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Frequency and severity of infections in day care: three-year follow-up
1Department of Pediatrics, University of Pittsburgh School of Medicine, Pennsylvania.
Insights
Children in day care experience more infections initially, but rates stabilize over three years. Long-term day care attendance shows a trend toward decreased illness duration and hospitalization risk.
Area of Science:
- Pediatrics
- Epidemiology
- Child Development
Background:
- Child care arrangements significantly impact children's health.
- Understanding infection patterns in different care settings is crucial for public health.
- Prospective studies are needed to track illness trends over time.
Purpose of the Study:
- To compare infection frequency, nature, and severity across home care, group care, and day care settings.
- To evaluate the long-term effects of sustained participation in specific child care environments.
- To identify potential differences in illness burden and health outcomes based on child care type.
Main Methods:
- Prospective cohort study design.
- Enrollment at birth with at least 36 months of observation.
- Bi-weekly telephone interviews to record illness type and severity using standardized forms.
Main Results:
- All child care groups showed peak infections in year 2.
- Day care children experienced more respiratory infections than home care children, with diminishing differences by year 3.
- Significant differences in illness proportion and respiratory illness duration between day care and home care children in years 1 and 2 were not significant in year 3.
Conclusions:
- Children in day care demonstrate a trend toward stabilized infection rates with longer attendance.
- Duration of illness and risk of hospitalization appear to decrease for children remaining in day care for three years.
- Sustained participation in day care may lead to a reduced overall illness burden over time.
Abstract:
This study was undertaken to compare prospectively the frequency, nature, and severity of infections in children participating in three types of child care arrangements: home care, group care (two to six children), and day care (seven or more children). Children were enrolled at birth and observed for at least 36 months. The families were telephoned every 2 weeks to record on a standardized form the type and severity of illness during the previous interval. Children remaining in their original child care group for 1, 2, or 3 years were compared with regard to the frequency and severity of illness. Each child care group had the highest number of infections in year 2. Children in day care had more respiratory infections during each year than children in home care, but the magnitude of the differences decreased in year 3. When the child care groups were compared for the proportion of children with more than six illness per year or more than 60 days of respiratory illness per year, significant differences observed in years 1 and 2 for day care children compared with home care children were no longer significant in year 3. We conclude that there is a trend toward stabilized or decreased rates of infection, duration of illness, and risk of hospitalization for children remaining in day care for 3 years.