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Abstract
BackgroundDay care-associated infectious diseases are widely recognized as a public health problem but rarely studied. Insights into their dynamics and their association with the day care setting are important for effective decision making in management of infectious disease control. This paper describes the purpose, design and potential of our national multi-center, day care-based sentinel surveillance network for infectious diseases (the KIzSS network). The aim of the KIzSS network is to acquire a long-term insight into the syndromic and microbiological aspects of day care-related infectious diseases and associated disease burden and to model these aspects with day care setting characteristics.Methods/designThe KIzSS network applies a prospective cohort design, following day care centers rather than individual children or staff members over time. Data on infectious disease symptoms and related morbidity (children and staff), medical consumption, absenteeism and circulating enteric pathogens (children) are collected on a daily, weekly or monthly basis. Every two years, a survey is performed to assess the characteristics of participating day care centers.DiscussionThe KIzSS network offers a unique potential to study infectious disease dynamics in the day care setting over a sustained period of time. The created (bio)databases will help us to assess day care-related disease burden of infectious diseases among attending children and staff and their relation with the day care setting. This will support the much needed development of evidence-based and pragmatic guidelines for infectious disease control in day care centers.
Highlights
Day care-associated infectious diseases are widely recognized as a public health problem but rarely studied
The Kinderdagverblijven Infectieziekten Surveillance Systeem (KIzSS) network offers a unique potential to study infectious disease dynamics in the day care setting over a sustained period of time
Syndrome surveillance allows for the quantification of the incidence and infectious disease burden of most common diarrheal, respiratory and exanthematous infections over time
Summary
This article describes the purpose, design and potential of a national sentinel surveillance system in child day care for infectious diseases, including syndromes, related morbidity, circulation of gastrointestinal pathogens and risk factors thereof with respect to the DCC setting. The major strength of the KIzSS network is the almost real-time, long-term syndrome and microbiological surveillance at the level of the DCC setting This information offers great potential for understanding infectious disease dynamics in day care. A consequence of the network’s ecological design is that no subject identifiable results are generated, making it difficult to study pathogen-disease interactions at the individual level This could lead to ecological fallacies in which correlations found at the DCC level are assumed to apply at the individual level as well, which may not be the case. After having proved its sustainability, ease-of-use and value to the DCC and research community alike, the KIzSS network might be adapted to incorporate additional syndrome groups, health-related events and (respiratory) pathogens of minor and major concern, further expanding the potential of its (bio)databases for studying infectious disease dynamics in day care centers.
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