title: Risk factors for cytomegalovirus seropositivity in a population of day care educators in Montréal, Canada.
abstract: BACKGROUND
  Horizontal transmission of cytomegalovirus (CMV) is common in the day care setting. Day care educators appear to be at a high risk of infection; however, studies are limited.
  
  
  OBJECTIVE
  To determine the proportion of CMV-seropositive female educators in the day care setting and to identify associated risk factors.
  
  
  METHODS
  Educator- and day care-level risk factors for CMV seropositivity were obtained by questionnaires from day care educators and directors, respectively. Sera were collected from educators and analyzed by enzyme-linked immunosorbent assay. Significant independent risk factors for CMV seropositivity were determined using a multivariable logistic regression model which was fitted using the generalized estimating equation method.
  
  
  RESULTS
  CMV seroprevalence in 473 female educators from 81 day care centers in Montréal, Canada, was 57%. Significant risk factors for CMV seropositivity were (i) increasing age (OR5-yr = 1.19; 95% CI = 1.05-1.35), (ii) low-income country of birth (OR = 10.23; 95% CI = 2.64-39.50) or middle-income country of birth (OR = 4.99; 95% CI = 2.39-10.40), (iii) having > or =2 children of their own (OR = 1.98; 95% CI = 1.19-3.31) and (iv) child-to-educator ratio >6 (18-35 months old) in a day care center (OR = 1.87; 95% CI = 1.25-2.81).
  
  
  CONCLUSIONS
  Day care educators have risks for CMV infection related to their work in the day care setting, as well as personal risk factors. A review of current guidelines for the prevention of CMV infection in day care is needed to ensure that recommendations are evidence based.
authors.affiliation: Community Health, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Serene A
authors.initials: SA
authors.lastname: Joseph
authors.forename: Claire
authors.initials: C
authors.lastname: Beliveau
authors.forename: Cristin J
authors.initials: CJ
authors.lastname: Muecke
authors.forename: Elham
authors.initials: E
authors.lastname: Rahme
authors.forename: Julio C
authors.initials: JC
authors.lastname: Soto
authors.forename: Gordon
authors.initials: G
authors.lastname: Flowerdew
authors.forename: Lynn
authors.initials: L
authors.lastname: Johnston
authors.forename: Donald
authors.initials: D
authors.lastname: Langille
authors.forename: Theresa W
authors.initials: TW
authors.lastname: Gyorkos
mesh_terms: D000328:Adult; D000367:Age Factors; D000914:Antibodies, Viral / Q000097:blood; D002656:Child Day Care Centers; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000635:transmission*; D018562:Disease Transmission, Infectious; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology*; D011792:Quebec; D012923:Social Class; D014505:Urban Population
chemical_list: D000914:Antibodies, Viral