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Published on: December 11, 2013
The day care center as a risk factor for acute respiratory infections
S Flores Hernández1, H Reyes Morales, R Pérez Cuevas
1Unidad de Investigación Epidemiológica, Centro Médico Nacional Siglo XXI, México, D.F., Mexico. floresh@dfl.telmex.net.mx
Insights
Infants in day care centers (DCC) experience significantly more acute respiratory infections (ARI) than those cared for at home. Further analysis of care quality is needed to reduce ARI incidence in DCC settings.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Acute respiratory infections (ARI) pose a significant health burden on infants.
- Day care centers (DCC) are common settings for early childhood care, potentially increasing exposure to infections.
- Understanding the comparative risk of ARI in DCC versus home-based care is crucial for public health strategies.
Purpose of the Study:
- To assess the risk of high morbidity from ARI in infants attending DCC.
- To compare the incidence, duration, and severity of ARI in infants in DCC versus those cared for at home.
Main Methods:
- A prospective cohort study design was employed.
- 282 infants (138 in DCC, 144 at home) were followed for one year.
- Weekly maternal interviews and monthly health updates were conducted to track ARI episodes and infant well-being.
Main Results:
- Infants in DCC had an ARI incidence of 14 episodes/child/year (median 74 sick days) compared to 6 episodes/child/year (median 40 sick days) for home-cared infants.
- The incidence density ratio for DCC infants was 2.33, with a relative risk of 5.27 after adjusting for covariates.
- No seasonal variations in ARI incidence were observed among DCC infants.
Conclusions:
- Infants attending DCCs face a substantially higher frequency of ARI compared to home-cared infants.
- The findings underscore the need for in-depth analysis of care quality in DCCs.
- Recommendations for measures to decrease ARI incidence in DCC settings are warranted.
Background:
This study was conducted to assess the magnitude of the risk of high morbidity (> or = 7 episodes/year) for acute respiratory infections (ARI) in infants attending day care centers (DCC), and to compare the incidence, duration, and severity of ARI in children staying at home (Home).
Methods:
Using a cohort design, 282 infants (DCC, 138 and Home, 144) were followed for a year. Age at entry into the study ranged from 43 days to 4 months. During follow-up, social workers interviewed the mothers weekly to register whether the infants had an ARI. Also, infant health conditions and physical growth were updated monthly.
Results:
ARI incidence was 14 episodes per child/year among DCC infants with a median of 74 sick days, while among children at home, the ARI incidence was 6 episodes, and the median was 40 days. The incidence density ratio for DCC children was 2.33 (95% CI, 2.13-2.54); after adjusting for other covariates, the relative risk increased to 5.27 (95% CI, 3.54-7.83).
Conclusions:
Infants attending DCCs will suffer ARI more frequently than children cared for at home. We did not find seasonal variations in the incidence rates among DCC infants. The quality of care provided at these facilities should be analyzed in more depth for proposing measures to decrease ARI incidence.
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