Abstract
Background: Infant contact information (skin-to-skin contact between infants and others) is important to understand Streptococcus pneumoniae transmission patterns. A few studies have investigated infant contact patterns by asking the mother/guardian to record all contacts a child makes in one day. However, this approach does not capture contact behaviour in day-care. Our study describes the frequency and nature of physical contacts of infants in day-care to understand infant infection risk in day-care in Nha Trang, Vietnam. Methods: This cross-sectional study enrolled infants aged <12 months, attending 10 randomly selected day-care centres in Nha Trang. Physical contacts of each infant for one day at the day-care centre were observed. The mean number of infants' contacts and factors associated with contact numbers were assessed using negative binomial regression. Results: In total 14 infants, aged 6-11 months, were enrolled, and a total of 96 contacts were recorded. The mean number of contacts an infant made in one day was 6.9. Infants who walked independently (age-adjusted rate ratio 1.68, 95% confidence interval 1.06-2.68) and those cared for in a larger group (1.99, 1.42-2.79) had more contacts at day-care. About 50% of infants made contact with at least one person from a commune different from the infant's, and 50% made contact with at least one other infant at day-care. Conclusion: This study found that day-care attendance may be one factor that increases contact rates of infants in Nha Trang and diversifies those contacts in terms of age and geographical spread. In this study, day-care attendance not only increased contact rates beyond those usually experienced by young children cared for at home but specifically increased contact rates with other children and adults from other communes. Day-care may play a key role in the transmission of respiratory pathogens like Streptococcus pneumoniae to infants.
Highlights
Streptococcus pneumoniae can cause otitis media, meningitis, sepsis, and pneumonia
Day-care may play a key role in the transmission of respiratory pathogens like Streptococcus pneumoniae to infants
This study aimed to describe the frequency and nature of infants’ physical contacts, as close interpersonal contacts relevant to the transmission of Streptococcus pneumoniae[9,10], in the day-care setting to aid our understanding of infant infection risk stemming from these settings in Nha Trang, Vietnam
Summary
Streptococcus pneumoniae can cause otitis media, meningitis, sepsis, and pneumonia. Young children and the elderly are most at risk for contracting these diseases[1]. To better assess the potential risks of a reduced dose of PCV schedule, we need to understand where infants contract pneumococci and from whom, as well as whether those groups are likely vaccine protected and offer indirect protection to infants. These considerations include both questions on what age groups infect infants and what proportion of transmission is local as opposed to coming from potentially unvaccinated populations across commune, city, or country borders. Day-care attendance increased contact rates version 2
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