoea in Meghalaya (10%), Tripura (6%), Assam, Arunachal Pradesh, Sikkim, Manipur lied (5–5.5%), Mizoram (4.3%) and least in Nagaland (3.4%) and overall northeast it is 6%

• Among northeast states and age wise prevalence, Sikkim has the highest prevalence (18.4%) of diarrhoea among children of less than 6 months, Meghalaya has highest prevalence of diarrhoea for children of age-group 6–12 months and 1–2 years while Arunachal Pradesh has highest rate of diarrhoea among 2–5 years children

• In comparison to the children of less than 6 months, the odds of diarrhoea among 6 to 12 months children were 2.18 times more and for 1–2 years children are 96% higher and for 2 to 5 years it is 39 percent higher

• The odds of diarrhoea was higher among children born in cesarean delivery than not cesarean delivery

• The vaccinations like BCG, DPT and Rota virus was found to have insignificant effect on diarrhoea in northeast states

About Fever

• A higher prevalence of fever was observed in Meghalaya (23%) and lowest in Arunachal Pradesh (9%)

• Among all age groups of children (less than 6 months,6 to 12 months,1–2 year and 2to 5 years) in northeast Indian states, the prevalence is highest in Meghalaya

• Compared to 1st birth order children, the 4 plus birth order children has more than 2 times higher odds of fever

• The programme factors like BCG and DPT was insignificant, however the Rota virus vaccination lowers the odds of fever among children

• The odds of fever were higher for the children born out of cesarean delivery than not born out of it

About ARI

• Higher prevalence of ARI was observed in Meghalaya (4.8%) followed by Assam (2.5%), Arunachal Pradesh (2.1%) while Mizoram and Sikkim it is less than 1 percent

• Among all age groups of children (less than 6 months,6 to 12 months,1–2 year and 2 to 5 years) in northeast Indian states, the prevalence of ARI is highest in Meghalaya

• The odds of ARI were higher for the children born out of cesarean delivery than not born out of it

• In comparison to the children of less than 6 months, the odds of ARI among 6 to 12 months children and for 1–2 years children are higher

• The vaccinations like BCG, DPT was insignificantly affecting the ARI, however, there is lower odds of ARI among the children who were given Rota virus than those who were not given