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Effect of infection control measures on the frequency of diarrheal episodes in child care: a randomized, controlled
1National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. leslee.roberts@anu.edu.au
Insights
Improved infection control in childcare centers significantly reduced diarrheal infections in children. Education on handwashing and infection prevention was key, especially for children over 24 months old.
Area of Science:
- Pediatric infectious diseases
- Public health interventions
- Childcare epidemiology
Background:
- Diarrheal infections are prevalent in childcare settings, posing a significant transmission risk.
- Childcare staff play a critical role in preventing disease spread.
- The study investigated the efficacy of enhanced infection control procedures.
Purpose of the Study:
- To determine if improved infection control procedures can reduce gastrointestinal infection transmission in childcare.
- To evaluate the impact of staff and child education on infection rates.
Main Methods:
- A cluster randomized controlled trial was conducted in Australian childcare centers.
- The intervention involved training childcare staff on infection transmission and handwashing.
- Illness data was collected via parent-reported telephone interviews every two weeks.
Main Results:
- Diarrheal episodes were reduced by 50% in intervention centers compared to control centers.
- The intervention's positive impact was primarily observed in children over 24 months of age.
- High compliance with handwashing in children led to a 66% reduction in diarrheal episodes.
Conclusions:
- Education on infection control for childcare staff and children effectively reduces diarrhea transmission.
- The benefits of infection control interventions were most pronounced in older children (over 24 months).
- Targeted handwashing education is crucial for minimizing diarrheal illness in childcare settings.
Background:
Diarrheal infections are common in children who attend child care, and preventing transmission of disease in this setting depends on actions by child care staff. We set out to discover whether transmission of gastrointestinal infections in child care could be reduced by improved infection control procedures.
Methods:
We performed a cluster randomized, controlled trial of an infection control intervention conducted in child care centers for 1 city in Australia. The intervention was training of child care staff about transmission of infection and handwashing and focused on both staff and child behavior. Implementation of the intervention was recorded by an observer. Illness was measured by parent report in telephone interviews every 2 weeks.
Results:
There were 311 child-years of surveillance for diarrheal episodes. The rate of episodes of diarrhea was 1.9 per child-year in intervention centers and 2.7 per child-year in control centers. Multivariable analysis showed that diarrheal episodes were significantly reduced in intervention center children by 50%. However, the impact of the intervention was confined to children over 24 months of age. For those centers in which children's compliance with handwashing was high, diarrheal episodes were reduced by 66%.
Conclusions:
This trial supports education about infection control, for staff and children in child care, as a means of reducing transmission of diarrhea. Reduction in episodes of diarrhea in children in child care was limited to children over 24 months of age.