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An open randomized controlled trial of infection prevention in child day-care centers
1Department of Pediatrics, University of Oulu, Finland. matti.uhari@oulu.fi
Insights
An infection prevention program in day-care centers significantly reduced infections in children and staff. This program also decreased antimicrobial prescriptions and parental work absences due to child illness, proving cost-effective.
Area of Science:
- Pediatric infectious diseases
- Public health interventions
- Daycare epidemiology
Background:
- Child care settings are significant hubs for infectious disease transmission.
- Reducing infection spread in daycares is crucial for child and community health.
Purpose of the Study:
- To evaluate the efficacy of a dedicated infection prevention program in reducing infections within child day-care centers.
- To assess the program's impact on antimicrobial use and parental work absenteeism.
Main Methods:
- A 15-month randomized controlled trial was conducted across 20 day-care centers.
- 10 centers implemented the infection prevention program, while 10 matched centers served as controls.
- Data collected included infection occurrences and absences due to illness for children, parents, and staff.
Main Results:
- Program centers showed significantly lower infection rates: 9% reduction in 3-year-olds and 8% in older children.
- Children in program centers received 24% fewer antimicrobial prescriptions.
- Parental work absences decreased by 2.5 man-years (24%) due to fewer child illnesses.
Conclusions:
- An effective infection prevention program can substantially decrease infections in day-care settings.
- Such programs offer significant benefits to families and day-care personnel.
- The intervention is cost-effective, even when implemented by a specialist nurse.
Objective:
Child care outside the home increases children's infections substantially. We have to evaluate the possibilities for reducing the transmission of infections by an infection prevention program.
Design And Methods:
A 15-month randomized controlled trial involving 20 day-care centers was conducted to evaluate the efficacy of an infection prevention program. The program was introduced in 10 centers and the other matched 10 centers served as controls. Records were made of the occurrence of infections and absences from care or work because of infections among the children, their parents and the personnel of the day-care centers.
Results:
Both the children and the personnel in the program centers had significantly fewer infections than those in the control centers, the reduction being 9% [95% confidence interval (95% CI), 4 to 16%, P < 0.002] among 3-year-old children and 8% (95% CI 0 to 14%, P = 0.049) among the older children. The children at the program centers received 24% fewer prescriptions of antimicrobials (95% CI 22 to 27%, P < 0.001). Likewise there were 2.5 man-year fewer absences from work on the part of parents because of a child's illness during 1 year in the program centers, a 24% difference (95% CI 18 to 29%, P < 0.001).
Conclusions:
Effective prevention of infections is possible in child day-care centers, and this can benefit both the families and the personnel. Such a program is cost-effective even if a specialist nurse implements it.
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