Risk of infectious diseases in children attending different types of day-care setting. Epicrèche Research Group.
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)
Collet
J P
JP
Unité de Pharmacologie Clinique, Université Claude-Bernard, Lyon, France.
Burtin
P
P
Gillet
J
J
Bossard
N
N
Ducruet
T
T
Dürr
F
F
D002654:Child Care; D002656:Child Day Care Centers; D002675:Child, Preschool; D015331:Cohort Studies; D003231:Conjunctivitis / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D005759:Gastroenteritis / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007224:Infant Care; D007239:Infections / Q000453:epidemiology*; D010033:Otitis Media / Q000453:epidemiology; D012008:Recurrence; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012307:Risk Factors; D012621:Seasons