Facteurs organisationnels associés à la répétition des épisodes infectieux des enfants accueillis en crèche à Paris

Abstract

Objective This study analyzes the organisational factors linked with episodes of infections in children attending child day-care setting in Paris. Population and methods A sample of children who attended parisian municipal child day-care setting, stratified on the type and the size of the day-care setting, was achieved. This cohort was followed from September 2000 to June 2001. We compared the risk of repeated infections according to the type of day-care setting (family day-care or day-care centre), and for the day-care centre according to the size (≤ 60 or > 60 places) and the structure of groups (mixing age groups or not). The events studied were the occurrence of at least: 6 episodes of any infection, 2 otitis, 2 gastroenteritis, 2 conjunctivitis or 5 upper respiratory tract infections. Results Nine hundred and ninety-three children were included in this study. The 878 children attending a day-care centre had a significant higher risk of infections compare to children in family day-care (RR = 2.92[1.58–5.38]) except for gastroenteritis and conjunctivitis. This relationship between the type of day-care setting and the repeated infections was especially shown for children younger than 1 year. The mixing of ages only increased the risk of conjunctivitis (RR=1.98[1.15–3.42]). No significant relationship between the size of the day care centre and the repetition of every studied infection was found. Conclusion This study strengthens the orientation of the more vulnerable children towards the family day-care centers.