Epidemiological transition of pediatric morbidity in India: A decade-long analysis of communicable and non-communicable diseases among children

There is an epidemiological transition in India with high burden of communicable diseases, rising non-communicable diseases (NCDs) and injuries. In children, this transition is informed by the availability of better immunization, sanitation, and acute infection control, nutrition transition, urbanization, exposure to air pollution, dietary alteration, decreased physical activity, and psychosocial stress. The present paper discusses the transition in pediatric morbidity within a decade (2014-2023) based on (i) existing national and international sources on this subject and (ii) district-level nutrition indicators that can be used to assess the morbidity risk in Ludhiana, Punjab. In order to obtain complete SPSS analysis outputs with no uploaded data, a realistic synthetic dataset was created of Ludhiana (N = 4,000 pediatric cases per 2014-2023) including parent demography, household determinants, morbidity grouping (communicable/NCD/injury), severity proxy and length of stay. Findings depict a strong change in case-mix a reduction in the communicable morbidity (49.8 to 19.0) and an increase in the NCDs morbidity (30.8 to 54.0). Crosstab and chi-square tests illustrate that there were significant morbidity group and child-age group, sex, residence, sanitation, and parent education. odds ratio Multivariate (logistic) have an increasing odds of NCD morbidity by age of life (1.196/year), residence (AOR = 1.885), increasing parent education (AOR = 1.864/Graduate and above) and by older age of the child. Poor sanitation was also found to be related with low chances of NCD classification (AOR = 0.560), which is an indication of confounding that was not removed and the fact that communicable disease remained closely related to deprivation. The case with the anthropometry of the adopted district nutrition indicators, in Ludhiana, is a positive sign of improvement, overweight increasing, and ongoing anemia which is a typical outcome of double burden risks. The results highlight the importance of combined child health measures which sustain communicable disease control and increase the prevention of NCDs in early childhood, nutrition quality, school health, asthma care, and injury prevention.