Researchers combined urban cluster-level data from the fifth National Family Health Survey, or NFHS-5, with gridded climatic and environmental indicators from NASA. The analysis assessed the prevalence, geographic clustering and correlates of morbidity among urban women. Chi-square tests and logistic regression were used to examine associations, while Moran’s I, cluster-outlier analysis and bivariate local indicators of spatial association, including biLISA, evaluated geographic patterns. The resulting odds ratios describe the likelihood of morbidity after adjustment for variables included in the study’s model; the supplied abstract does not specify the full adjustment set or provide the clinical composition of the morbidity outcome.

Temperature showed a statistically significant association with morbidity in the multivariable model. Women living in areas where temperatures exceeded 25 °C had 11.9% higher adjusted odds of morbidity than women in comparison areas. The reported adjusted odds ratio was 1.119, with a confidence interval of 1.057–1.185. By contrast, residence at altitudes above 200 metres was associated with 20.6% lower adjusted odds, represented by an adjusted odds ratio of 0.794 and a reported confidence interval of 0.765–0.824. These estimates come from an observational analysis and should not be interpreted as demonstrating direct effects of altitude or temperature on individual health.

Rainfall was also significantly associated with morbidity. Urban areas receiving more than 150 millimetres of rainfall had 8.8% higher adjusted odds of morbidity than comparison areas, with an adjusted odds ratio of 1.088 and a reported confidence interval of 1.045–1.132. The strongest environmental association involved ambient PM2.5: women living where concentrations exceeded 40 µg/m³ had 24.3% higher adjusted odds of morbidity. That estimate had an adjusted odds ratio of 1.243 and a reported confidence interval of 1.185–1.305. Household indoor air pollution, designated HIAP in the study, was associated with 9.3% higher adjusted odds, with an adjusted odds ratio of 1.093 and a reported confidence interval of 1.026–1.164.

Spatial analysis placed morbidity hotspots in northern, eastern, central and southern India. The biLISA results showed positive local spatial association between morbidity and rainfall, temperature, PM2.5 and household indoor air pollution, indicating that locations with relatively high values of a given indicator tended to occur near other locations with relatively high morbidity. The demographic and behavioural analysis also found higher odds among women aged 40–49 years, women with overweight, tobacco users, alcohol consumers and women from higher wealth groups. Together, the findings present a broad national view of environmental and social correlates of morbidity, with cluster-level exposure measures and observational associations limiting direct interpretation for individual risk.

Subject of Research: Environmental and sociodemographic correlates of morbidity among urban women in India

Article Title: Linkages between climatic, environmental, sociodemographic and behavioural factors with morbidity among women in urban India

Article References: Sarkar, S., & Dolui, M. (2026). Linkages between climatic, environmental, sociodemographic and behavioural factors with morbidity among women in urban India. Discover Sustainability. https://doi.org/10.1007/s43621-026-04817-y

Image Credits: AI Generated

DOI: 10.1007/s43621-026-04817-y

Keywords: urban women’s health, morbidity, air pollution, PM2.5, household air pollution, temperature, rainfall, spatial analysis, NFHS-5, India, Linkages, between

The study team, led by Rosalon Guvengue Caputo Pedro of Clínica Sagrada Esperança and the Universidade da Beira Interior in Portugal, examined electronic medical records from all children aged one month to fifteen years admitted to the hospital’s Department of Pediatrics between January and December 2024. Of 1,169 pediatric admissions during that twelve-month window, 262 involved chronic diseases and met the eligibility criteria. Within that group, 97 children — 37.0 percent — carried a diagnosis of sickle cell anemia, making it the most common chronic condition on the ward and a dominant driver of pediatric inpatient care at the facility.

Sickle cell anemia is the most severe common form of sickle cell disease, a group of inherited disorders caused by a single mutation in the gene encoding hemoglobin, the oxygen-carrying protein inside red blood cells. The mutation causes hemoglobin molecules to polymerize into stiff rods when oxygen levels drop, deforming the normally pliable disc-shaped red cells into rigid crescents. These sickled cells clog small blood vessels, break down prematurely, and deprive tissues of oxygen, producing the disease’s hallmark complications: episodic vaso-occlusive pain crises, chronic hemolytic anemia, stroke, acute chest syndrome, and heightened vulnerability to serious infections. Sub-Saharan Africa carries the heaviest global burden of the disease, and Angola sits squarely within the high-prevalence belt that stretches across the continent.

What makes the new findings striking is how sharply the clinical profiles of the two patient groups diverged. Children with sickle cell anemia had a median of two previous hospitalizations before the admission captured in the study, with an interquartile range stretching from zero to five, while children with other chronic diseases had a median of zero, with an interquartile range of zero to one. That difference, highly statistically significant, underscores a pattern familiar to hematologists: sickle cell anemia is not a single catastrophic event but a relapsing condition that repeatedly pulls children back into hospital beds throughout childhood.

The intensity of each admission also differed. Children with sickle cell anemia spent a median of seven days in the pediatric intensive care unit, compared with three days for children with other chronic conditions, and their overall hospital stays ran longer, with a median of five days versus four. Both differences reached statistical significance. In practical terms, a single child with sickle cell anemia could occupy scarce pediatric intensive care capacity for twice as long as a peer admitted with another chronic illness, a sobering calculation for any health system weighing how to allocate limited beds, ventilators, and nursing staff.

Laboratory data told a parallel story of physiological stress. On admission, children with sickle cell anemia had markedly lower hemoglobin levels than their counterparts with other chronic diseases, reflecting the chronic hemolysis that defines the disorder. Their white blood cell counts and C-reactive protein levels were also higher, consistent with the inflammatory flare-ups and infections that frequently precipitate sickle cell admissions. When the researchers used median regression to adjust for age and sex, the hemoglobin gap persisted: children with sickle cell anemia had an adjusted median hemoglobin concentration 4.47 grams per deciliter lower than the comparison group, a difference so large it approaches the threshold at which transfusion becomes medically urgent.

Treatment patterns mirrored the underlying severity. Seventy-six percent of children with sickle cell anemia received analgesia during their admission, compared with 45 percent of children with other chronic diseases, reflecting the prominence of vaso-occlusive pain as a reason for hospitalization. More dramatically, 26 percent of the sickle cell group required blood transfusion, five times the rate seen in the other chronic disease group. Every one of these differences was statistically significant. For a country where safe blood supplies depend on voluntary donation and cold-chain logistics, a transfusion demand concentrated in a single disease category represents both a clinical challenge and a public health planning problem.

Notably, in-hospital mortality was low in both groups and did not differ significantly between them. The authors are careful to place an important caveat on that encouraging figure. The study was conducted in a well-resourced private tertiary hospital serving a predominantly insured population in Luanda, and the outcomes observed there cannot be assumed to represent the experience of most Angolan children. Across the wider region, where diagnosis may come late, follow-up may be fragmented, and disease-modifying therapy such as hydroxyurea may be inaccessible, mortality from sickle cell disease remains far higher. The low death rate in this cohort is best read as a portrait of what good tertiary care can achieve, not as a measure of the national situation.

The retrospective design carries its own limitations. Because the analysis relied on routinely collected electronic medical records, it captured only children who reached and were admitted to this particular hospital, potentially missing the sickest children who never arrived and the milder cases managed as outpatients. The single-center, single-year window limits generalizability, and the comparison group of children with other chronic diseases was heterogeneous, spanning a range of conditions with different natural histories. Still, the study’s strength lies in its direct head-to-head comparison of resource utilization, an angle rarely quantified in African pediatric settings where data on chronic childhood illness remain scarce.

The authors argue that their findings should sharpen priorities for Angolan child health policy. Strengthening early diagnosis — most powerfully through newborn screening programs that identify affected infants before their first crisis — building structured follow-up, expanding access to disease-modifying therapy such as hydroxyurea, and ensuring equitable access to comprehensive pediatric sickle cell care should remain national priorities. Globally, the study adds to a growing body of evidence that sickle cell disease, long overshadowed by infectious diseases in global health funding and research agendas, is a chronic condition whose burden on hospitals, families, and health budgets in Africa is enormous and measurable. As survival improves with better care, more children with sickle cell anemia will live into adolescence and adulthood, making the investment case for systematic, lifelong disease management stronger with every study that documents its weight on the wards.

Subject of Research: Hospital burden of sickle cell anemia among children in Angola

Article Title: Burden of sickle cell anemia among hospitalized children in Angola: a retrospective study

Article References: Pedro, R. G. C., Caputo, E. O., Valente, G. B., Cassule, L. A., & Jorge, A. M. M. (2026). Burden of sickle cell anemia among hospitalized children in Angola: a retrospective study. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07666-w

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07666-w

Keywords: sickle cell anemia, pediatrics, Angola, hospitalization, chronic disease, anemia, blood transfusion, healthcare utilization, morbidity, sub-Saharan Africa, retrospective study, pediatric intensive care