title: Risk factors for respiratory infections among children attending day care centres.
abstract: BACKGROUND
  Upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI) and acute otitis media (AOM) are common in children attending day care centres.
  
  
  OBJECTIVE
  This study aimed to characterize the risk factors of URTI, LRTI and AOM in children attending day care.
  
  
  METHODS
  A cross-sectional study was conducted in children aged up to 3 years (n = 152) of six day care centres in Porto. Logistic regression was used on independent variables: mother-related, household-related, child-related and day care-related risk factors as predictors of the dependent variables: URTI, LRTI and AOM.
  
  
  RESULTS
  The risk of URTI increased as the number of children decreased [odds ratio (OR) = 0.620, 95% CI = 0.411-0.935], as the area per child decreased (OR = 0.434, 95% CI = 0.206-0.914) and as the disinfection of WC/diapers-change increased (OR = 2.56, 95% CI = 1.089-6.017). There was a higher risk of URTI if nasal aspirators (OR = 6.763, 95% CI = 1.022-44.753), rather than physiologic serum (OR = 5.296, 95% CI = 1.097-25.559), were used at day care centres. The risk of LRTI increased as the household size decreased (OR = 0.213, 95% CI = 0.048-0.937) and it was higher if the child had no siblings (OR = 7.831, 95% CI = 1.065-57.578). The risk of LRTI was higher if the child was not exclusively breastfed (OR = 24.612, 95% CI = 1.108-546.530) and the risk increased as the duration of exclusive breastfeeding decreased (OR = 0.396, 95% CI = 0.170-0.920). The risk of AOM increased as the birth body mass index (OR = 2.247, 95% CI = 1.011-4.992) and weight (OR = 1.607, 95% CI = 1.014-2.545) increased and if nasal aspirators were used (OR = 6.763, 95% CI = 1.022-44.753).
  
  
  CONCLUSIONS
  URTI were related with day care centres' risk factors, LRTI were associated with mother-related and household-related risk factors and AOM was connected with child-related risk factors.
authors.affiliation: Department of Physiotherapy, School of Allied Health Technologies, Polytechnic Institute of Porto, Vila Nova de Gaia and Department of Health Sciences, University of Aveiro, Aveiro, Portugal. ama@estsp.ipp.pt.
authors.forename: Ana S
authors.initials: AS
authors.lastname: Alexandrino
authors.affiliation: Department of Physiotherapy, School of Allied Health Technologies, Polytechnic Institute of Porto, Vila Nova de Gaia and.
authors.forename: Rita
authors.initials: R
authors.lastname: Santos
authors.affiliation: Department of Physiotherapy, School of Allied Health Technologies, Polytechnic Institute of Porto, Vila Nova de Gaia and.
authors.forename: Cristina
authors.initials: C
authors.lastname: Melo
authors.affiliation: Department of Health Sciences, University of Aveiro, Aveiro, Portugal.
authors.forename: José M
authors.initials: JM
authors.lastname: Bastos
mesh_terms: D000208:Acute Disease; D001942:Breast Feeding / Q000706:statistics & numerical data; D002656:Child Day Care Centers / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D010033:Otitis Media / Q000453:epidemiology* / Q000209:etiology; D011174:Portugal / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000209:etiology / Q000635:transmission; D012307:Risk Factors
keywords: At-risk groups; ear; health promotion; nose and throat (ENT, otolaryngology); paediatrics; upper respiratory infections/common cold/bronchitis.