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Published on: March 10, 2020
Characteristics of child daycare centres associated with clustering of major enteropathogens
R Pijnacker1, L Mughini-Gras1, H Vennema1
1Center for Infectious Disease Control,National Institute for Public Health and the Environment (RIVM),The Netherlands.
Insights
Daycare centers with paddling pools, sandpits, or pets had higher enteropathogen risks. Strict hygiene practices, like daily toy cleaning and excluding sick children, significantly reduced infection clusters.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Childcare Health
Background:
- Understanding enteropathogen transmission in childcare settings is crucial for public health.
- Limited data exists on specific daycare center (DCC) characteristics influencing pathogen clustering.
Purpose of the Study:
- To identify DCC characteristics associated with time-clustered enteropathogen occurrence in children.
- To inform targeted interventions for reducing gastrointestinal illness in childcare.
Main Methods:
- Utilized the KIzSS network data from 43 Dutch DCCs (2010-2013).
- Applied space-time scan statistics and canonical correlation analysis to identify pathogen clusters.
- Employed logistic regression to pinpoint DCC factors linked to clustering.
Main Results:
- Increased odds of enteropathogen clustering linked to paddling pools, sandpits, pet ownership, high child numbers, and outbreak reporting.
- Decreased odds associated with specific hygiene practices: dedicated potty disposal, chlorine-based vomit cleaning, daily/outbreak toy cleaning, and exclusion of ill children.
Conclusions:
- DCC features like recreational water/sand areas and animal presence are risk factors for enteropathogen outbreaks.
- Implementing enhanced hygiene protocols and exclusion policies can effectively mitigate infectious disease transmission in childcare settings.
Abstract:
Insights into transmission dynamics of enteropathogens in children attending daycare are limited. Here we aimed at identifying daycare centre (DCC) characteristics associated with time-clustered occurrence of enteropathogens in DCC-attending children. For this purpose, we used the KIzSS network, which comprises 43 DCCs that participated in infectious disease surveillance in The Netherlands during February 2010-February 2013. Space-time scan statistics were used to identify clusters of rotavirus, norovirus, astrovirus, Giardia lamblia and Cryptosporidium spp. in a two-dimensional DCC characteristic space constructed using canonical correlation analysis. Logistic regression models were then used to further identify DCC characteristics associated with increased or decreased odds for clustering of enteropathogens. Factors associated with increased odds for enteropathogen clustering in DCCs were having indoor/outdoor paddling pools or sandpits, owning animals, high numbers of attending children, and reporting outbreaks to local health authorities. Factors associated with decreased odds for enteropathogen clustering in DCCs were cleaning child potties in designated waste disposal stations, cleaning vomit with chlorine-based products, daily cleaning of toys, extra cleaning of toys during a suspected outbreak, and excluding children with gastroenteritis. These factors provide targets for reducing the burden of gastrointestinal morbidity associated with time-clustered occurrence of major enteropathogens in DCC attendees.
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