title: Household economic impact and attitudes toward school closures in two cities in Argentina during the 2009 influenza A (H1N1) pandemic.
abstract: BACKGROUND
  School closures were widely implemented in Argentina during the 2009 H1N1 influenza virus pandemic.
  
  
  OBJECTIVE
  To assess the economic impact of school closures on households, their effectiveness in preventing children from engaging in social group activities, and parental attitudes toward them.
  
  
  METHODS
  Three schools that closed for 2 weeks in response to the pandemic were identified in two socioeconomically distinct cities in Argentina. All households with children enrolled in these schools were surveyed. Direct and indirect costs attributable to closures were estimated from the household perspective. Other information collected included children activities during the closures and parental attitudes toward the intervention.
  
  
  RESULTS
  Completed questionnaires were returned by 45% of surveyed households. Direct and indirect costs due to closures represented 11% of imputed monthly household income in the city with lower socioeconomic status, and 3% in the other city (P=0·01). Non-childcare expenses and loss of workdays were more common in the city with lower socioeconomic status. Childcare expenses were less common and were experienced by a similar percentage of households in both cities. About three-quarters of respondents in both cities agreed with the closures. The main concern among those who disagreed with closures was their negative impact on education. Children in more than two-thirds of affected households left their home at least once during the closures to spend time in public places.
  
  
  CONCLUSIONS
  School closures may more significantly impact low-income households. Authorities should consider the range of economic impacts of school closures among families when planning their implementation.
authors.affiliation: Los Angeles County Department of Public Health, Los Angeles, CA, USAU.S. Centers for Disease Control and Prevention, Atlanta, GA, USAMinisterio de Salud de la Nación, Buenos Aires, ArgentinaInstituto Nacional de Epidemiología, Mar del Plata, ArgentinaDirección de Epidemiología e Inmunizaciones, Olavarría, Argentina.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Basurto-Dávila
authors.forename: Roberto
authors.initials: R
authors.lastname: Garza
authors.forename: Martin I
authors.initials: MI
authors.lastname: Meltzer
authors.forename: Oreste L
authors.initials: OL
authors.lastname: Carlino
authors.forename: Rachel
authors.initials: R
authors.lastname: Albalak
authors.forename: Pablo W
authors.initials: PW
authors.lastname: Orellano
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Uez
authors.forename: David K
authors.initials: DK
authors.lastname: Shay
authors.forename: Cora
authors.initials: C
authors.lastname: Santandrea
authors.forename: María
authors.initials: M
authors.lastname: del Carmen Weis
authors.forename: Francisco
authors.initials: F
authors.lastname: Averhoff
authors.forename: Marc-Alain
authors.initials: MA
authors.lastname: Widdowson
mesh_terms: D000293:Adolescent; D000328:Adult; D001118:Argentina / Q000453:epidemiology; D001290:Attitude; D002648:Child; D003140:Communicable Disease Control / Q000191:economics* / Q000379:methods*; D017281:Cost of Illness; D005191:Family Characteristics; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification; D007251:Influenza, Human / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D058873:Pandemics / Q000191:economics*; D012574:Schools; D011795:Surveys and Questionnaires