title: Infectious morbidity and resource use in children under 2 years old at childcare centres.
abstract: OBJECTIVE
  To analyse the associations between childcare centres and infectious morbidity and resource consumption.
  
  
  METHODS
  Cohort study from birth to 2 years.
  
  
  METHODS
  number and types of infections, drug consumption and medical visits. Exposure variable: attending or not attending a childcare centre. School age: 6-12, >12-18, >18-24 months.
  
  
  RESULTS
  The initial cohort comprised 445 children, and the final cohort comprised 419 children. The mean number of recurrent infections and wheezing was higher in children attending childcare centres in all age groups with significant differences. Recurrent acute otitis media was observed in the 12- to 18-month group with an odds ratio of 6.04 (95% confidence interval, 1.3-27.6; P = 0.001) in the children attending childcare centres. In children older than 6 months, there was greater consumption of antibiotics, inhaled bronchodilators, oral and inhaled corticosteroids and montelukast.
  
  
  CONCLUSIONS
  Attending a childcare is associated with an increased frequency of recurrent infections and wheezing, as well as the consumption of antibiotics, bronchodilators, corticosteroids and montelukast.
authors.affiliation: Andalusian Health Service, Carihuela Health Centre, Málaga, Spain.
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Del Castillo-Aguas
authors.affiliation: Andalusian Health Service, Trinidad Health Centre, Málaga, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Gallego-Iborra
authors.affiliation: Andalusian Health Service, Delicias Health Centre, Málaga, Spain.
authors.forename: Mario
authors.initials: M
authors.lastname: Gutiérrez-Olid
authors.affiliation: Fimabis, Málaga, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Pérez-González
authors.affiliation: Andalusian Health Service, Puerto de la Torre Health Centre, Málaga, Spain.
authors.forename: Ginesa
authors.initials: G
authors.lastname: Moreno-Muñoz
authors.affiliation: Andalusian Health Service, Delicias Health Centre, Málaga, Spain.
authors.forename: Juana M
authors.initials: JM
authors.lastname: Ledesma-Albarrán
mesh_terms: D002656:Child Day Care Centers; D015331:Cohort Studies; D003141:Communicable Diseases / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D009017:Morbidity; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology
keywords: childcare centre; health resource; infectious disease risk; infectious morbidity