Infection prevention at day-care centres: Feasibility and possible effects of intervention

Figures & data

Table I.  Characteristics of the study population according to questionnaire data: Comparison between intervention and control groups.

	Intervention group (n = 140)	Control group (n = 145)
Mean (SD) age (months)	46 (15)	44 (17)
Two adults in the family (%)	88	97
Siblings in the family (%)	64	85
Smokers in the home (%)	13	7
Living in detached house (%)	63	75
Having own room (%)	79	70
Child being infection-prone (%)	16	15
Child having asthma/allergy (%)	24	15

Table II.  Personnel's experience of infections in children at study start compared with study end.

	Number of personnel
	Intervention day-care centre		Control day-care centre
	Start (n = 31)	End (n = 31)	Start (n = 32)	End (n = 30)
Respiratory tract infections are always or often problematic	7	5	7	2
Gastroenteric infections are always or often problematic	0	1	3	2
We have guidelines when children ought to stay at home due to infectious diseases	13^1	25^1	26	30
Children stay at home long enough after an infection episode	1^2	6^2	6	7
It is easier to convince the parents to keep the child at home if the parents are well informed	12	15	15	12

¹Comparing start vs. end: chi-squared test, p = 0.002; ²comparing start vs. end: Fischer's exact test, p = 0.05.

Table III.  Parents’ experience of information concerning infections in children, at study start compared with study end.

	Percentage of parents
	Intervention day-care centre		Control day-care centre
	Start (n = 127)	End (n = 111)	Start (n = 117)	End (n = 124)
The information about when to keep an infectious child at home is satisfactory	35^1	49^1	44	47
The information from the day-care centre personnel about infectious diseases is enough	38^2	57^2	49	48

¹Comparing start vs. end: chi-squared test, p = 0.03; ²comparing start vs. end: chi-squared test, p = 0.003.

Table IV.  Comparison between intervention and control groups regarding sickness absence, doctor's consultations, and antibiotic prescriptions.

	Intervention group (n = 144 children)	Control group (n = 148 children)
Days of absence per child: mean (SD)	10.5 (8.6)	11.2 (7.4)
Episodes of absence per child: mean (SD)	4.1 (2.5)	4.7 (2.4)
Doctor consultations per child: mean (SD)	0.8 (1.2)	1.1 (1.3)
Percentage consulting a doctor	47	59
Antibiotic prescriptions per child: mean (SD)	0.4 (0.8)	0.7 (1.0)
Percentage given antibiotics	38	42

Table V.  Reasons for sickness absence: Comparison between intervention and control groups.

	Percentage
Diagnosis	Intervention day-care centres (n = 577 episodes)		Control day-care centres (n = 696 episodes)
Respiratory tract infection	56.1		61.0
Common cold		45.9		49.1
Tonsillitis		2.1		2.4
Otitis media		5.2		7.9
Protracted cough		2.4		1.6
Pneumonia		0.3		0.6
Chickenpox	6.8		2.9
Gastroenteritis	17.7		13.9
Other infection	15.4		17.4
Other illness	4.2		4.2
Total	100.0		100.0

Table VI.  Multilevel analysis of the effect of the intervention on sickness absence, doctor's consultations, and antibiotic prescription.

Sickness absence					Doctor's consultations		Antibiotic prescriptions
	Days		Episodes
	Model 1	Model 2	Model 1	Model 2	Model 1	Model 2	Model 1	Model 2
Fixed effects
Intervention vs. control RR (95% CI)		0.95 (0.78–1.15)		0.90 (0.78–1.05)		0.81 (0.63–1.04)		0.70 (0.48–1.02)
Infection-prone vs. not infection-prone RR (95% CI)		1.48 (1.35–1.63)		1.36 (1.17–1.58)		2.80 (2.13–3.67)		2.99 (2.06–4.34)
Asthma vs. not asthma RR (95% CI)		1.20 (1.09–1.31)		1.09 (0.95–1.26)		1.10 (0.82–1.47)		0.94 (0.60–1.49)
Random effects
Dept. variance (SE)	0.09(0.03)*	0.04(0.02)*	0.04(0.02)*	0.01(0.01)ns	0.09(0.05)ns	0.00(0.00)ns	0.18(0.10)ns	0.02(0.05)ns
Median mean ratio	1.33	1.21	1.33	1.10	1.33	1.00	1.50	1.14

*p < 0.05; ns = not significant.