title: The day care center as a risk factor for acute respiratory infections.
abstract: BACKGROUND
  This study was conducted to assess the magnitude of the risk of high morbidity (> or = 7 episodes/year) for acute respiratory infections (ARI) in infants attending day care centers (DCC), and to compare the incidence, duration, and severity of ARI in children staying at home (Home).
  
  
  METHODS
  Using a cohort design, 282 infants (DCC, 138 and Home, 144) were followed for a year. Age at entry into the study ranged from 43 days to 4 months. During follow-up, social workers interviewed the mothers weekly to register whether the infants had an ARI. Also, infant health conditions and physical growth were updated monthly.
  
  
  RESULTS
  ARI incidence was 14 episodes per child/year among DCC infants with a median of 74 sick days, while among children at home, the ARI incidence was 6 episodes, and the median was 40 days. The incidence density ratio for DCC children was 2.33 (95% CI, 2.13-2.54); after adjusting for other covariates, the relative risk increased to 5.27 (95% CI, 3.54-7.83).
  
  
  CONCLUSIONS
  Infants attending DCCs will suffer ARI more frequently than children cared for at home. We did not find seasonal variations in the incidence rates among DCC infants. The quality of care provided at these facilities should be analyzed in more depth for proposing measures to decrease ARI incidence.
authors.affiliation: Unidad de Investigación Epidemiológica, Centro Médico Nacional Siglo XXI, México, D.F., Mexico. floresh@dfl.telmex.net.mx
authors.forename: S
authors.initials: S
authors.lastname: Flores Hernández
authors.forename: H
authors.initials: H
authors.lastname: Reyes Morales
authors.forename: R
authors.initials: R
authors.lastname: Pérez Cuevas
authors.forename: H
authors.initials: H
authors.lastname: Guiscafré Gallardo
mesh_terms: D000208:Acute Disease; D002656:Child Day Care Centers; D006801:Humans; D015994:Incidence; D007223:Infant; D008800:Mexico / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000635:transmission*; D012307:Risk Factors