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Day-care and otitis media in young children: a critical overview
M M Rovers1, G A Zielhuis, K Ingels
1Department of Otorhinolaryngology, University Hospital, Nijmegen, The Netherlands. m.rovers@mie.kun.nl
Insights
Attending day-care increases a child's risk of developing otitis media (middle ear infections). This risk appears to be linked to the number of children in care, likely due to increased exposure to pathogens.
Area of Science:
- Pediatrics
- Epidemiology
- Infectious Diseases
Background:
- Otitis media is a common childhood illness.
- The role of daycare in otitis media development requires further investigation.
Purpose of the Study:
- To review evidence on the association between daycare and otitis media in children aged 0-4 years.
- To conduct a meta-analysis of relevant studies.
Main Methods:
- Systematic literature search of Medline and reference lists.
- Inclusion of 17 studies with calculable odds ratios and confidence intervals for children aged 0-4.
- Meta-analysis to synthesize findings.
Main Results:
- All 17 included studies found a significant association between attending daycare and otitis media.
- The link between otitis media and family care was less clear.
- Study design variations did not explain the observed association.
Conclusions:
- Daycare is a confirmed risk factor for otitis media in young children.
- The number of children in daycare settings appears to influence the risk.
- Increased exposure to otitis media pathogens in group settings is the probable cause.
Unlabelled:
To review the evidence concerning the association between (different forms of) day-care and otitis media in children aged 0-4 years, we performed a meta-analysis of studies identified by a systematic search with Medline from 1966 to July 1997 and by the reference lists. Seventeen articles were classified as useful because these articles studied children of 0-4 years of age and because odds ratios as well as confidence intervals were presented or could be calculated. All these studies found a association between attending a day-care centre and otitis media. The association between otitis media and family care was less clear. Differences in study design, age of the subjects, and controlled variables did not explain the association.
Conclusion:
Day-care is a risk factor for developing otitis media: the number of children seems to be important for this effect, probably due to increased exposure to otitis media pathogens.