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Introduction: A large proportion of under-5 mortality in the world occurs in the sub- Saharan region and South East Asia and these deaths are mostly due to preventable diseases. Socio-economic status of the household, maternal education, maternal employment status, child‟s age and gender are said to be determinants of children‟s morbidity and mortality. An inverse relationship between illness, mortality and socioeconomic status has been observed with morbidity and mortality concentrated in children in the lower socio-economic class and substantial reductions occurring in higher socio-economic class. Objectives: To determine the prevalence of all-cause morbidity, proportional morbidity from common illnesses and the maternal, household and community socio-demographic risk factors associated with morbidity in children under-5 years of age in the Agincourt health and Socio-Demographic Surveillance System (AHDSS) site, Mpumalanga Province, in 2006. Methods: Secondary data analysis based on a child morbidity survey for children under-5 years was linked to the Agincourt Health and Socio-demographic Surveillance System site between August and December 2006. Caregivers of 6 404 children were administered a health care utilization questionnaire and 732 children were reported to have had an illness in the preceding 14 days. Stata version 10.0 was used for data handling, cleaning and statistical analysis. Results: Nine percent of the children in the AHDSS site had had an illness in the 14 days preceding the survey. Illnesses due to other infections contributed to over half of the proportion of morbidity in the children. This was followed by fever, acute respiratory infections, malnutrition, gastro intestinal disease and lastly injuries. The 12-23 months age group had the highest proportion of morbidity due to malnutrition and gastro intestinal diseases compared to the other age groups, although this relationship was not significant. A significant difference in proportion of morbidity between children living in households headed by Mozambicans and those living in households headed by South Africans was found. A younger age, higher birthweight, living in a household headed by an individual with only (primary) and living in a community without a clinic increased the likelihood of a child being reported ill. Conclusion: A younger age, higher birthweight, living with a household head with some education (primary and less) and poor access to a community health center in the village of residence increased the risk of a caregiver reporting a illness in a child. Confounding factors could have attributed to the observed association found between morbidity and high birthweight as well as that found between household head education status and morbidity. Further investigations as to why increase in household head education and higher birthweight is associated with morbidity is necessary. More research is needed to find out which factors at all levels (individual, household and community) unique to this region, contribute to making younger children more vulnerable to acquiring an illness.

Foi analisada a totalidade das saídas (105.116) de pacientes dos 31 hospitais de assistência hospitalar geral da 3a. Região Administrativa do Estado de São Paulo, no ano de 1975, segundo as variáveis: hospital, procedência, idade, sexo, condição de saída, fontes de financiamento e tempo de permanência, sempre relacionadas ao diagnóstico principal. As causas de internação mais freqUentes foram em primeiro lugar as relativas à gravidez, parto e puerpério (27,1 por cento ), seguidas pelas doenças do aparelho respiratório (11,4 por cento ), doenças do aparelho circulatório (8,9 por cento ) e doenças infecciosas e parasitárias (8,2 por cento ). A grande maioria dos atendimentos foi feita no próprio município de residência (83,8 por cento ); os porcentuais de residentes fora do município de atendimento mais significativos foram os referentes às neoplasias e doenças do sistema nervoso e órgãos dos sentidos. Não houve diferença no comportamento das internações quanto ao sexo, quando excluídas as doenças da gravidez, parto e puerpério, sendo que os maiores coeficientes de saídas foram dos grupos etários extremos: menores de 1 ano e maiores de 65 anos. Nos primeiros, o grupo de causas mais importante foi o das infecciosas e nos últimos, o das doenças circulatórias. O coeficiente de mortalidade hospitalar do Vale do Paraíba foi 2,8 por 100 saídas, variando bastante na dependência dos diagnósticos, das idades e fontes de financiamento. Estas se mostraram com distribuição diferenciada nas internações do Vale, mesmo quando analisadas\'por diagnósticos ou idade. O tempo médio de permanência se mostrou diferente nas internações pagas pelas várias fontes, assim como na dependência de cada hospital, de grupos etários (os extremos foram maiores), sexo e condição da saída. O fato de serem ou não os pacientes procedentes do próprio município de atendimento, não interferiu no resultado da duração média de permanência. / The total of 105.116 hospital discharges from 31 hospitals belonging to the Third Administrative Region of the State of São Paulo (Vale do Paraiba), Brazil, ocurred in 1975, were analyzed according to the following variables: hospital, origin (patient\'s place of residence), age, sex, health status of the patient discharged, sources of financing and length of stay, always related to the main diagnose. The leading causes of hospitalization were (ICD-9): - complications of pregnancy, childbirth and the puerperium (27.1 per cent ) - diseases of the respiratory system (11.4 per cent ) - diseases of the circulatory system (8.9 per cent ) - infective and parasitic diseases (8.2 per cent ) The majority of the attendances was done in the same city of the patients\' residence (83.8 per cent ) except for neoplasms and diseases of the nervous system and sense organs. No difference was found in the analysis of the hospitalizations by sex, when\'excluded complications of pregnancy, childbirth and the puerperium. The group of patients under one year and 65 years and over showed highest hospitalization rates. The leading cause of hospitalization within the first group was infective and parasitic diseases and within the second group, diseases of the circulatory system. The hospital mortality rate was 2.8 deaths per hundred discharges for the Vale do Paraiba as a whole, having a large variability according to the diagnoses, the patients age and the financial source. The average length of stay varied with financial source, the hospital, patients\' age (the more prolonged stays were those of the youngest and oldest age group), sex and health status at the moment of discharge. Average length of stay did not vary when taking into account the fact that patient was or was not hospitalized in his own city of residence.

Foi analisada a totalidade das saídas (105.116) de pacientes dos 31 hospitais de assistência hospitalar geral da 3a. Região Administrativa do Estado de São Paulo, no ano de 1975, segundo as variáveis: hospital, procedência, idade, sexo, condição de saída, fontes de financiamento e tempo de permanência, sempre relacionadas ao diagnóstico principal. As causas de internação mais freqUentes foram em primeiro lugar as relativas à gravidez, parto e puerpério (27,1 por cento ), seguidas pelas doenças do aparelho respiratório (11,4 por cento ), doenças do aparelho circulatório (8,9 por cento ) e doenças infecciosas e parasitárias (8,2 por cento ). A grande maioria dos atendimentos foi feita no próprio município de residência (83,8 por cento ); os porcentuais de residentes fora do município de atendimento mais significativos foram os referentes às neoplasias e doenças do sistema nervoso e órgãos dos sentidos. Não houve diferença no comportamento das internações quanto ao sexo, quando excluídas as doenças da gravidez, parto e puerpério, sendo que os maiores coeficientes de saídas foram dos grupos etários extremos: menores de 1 ano e maiores de 65 anos. Nos primeiros, o grupo de causas mais importante foi o das infecciosas e nos últimos, o das doenças circulatórias. O coeficiente de mortalidade hospitalar do Vale do Paraíba foi 2,8 por 100 saídas, variando bastante na dependência dos diagnósticos, das idades e fontes de financiamento. Estas se mostraram com distribuição diferenciada nas internações do Vale, mesmo quando analisadas\'por diagnósticos ou idade. O tempo médio de permanência se mostrou diferente nas internações pagas pelas várias fontes, assim como na dependência de cada hospital, de grupos etários (os extremos foram maiores), sexo e condição da saída. O fato de serem ou não os pacientes procedentes do próprio município de atendimento, não interferiu no resultado da duração média de permanência. / The total of 105.116 hospital discharges from 31 hospitals belonging to the Third Administrative Region of the State of São Paulo (Vale do Paraiba), Brazil, ocurred in 1975, were analyzed according to the following variables: hospital, origin (patient\'s place of residence), age, sex, health status of the patient discharged, sources of financing and length of stay, always related to the main diagnose. The leading causes of hospitalization were (ICD-9): - complications of pregnancy, childbirth and the puerperium (27.1 per cent ) - diseases of the respiratory system (11.4 per cent ) - diseases of the circulatory system (8.9 per cent ) - infective and parasitic diseases (8.2 per cent ) The majority of the attendances was done in the same city of the patients\' residence (83.8 per cent ) except for neoplasms and diseases of the nervous system and sense organs. No difference was found in the analysis of the hospitalizations by sex, when\'excluded complications of pregnancy, childbirth and the puerperium. The group of patients under one year and 65 years and over showed highest hospitalization rates. The leading cause of hospitalization within the first group was infective and parasitic diseases and within the second group, diseases of the circulatory system. The hospital mortality rate was 2.8 deaths per hundred discharges for the Vale do Paraiba as a whole, having a large variability according to the diagnoses, the patients age and the financial source. The average length of stay varied with financial source, the hospital, patients\' age (the more prolonged stays were those of the youngest and oldest age group), sex and health status at the moment of discharge. Average length of stay did not vary when taking into account the fact that patient was or was not hospitalized in his own city of residence.