The day care center as a risk factor for acute respiratory infections

Background This study was conducted to assess the magnitude of the risk of high morbidity (greater than or equal to 7 episodes/year) for acute respira tory infections (ARI) in infants attending day care centers (DCC), and to c ompare 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 m onths. During follow-up, social workers interviewed the mothers weekly to r egister 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 wit h 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 fo r DCC children was 2.33 (95% CI, 2.13-2.54); after adjusting for other cova riates, the relative risk increased to 5.27 (95% CI, 3.54-7.83). Conclusions. Infants attending DCCs will suffer ARI more frequently than ch ildren cared for at home. We did not find seasonal variations in the incide nce rates among DCC infants. The quality of care provided at these faciliti es should be analyzed in more depth for proposing measures to decrease ARI incidence. (C) 1999 IMSS. Published by Elsevier Science Inc.