Risk of infectious diseases in children attending different types of day-care setting. Epicrèche Research Group
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J P Collet1, P Burtin, J Gillet
1Unité de Pharmacologie Clinique, Université Claude-Bernard, Lyon, France.
Insights
Children in small day-care centers (DCCs) face a higher risk of recurrent infections compared to family day care. Large DCCs showed intermediate infection risks, highlighting the impact of group size on child health.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Childcare settings are common for young children.
- Understanding infection transmission in different childcare environments is crucial for public health.
Purpose of the Study:
- To compare the risk of recurrent infections in children attending family day care, small day-care centers (DCCs), and large DCCs.
Main Methods:
- A prospective cohort study involving 1,242 children across three childcare settings.
- Infectious episodes were defined and tracked over an 8.5-month follow-up period.
- Surveillance methods were standardized across all childcare types.
Main Results:
- Children in small DCCs (10-20 children) had a significantly higher risk of multiple infectious episodes (OR=2.4) compared to family day care (≤3 children).
- Specific increased risks observed in small DCCs included upper respiratory tract infections, otitis media, conjunctivitis, and croup.
- Children in large DCCs (≥40 children) exhibited infection risks intermediate between family day care and small DCCs.
Conclusions:
- Childcare center size is associated with the risk of recurrent infections in children.
- Smaller group sizes, like those in family day care, may offer a protective effect against infection transmission.
- Further research into optimizing childcare environments to minimize infection spread is warranted.
Abstract:
This population-based prospective cohort study compared the risk of recurrent infections in children attending family day care (< or = 3 children per family), small (10-20 children) day-care centers (DCCs), and large (> or = 40 children) DCCs. The parents of a total of 1,242 children participated in the study (97% of the families initially contacted). An infectious episode was defined as the acute occurrence of a new symptom lasting for at least 48 h and resulting in specific treatment. Two episodes were counted as such only if they were separated by a symptom-free week. Surveillance was under the responsibility of a nursing director and was similar for all three types of DCCs. During the 8.5-month follow-up period, 3,639 infectious episodes were recorded. Compared to those in family day-care, children attending small DCCs presented a higher risk for > or = 6 total infectious episodes [odds ratio (OR) = 2.4; 95% confidence interval (CI) = 1.6-3.7]; > or = 5 upper respiratory tract infections (OR = 2.2; 95% CI = 1.4-3.4); > or = 2 episodes of otitis media (OR = 2.6; 95% CI = 1.0-2.6); > or = 2 episodes of conjunctivitis (OR = 4.1; 95% CI = 2.1-8.2); and > or = 2 episodes of croup (OR = 4.1; 95% CI = 1.6-10.9). The risk for children attending large DCCs was intermediate between those in family day care and those in small DCCs.(ABSTRACT TRUNCATED AT 250 WORDS)