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Respiratory illness in preschool children with different forms of day care
Insights
Children in day-care centers experience more respiratory illnesses. However, increasing group size beyond six children in family day-care homes did not significantly increase illness incidence.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Respiratory tract infections are common in young children.
- Day-care settings may influence disease transmission due to increased social contact.
Purpose of the Study:
- To investigate the incidence of respiratory tract disease in Swedish children attending different types of childcare.
- To compare illness rates among children in day-care centers, home care, and family day-care homes.
Main Methods:
- A preliminary nine-month study compared 41 children in day-care centers with 41 in home care.
- A subsequent eight-month study compared children under 2 years in day-care centers (108), home care (57), and family day-care homes (42).
- Data collected included days with respiratory symptoms and febrile illnesses per child.
Main Results:
- Children under 2 in day-care centers had more febrile illnesses (4-5 per child) compared to home care (1-2 per child).
- Children in family day-care homes (average 4 children) experienced similar illness rates to those in day-care centers.
- Increasing child contacts beyond 4-6 in family day-care did not markedly increase respiratory tract disease incidence.
Conclusions:
- Day-care centers are associated with higher rates of febrile illness in young children.
- Family day-care with a small number of children (around 4) shows similar illness rates to larger day-care centers.
- The number of children in a small group setting (up to 4-6) appears to be a critical factor in illness transmission, rather than a linear increase with group size.
Abstract:
The incidence of respiratory tract disease was investigated in three groups of Swedish children: those in 14 day-care centers with 18 to 68 children each; those in home care (usually no siblings); and those in family day-care homes (average, four children). In family day-care homes a mother cared for her own and one to four other children during the day. A preliminary nine month study of 41 preschool children attending a day-care center and 41 comparable children in home care showed that children under 2 years of age in the center had more days with respiratory symptoms and more febrile illnesses (four per child) than those in home care (one per child). In a subsequent eight-month study of children under 2 years of age, children in day-care centers and home care were compared with children in family day-care homes. The 108 children in centers had more febrile illness (five per child) than the 57 children in home care (two per child), but the 42 children in family day-care homes had as many illnesses as those in day-care centers. The data suggest that increasing the number of contacts of an infant in day care beyond four to six children does not increase remarkably the incidence of respiratory tract disease.