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Day-care and meningococcal disease in young children
1European Programme for Intervention Epidemiology Training, Saint Maurice, France.
Insights
Day-care attendance may lower the risk of meningococcal disease in children. This study found that children attending day-care had a reduced risk compared to non-attenders, suggesting protective factors in this environment.
Area of Science:
- Epidemiology
- Infectious Diseases
- Pediatrics
Background:
- The Republic of Ireland has the highest incidence of meningococcal disease in Europe.
- Children under 5 years old account for 40% of all cases.
- Day-care attendance is a known risk factor for Haemophilus influenzae type b (Hib) meningitis, but its association with meningococcal disease was unknown.
Purpose of the Study:
- To determine if day-care attendance is a risk factor for meningococcal disease in pre-school children.
- To investigate other potential risk factors such as household crowding and adult contact.
Main Methods:
- A case-control study was conducted with 130 laboratory-confirmed cases of meningococcal disease and 390 matched controls.
- Participants were pre-school children matched on age, gender, and place of residence.
Main Results:
- Multivariate analysis indicated that day-care attenders had a significantly lower risk of meningococcal disease (OR 0.3, 95% CI 0.1-0.7) compared to non-attenders.
- The number of adults in a household and household crowding were identified as independent risk factors for the disease.
Conclusions:
- Regular day-care attendance may be associated with a reduced risk of meningococcal disease in children.
- This protective effect might be due to reduced contact with asymptomatic adult carriers of Neisseria meningitidis.
Abstract:
The Republic of Ireland has the highest incidence of meningococcal disease in Europe with 40% of all cases occurring in children under the age of 5 years. Attending day-care increases the risk of certain infections, including Haemophilus influenzae type b (Hib) meningitis. The risk of meningococcal disease associated with day-care is not known. We conducted a case-control study among pre-school children with 130 laboratory-confirmed cases and 390 controls, matched on age, gender and place of residence, to determine if day-care attendance was a risk factor for meningococcal disease. Multivariate analysis showed that day-care attenders had a lower risk of disease than non-attenders (OR 0.3, 95% CI 0.1-0.7) whereas the number of adults in a household, and household crowding were independent risk factors for disease. Asymptomatic carriers of Neisseria meningitidis are the main source of transmission and these carriers are usually adults. Regular day-care attendance may reduce this risk by removing children from close and prolonged contact with adults.