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As described earlier, the morbidity data were collected for all family members on each week of the study. Data collection proved to be a more difficult task than anticipated, as often household members left at dawn to go to the fields and returned very late at night. This pattern was especially true of those respondents who were shepherds; many simply spent the entire night in the fields and food was brought to them by family members. When a family member was unavailable for direct questioning, another family member was asked to reply only if he or she was confident of the absent member's health for that week.
Types of Morbid Conditions
Both acute and chronic conditions were prevalent among the respondents. Simple osteoarthritis, allergic bronchitis, ear complaints, and tuberculosis were most often chronic conditions. Complaints of joint pains appear at a very early age among Indian villagers; this is hardly surprising, given the physical nature of their work. Allergic bronchitis, often exacerbated during harvest and threshing, was prevalent. Tuberculosis is prevalent in the village as a whole, and five cases were diagnosed among approximately 350 respondents. Hearing loss and chronic ear infections were also common.
The acute conditions were more often episodes of respiratory infection or diarrhoea in children followed by ear infections (otitis media). For adults, respiratory infections were the most common complaint. These findings are similar to the results of other studies discussed previously.
Percentage of respondents reporting one or more days of illness per week, by round
Acute infectious disease in children: percentage of children under six ill, by week
Duration of Illness and Illness Rates
Each respondent was asked the duration of the stated complaint. Just half of the study members responded with "all week," "about a week" or some variation of the above, while 25 per cent specified three or four days. The remaining 25 per cent indicated durations of 1, 2, 5, and 6 days.
The minimum percentage of the respondents who were ill for any reason during any of the weeks was 1 4 per cent. The periods of least illness corresponded to the summer season and the week before the major festival, Diwali. Perhaps people were too busy then to think about their usual aches and pains, coughs, and colds.
The maximum illness rate was 28 per cent of the respondents. The high illness rates fell into three peaks, weeks 18 to 27, 32 to 39 and 44 to 50. The first two peaks corresponded to periods of very high labour-force participation: the first occurred during the kharif (monsoon season) and the second during the coldest period of the year. The reason for the occurrence of the third peak is unknown.
TABLE 14. Percentage of Harvard standard weight and height for age by sex: infants and infants and young children
| Age | Weight | Height | |||
| Sex | Number | Mean percentage ±standard deviation | Number | Mean percentage ± standard deviation | |
| 0-5 months | Total | 19 | 93 ± 15.4 | 13 | 97 ± 2.3 |
| M | 14 | 94 ± 11.8 | 11 | 97 ± 2.9 | |
| F | 5 | 89 ± 24.2 | 2 | 97 ± 1.8 | |
| 6-11 months | Total | 41 | 79 ± 7.6 | 39 | 95 ± 3.0 |
| M | 20 | 84 ± 8.4 | 20 | 96 ± 2.8 | |
| F | 1 | 75 ± 2.3 | 19 | 93 ± 2.5 | |
| 12-17 months | Total | 68 | 73 ± 8.3 | 68 | 91 ± 3.9 |
| M | 23 | 81 ± 5.7 | 23 | 93 ± 2.2 | |
| F | 45 | 69 ± 6.7 | 45 | 90 ± 4.3 | |
| 18-23 months | Total | 88 | 73 ± 8.2 | 83 | 89 ± 3.4 |
| M | 39 | 77 ± 5.8 | 38 | 89 ± 2.0 | |
| F | 49 | 70 ± 8.5 | 45 | 88 ± 4.2 | |
| 24-29 months | Total | 66 | 74 ± 6.9 | 63 | 88 ± 3.1 |
| M | 31 | 76 ± 5.0 | 28 | 88 ± 2.4 | |
| F | 35 | 72 ± 7.8 | 35 | 87 ± 3.5 | |
| 30-35 months | Total | 23 | 69 ± 6.6 | 23 | 85 ± 3.7 |
| M | 12 | 73 ± 5.2 | 12 | 88 ± 4.3 | |
| F | 11 | 65± 5.5 | 11 | 84±2.9 | |
| 31 months5 years | Total | 483 | 73± 10.6 | 482 | 88±6.1 |
| M | 261 | 75 ± 9.6 | 262 | 89 ± 5.2 | |
| F | 222 | 70 ± 11.1 | 220 | 87 ± 6.7 | |
TABLE 15. Weight for height as percentage of Indian standards
| Age | Sex | Number | Mean percentage ±standard deviation |
| 0-5 months | Total | 13 | 104 ± 11.9 |
| M | 11 | 105 ± 12.9 | |
| F | 2 | 101 ±1.2 | |
| 6-11 months | Total | 39 | 92 ±7.6 |
| M | 20 | 93 ±8.8 | |
| F | 19 | 91 ±6.1 | |
| 12-17 months | Total | 68 | 87 ±8.3 |
| M | 23 | 92 ±6.1 | |
| F | 45 | 85 ±8.0 | |
| 18-23 months | Total | 83 | 88 ±7.2 |
| M | 38 | 92 ±5.7 | |
| F | 45 | 86 ±7.2 | |
| 24-29 months | Total | 63 | 89 ±5.4 |
| M | 28 | 91 ±4.2 | |
| F | 35 | 88 ±5.9 | |
| 30-35 months | Total | 23 | 89 ±5.5 |
| M | 12 | 93 ±1.8 | |
| F | 11 | 85 ±4.9 | |
| 3-5 years | Total | 481 | 90 ±7.3 |
| M | 61 | 91 ±6.9 | |
| F | 20 | 89 ±7.9 | |
| 6-9 years | Total | 342 | 88 ±6.8 |
| M | 174 | 89 ±5.7 | |
| F | 168 | 87 ±7.7 | |
| 10-12 years | Total | 218 | 87 ±4.8 |
| M | 99 | 88 ±4.5 | |
| F | 119 | 87 ±5.0 | |
| 13-18years | Total | 258 | 91 ±10.0 |
| M | 125 | 86 ± 7.6 | |
| F | 133 | 95 ± 10.3 | |
| 9 years + | Total | 1,459 | 82 ± 9.4 |
| M | 670 | 78 ± 7.8 | |
| F | 789 | 84 ± 9.8 |
The percentage of people ill in the village was graphed for each week of the year (fig. 2). Chronic conditions were excluded. The percentage of time that each family was ill was calculated for the year, to be used in later analysis. The illness rate ranged from 6.6 to 36.5 per cent per week. Figure 3 shows the percentage of children under six years of age who exhibited an acute infectious disease for each of the study weeks. Generally, higher rates prevailed during the rainy season and the winter (rabi) months, while the hot season brought reduced rates of illness.
TABLE 16. Arm circumference, percentage of standard, all ages
| Age | Number | Mean
percentage for age standard deviation |
| 0-5 months | 15 | 96 ± 6.8 |
| 6-11 months | 41 | 87 ± 5.1 |
| 12-17 months | 66 | 85 ± 6.4 |
| 18-23 months | 84 | 87 ± 6.0 |
| 24-29 months | 65 | 87 ± 5.7 |
| 30-35 months | 23 | 85 ± 7.1 |
| 3-5 years | 472 | 87 ± 6.4 |
| 6-9 years | 333 | 88 ± 7.6 |
| 10-12 years | 210 | 89 ± 7.2 |
| 13-18 years | 250 | 87 ± 9.6 |
| 19 years + (males) | 641 | 86 ± 7.7 |
| 19 years + (females) | 770 | 81 ± 7,3 |
Anthropometry
Height, weight, and arm circumference were measured monthly for each respondent-a difficult task in shepherd families. An analytical problem was posed by the longitudinal nature of the data. As each respondent had a birthday during the year, to shift standards within the year could have caused each individual to become suddenly "underweight"; thus, for individuals above five years of age, the standards and age used are those at week 1. If the individual was under the age of five, the exact age is used, as the standards are presented at monthly intervals. All statistics were computed for every record and then for average percentages over the year for every individual as well. The latter are the most useful, as the former are biased in favour of individuals who were measured frequently during the year.
Summary of all Anthropometric Indices
Table 14 presents the percentage of the Harvard standards for both weight and height for young children from birth to five years of age. Using the Indian standards the figures rise by a few percentage points, but the relative positions do not change. As with the food intake data, females are below males in the individual categories of weight for age. After five months of age, males become steadily worse off; females do not exhibit such a clear trend. Both groups, however, are clearly well below the desirable weights for age. The same is true of height for age (table 14). Table 15 presents weight for height as a percentage of Indian standards and shows a gradual deterioration in the percentages of the standard attained throughout early childhood, followed by an improvement during the period from 3 to 18, at which time males and females attain 78 and 84 per cent of the standard weight for height. It can be seen that, until the ages of 10 to 12, males are in a better position than females. Thereafter, females are in a better position, with adult males achieving only 78 per cent of the standard weight for height as opposed to 84 per cent for females. Overall, it is clear that adult males have a more difficult time maintaining their weight for height.
TABLE 17. Percentage of standard height for agea by sex: Waterlow classification
| Percentage of standard height/age | Total | Age in months | |||||||
| Sex | Number | Percentage | 0-5 | 6-11 | 12-17 | 18-23 | 24-35 | 36-60 | |
| >90 | M | 240 | 60.9 | 11 (100)b | 20 (100) | 20 (27.0) | 23 (60.5) | 13 (32.5) | 153(58.4) |
| >90 | F | 169 | 44.8 | 2 (100) | 19 (100) | 32 (71.1) | 23 (51.1) | 13 (28.3) | 80(36.4) |
| 80-89 | M | 138 | 35.0 | 0 | 0 | 3 (13.0) | 15 (39.5) | 26 (65.0) | 94(35.9) |
| 80-89 | F | 173 | 45 9 | 0 | 0 | 12 (26.7) | 19 (42.2) | 33 (71.7) | 10949.5) |
| 70-79 | M | 16 | 4.1 | 0 | 0 | 0 | 0 | 1 (2.5) | 15(5.7) |
| 70-79 | F | 35 | 9.3 | 0 | 0 | 1 (2.2) | 3 (6.7) | 0 | 31(14.1) |
a. Harvard standards.
b. Figures in parentheses are the percentage of that sex alone
falling into the given category.
TABLE 18. Percentage of standard height for agea by sex: Gomez classification
| Percentage of standard height/age | Total | Age in months | |||||||
| Sex | Number | Percentage | 0-5 | 6-11 | 12-17 | 18-23 | 24-35 | 36-60 | |
| 90 | M | 20 | 2.5 | 11 (78.6)b | 5 (25.0) | 0 | 0 | 0 | 4(1.5) |
| 90 | F | 9 | 1.1 | 3 (60.0) | 0 | 0 | 0 | 0 | 6 |
| 5 89 | M | 213 | 27.0 | 2 (14.3) | 13 (65.0) | 18 (78.3) | 26 (66.7) | 22 (51.2) | 132(50.2) |
| 5-89 | F | 120 | 15.2 | 1 (20.0) | 10 (47.6) | 8 (17.8) | 16 (32.7) | 18 139.1) | 67(30.2) |
| 0-74 | M | 149 | 19.0 | 1 (7.1) | 2 (10.0) | 5 (21.7) | 13 (33.3) | 21 (48.8) | 107(41.0) |
| 0-74 | F | 192 | 24.4 | 0 | 11 (52.4) | 36 (80.0) | 28 (57.1) | 22 (47.8) | 95(42.8) |
| 60 | M | 18 | 2.3 | 0 | 0 | 0 | 0 | 0 | 18(7 0) |
| 60 | F | 67 | 8.5 | 1 (20.0) | 0 | 1 (2.2) | 5 (10.2) | 6 (13.1) | 54(24.3) |
a. Harvard standards.
b. Figures in Parentheses are the percentage of that sex alone
falling into the given category.
Arm circumference data (table 16) show a similar trend; however, differences were noted only between adult males and females, who exhibited an average difference of five percentage points.
Seasonal Variations in Anthropometric Measurements
The possibility of seasonal variation in anthropometry was explored by dividing the year into three major seasons: -season 1: dry, post-harvest, little farm activity; - season 2: monsoon, pre-harvest, high farm activity; and - season 3: winter, harvest, moderate farm activity.
A slight drop of one to two percentage points occurred for all anthropometric indices in season 2; however, none of them proved to be statistically significant. Children under six were plotted individually, but only a few of them varied more than 5 per cent of the standard during the year for any measurement.
TABLE 19. Principal work pattern by week for all working respondents
| Work pattern | Frequency | Percentage |
| Agricultural labourer | 1,660 | 17.9 |
| Own farm work | 3,256 | 35 0 |
| Permanent servant | 619 | 6.7 |
| Shepherd | 547 | 5.9 |
| Combination of above | 826 | 8.9 |
| Construction labourer | 302 | 3.2 |
| Household work | 2,087 | 22.4 |
Once again, the severity of malnutrition is demonstrated using the Waterlow classification of height for age (table 171 and the Gomez classification using weight for age (table 18), which measure stunting and wasting respectively. With these systems, one can see that stunting and wasting are less severe, or entirely absent, in the youngest children.
