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Frequency and severity of infections in day care
E R Wald1, B Dashefsky, C Byers
1University of Pittsburgh School of Medicine, Department of Pediatrics, Children's Hospital of Pittsburgh, PA 15213.
Insights
Children in group or day care experienced more frequent and severe infections than those in home care. Day care also led to higher rates of ear-related surgeries, highlighting infection risks in childcare settings.
Area of Science:
- Pediatrics
- Infectious Diseases
- Child Development
Background:
- Childcare arrangements significantly impact young children's health.
- Understanding infection rates across different childcare settings is crucial for public health.
Purpose of the Study:
- To prospectively compare infection frequency, nature, and severity in home care, group care, and day care settings.
- To assess the long-term health outcomes related to different childcare environments.
Main Methods:
- Prospective observational study of 244 infants from birth for 12-18 months.
- Bi-weekly telephone interviews to record illness type and severity.
- Life table analysis to compare infection episodes across childcare types.
Main Results:
- Children in group and day care had significantly more respiratory infections, prolonged illness duration, and severe illnesses than home-care children.
- Day care children experienced higher rates of myringotomy and tube placement (21%) compared to home care (3%).
- Life table analysis confirmed fewer infection episodes in home care versus day care.
Conclusions:
- Group and day care settings are associated with increased infection burden in young children.
- Childcare type influences the need for medical interventions such as ear tube placement.
- Home care appears to offer a protective effect against frequent and severe infections in early childhood.
Abstract:
This study was undertaken to compare prospectively the frequency, nature, and severity of infections experienced by children 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 12 to 18 months. At entry there were 159 children in home care, 40 in group care, and 45 in day care. The families were telephoned every 2 weeks to record on a standardized form the type and severity of illnesses experienced during the previous interval. Severe illnesses were defined by high fever, duration exceeding 10 days, or physician visit. Children remaining in their original child care group for at least 1 year were compared with regard to the frequency and severity of illness. Children in group care and day care were more likely than children in home care to experience at least six respiratory infections, more than 60 days of illness, and more than four severe illnesses (P less than 0.01). Similarly, life table analyses showed that children in home care had fewer episodes of infection than did children in day care (P less than 0.01). Although no children were hospitalized because of acute infections during the first year of study, hospitalization for myringotomy and tube placement occurred in 21% of children in day care and 3% of children in home care (P less than 0.01).