Children In Day Care Centers Research Articles

Comparison of nutritional status of pre‐school children at day care centres and at home from different socioeconomic backgrounds in Beirut

This study investigated the effect of attending day care centres on the nutritional status of 818 pre‐school children under 5 years of age in comparison with home based children, taking into consideration their social class. A random sample of 10 high class (HCD) and low class day care centres (LCD) was selected, in addition to a random sample of houses in high class (HCR) and low class residential areas (LCR) in Beirut. Anthropometric measurements and dietary intake data were collected. Attending day care centres, regardless of social class, showed that children in HCD and LCD had significantly greater height for age than home based children. When stratified by social class, a higher proportion of LCR had severe and mild stunting in comparison with their LCD counterparts. For high class children, being home based did not result in adverse effects on growth to the same extent as children from low socioeconomic backgrounds. Dietary intake data showed deficiencies in most nutrients in both day care and home based children reflecting the same differences observed in the anthropometric data, i.e. a better consumption of nutrients by children in day care centres, particularly in LCD vs. LCR. Findings from this study show that day care service results in a better nutritional status for children and its effects are more pronounced in those from lower socioeconomic groups.

Natural Rates of Compliant Behavior in Preschool Children in Day Care Settings∗

Noncompliance in preschool children is a common problem. In fact, it is the most frequent complaint of parents of children referred to clinics for treatment of behavior problems, and of parents of children with mental disabilities. Noncompliance also underlies, or is associated with, a number of other childhood disorders and appears to be a significant predictor of maladjustment later in life. Thus, the goal of many treatment programs for children with behavior disorders is to improve their rate of compliant behavior. Yet, despite its pervasiveness, little normative data exists on compliant behavior. The purpose of this study was to collect data on the natural rates of compliant behavior in preschool children in day care centers at 2‐, 3‐, and 4‐years of age. The results show that the mean rate of compliant behavior for all children was 84%. In general, overall compliance appeared to increase with age. Children were more compliant to direct requests than to indirect or group requests. Overall, girls were ...

The changing epidemiology of astrovirus-associated gastroenteritis: a review.

Our understanding of the epidemiology of astrovirus-associated gastroenteritis has changed markedly with each improvement in detection method. In early surveys based on electronmicroscopy (EM), astroviruses appeared to be a rare cause of gastroenteritis, being found in fewer than 1% of children with diarrhea, usually in small outbreaks of disease and primarily during the winter season. The development and use of monoclonal antibodies and enzyme immunoassays (EIA) to detect astroviruses led to reports of a higher prevalence (2.5%-9%) of astrovirus infection among patients hospitalized with diarrhea. Astroviruses appeared second only to rotaviruses as a cause of hospitalization for childhood viral gastroenteritis. Studies based on EIA detection of astroviruses indicate that astroviruses are common causes of diarrhea in children worldwide, and that most children are infected during their first two years of life. The elderly and the immunocompromised represent high-risk groups as well. The observations that newborns monitored prospectively rarely have repeat disease and that the rate of detection decreases with increasing age suggest that immunity to astroviruses, as immunity to rotaviruses, may develop early in life. The cloning and sequencing of astroviruses have led to more sensitive assays to detect the viruses by reverse transcription, polymerase chain reaction (RT-PCR). Application of RT-PCR for detection of astroviruses in children in day-care centers showed a marked increase in the detected prevalence of astrovirus-associated diarrhea, the rate of asymptomatic infection, and the duration of shedding of virus among those infected, when compared with studies that used other methods. As with rotaviruses, neither the mode of transmission nor the reservoir of astrovirus infection has been identified. Both immune and molecular-based assays to detect astrovirus serotypes indicate that serotype 1 is most common worldwide, although the predominant serotypes may vary by region and time. In the absence of obvious strategies to prevent astrovirus-associated diarrhea, vaccines might be considered if further studies establish that the disease burden would render such a vaccine cost-effective.

A Pacifier Increases the Risk of Recurrent Acute Otitis Media in Children in Day Care Centers

To follow up a previous retrospective analysis in which we found the use of a pacifier to be a risk factor for recurrent acute otitis media (AOM). In the present prospective study, the occurrence of AOM and the use of a pacifier were recorded in 845 children attending day care centers during a 15-month period. More than three attacks of AOM occurred in 29.5% of the children younger than 2 years using pacifiers and in 20.6% of those not doing so (relative risk, 1.6; 95% confidence interval [CI], 0.6, 4.1); in children 2 to 3 years of age, the figures were 30.6% and 13.2%, respectively (relative risk, 2.9; 95% CI, 1.2, 7.3). Logistic modeling with adjustment for age and the duration of monitoring showed the occurrence of AOM to be associated with the time during which a pacifier was used. The use of a pacifier increased the annual incidence of AOM from 3.6 (95% CI, 2.5, 4.9) to 5.4 episodes (4.4, 6.6) in children younger than 2 years and from 1.9 (1.4, 2.5) to 2.7 (2.2, 3.3) in children 2 to 3 years of age. The population-attributable risk of AOM attacks due to the use of a pacifier was 176 attacks, ie, 459 to 635 attacks per year, in the youngest children and 69 attacks, ie, from 264 to 333 attacks per year, in those 2 to 3 years of age. It can be calculated that the use of a pacifier was responsible for 25% of the attacks in children younger than 3 years. Breastfeeding, parental smoking, thumb sucking, using a nursing bottle, and the social class of the family failed to show such strong associations with the occurrence of AOM. We conclude that the use of a pacifier is a significant risk factor for recurrent AOM and suggest that pacifiers should be used only during the first 10 months of life, when need for sucking is strongest, and AOM is uncommon.

Evaluation of the effects of disinfectants on rotavirus RNA and infectivity by the polymerase chain reaction and cell-culture methods

Rotaviruses have been linked to outbreaks of acute gastroenteritis of children in day-care centres and hospital paediatric wards. There is, therefore, the need for monitoring effective decontamination of such environments. We have evaluated the effects of seven different methods of disinfection/inactivation (four chemical and three physical) on rotavirus using the PCR and cell-culture methods. We observed that 6% H2O2, 2500 ppm chlorine, an ethano-phenolic disinfectant, u.v. irradiation and heat completely destroyed the infectivity of rotavirus as well as RNA amplifiable by PCR. On the other hand, treatment with 80% ethanol resulted in the loss of infectivity despite the fact that RNA was still amplifiable. Rotavirus subjected to drying over a 24 h period still retained amplifiable RNA but infectivity was reduced by 100-fold when compared to the control. This study demonstrated an agreement between PCR and cell-culture monitoring systems, however, PCR is a more rapid and sensitive assay.

Form of day care and respiratory infections among Finnish children.

The relationship between respiratory infectious diseases and form of day care was assessed in a retrospective cohort study of 2568 randomly selected children aged 1 through 7 years in Espoo, Finland. Day-care center children had an increased risk for the common cold, acute otitis media, and pneumonia. The risk concentrated in 1-year-old children, for whom the adjusted relative risks (incidence density ratios) for the common cold, otitis media, and pneumonia were 1.69 (95% confidence interval [CI] = 1.43, 2.01), 1.99 (95% CI = 1.57, 2.52), and 9.69 (95% CI = 2.31, 40.55), respectively. Among 1-year-old children, the proportion of infections attributable to care at day-care centers were 41% (95% CI = 30, 50) for colds, 50% (95% CI = 36, 60) for otitis media, and 85% (95% CI = 57, 98) for pneumonia. The results provide evidence that care in day-care centers is a determinant of acute respiratory infections in children under 2, whereas family day care does not essentially increase risk.

Risk of diarrheal disease in Ecuadorian day-care centers

To determine the risk for diarrheal disease (DD) in day-care centers (DCC) for children residing in a poor urban slum area of Quito, Ecuador, compared with that for children from the same environment but cared for in their own residential home (RH), a prospective age-, sex- and locale-controlled study of DD was conducted, including 115 children in DCC and 115 in RH, ages 12 to 42 months. The overall incidence of DD was 46/1000 child weeks. Diarrhea was more common in DCC than in RH (relative risk (RR), 1.75; 95% confidence interval (CI), 1.38 to 2.22; P < 0.001). Poor hygienic practices were more prevalent in DCC than in RH. The use of reused water for child handwashing before eating and for washing raw vegetables was associated with a higher risk of DD in DCC than in RH (RR = 4.08, CI 2.93 to 5.67, P < 0.001; RR = 3.90, CI 2.79 to 5.44, P < 0.001, respectively). These two practices were risk factors in the DCC (RR = 2.74, CI 2.08 to 3.68, P < 0.001; RR = 2.05, CI 1.55 to 2.71, P < 0.001, respectively) when compared with their absence in the same DCC. Shigella (RR = 3.58, CI 1.19 to 10.78, P < 0.02), Aeromonas (RR = 10.47, CI 1.35 to 81.05, P < 0.01), rotavirus (RR = 2.86, CI 1.87 to 4.39, P < 0.001) and Giardia (RR = 1.59, CI 1.00 to 2.59, P < 0.05) were more common in DCC than in RH. More than two-fifths of the Shigella and Aeromonas isolates were resistant to trimethoprim-sulfamethoxazole.(ABSTRACT TRUNCATED AT 250 WORDS)

Care for children in day care centers

What needs do children aged 2 to 6 years have for care and how are these needs met? First, it is well-known from studies by Bowlby, Spitz, and others that babies need emotional communication with an adult. It appears from the present study that older children need not only this, but also attention to and interest in what they are occupied with. Secondly, different patterns of care were found. The main result was a pattern of high quality of care and a pattern of low quality of care, the main difference being the teacher's degree of attention to, interest, and engagement in the activity of the child. Finally, it was found that the joint activity and the interchange among the children had a character similar to the pattern of care in the children's day care center. These results are discussed in the context of personality development.

Meningitis Due to Ceftriaxone-ResistantStreptococcus pneumoniae

To the Editor: Penicillin-resistant strains of Streptococcus pneumoniae are found in many countries and are spreading, especially among children in day-care centers. Many authorities now recommend ...

Safety And Immunogenicity Of An Inactivated Hepatitis A Vaccine In Preschool Children

Young children in day care centers are an important source of hepatitis A virus (HAV) infection. The safety and immunogenicity of an inactivated HAV vaccine was evaluated in 57 children in day care centers. Nonimmune healthy children were given 0.5 mL of vaccine with subsequent doses: group A (28 children), second and third doses 1 and 2 months after the first; group B (29 children), second and third doses at 1 and 6 months. Antibody to HAV was measured before each dose and 8 months after the initial dose. All children developed antibody to HAV. Groups A and B had similar levels of antibody at 2 months; levels were lower in group B before the third dose and higher 8 months after the first dose. Local reactions after vaccination were reported in 17 children (29.8%). Minor systemic side effects that cleared spontaneously were observed in 27 children (47%).

Fecal Coliform Contamination in Child Day-Care Centers

Enteropathogens associated with outbreaks of diarrhea in child day-care centers can be spread by the fecal-oral route through hands or environmental objects that are contaminated. The purpose of this study was to determine the prevalence of fecal coliform contamination in day-care centers. During a 6-month period, on four separate occasions, cultures were taken from environmental surfaces and the hands of children and teachers at six licensed day-care centers. Fecal coliforms were recovered from 64 (9.5%) of the 675 surfaces sampled. Recovery rate was not influenced by the socioeconomic status of the clientele, time of year, or presence of children who were not toilet trained. All children wore paper diapers. Recovery rates did differ significantly for different areas: the kitchen showed a relatively high recovery rate (19%), and toys and toilets showed remarkably low rates (2% and 4%, respectively). Centers with formal hand-washing procedures had lower recovery rates than those without such practices. We also demonstrated a high recovery rate from hands of staff (16%); 6% of cultures taken from children's hands were positive. Contamination of hands and classroom objects is a potential source for transmitting enteric diseases among children in day-care centers.

Acquisition of serum isotype-specific and G type-specific antirotavirus antibodies among children in day care centers.

The acquisition of serum antirotavirus antibodies among children in day care centers was monitored through two rotavirus seasons. Twenty-six children were monitored daily for diarrhea and weekly for stool rotavirus excretion through a rotavirus season of infections with serotype G1 and a successive season of infections with both G1 and G3. Sera were collected before and after each rotavirus season and tested for antirotavirus IgA and IgG and for G type-specific blocking antibody. The prevalence of protective serum IgA and IgG titers increased from 36% and 45% before Season 1 to 77% and 96% after Season 2, respectively (P < 0.02 and 0.001). G type-specific antibodies also increased (G1, P < 0.001; G2, P = 0.005; G3, P = 0.003; G4, P = 0.006), including for noncirculating types. Homotypic and heterotypic antibodies increased as the number of rotavirus infections experienced by a child increased. The group of children with two proven infections developed protective isotype-specific and G type-specific antibodies. These results indicate that in first exposures to rotavirus G types, children develop predominantly homotypic antibody. However, as the number of rotavirus infections increase, children develop heterotypic antibody to G types at levels that correlate with broad protection against rotavirus infection and illness, despite exposure to a restricted number of G types.

Comparative study of breastfeeding period among children from internal and external day-care centers

A cross-sectional study was performed with 137 mothers and their children aged 0 - 35.9 months attending day-care centers (DCC) of Parobé and Três Coroas, Rio Grande do Sul, Brazil. The study analyzed the duration of breastfeeding among the children according to DCC in the same mothers' working place (internal DCC) or far from mothers' working place (external DCC). The prevalence of breastfeeding at 3, 6 and 12 months was 60%, 26% and 7%, respectively. There was a high statistically significant association between children in internal DCC and breastfeeding over 3 months of life (X(2)= 18.65; p = 0.00001). Mothers with children in internal DCC breastfed more during their working period then mothers with children in external DCC. The closeness of internal DCC to the working place may give the mothers a sense of serenity and safety. There is also more availability of the mothers to breastfeed during working time,this way maintaining the stimulation to breastmilk production and avoiding the introduction of bottle complements.

Abuse of children in day care centres

Abuse of children in day care centres

Abuse of children in day care centres: Characteristics and consequences

AbstractWhile day care sexual abuse cases share features in common with sexual abuse in other settings, many characteristics of abuse in day care settings merit special attention. These factors include the young age of the child victims, the involvement of multiple victims and multiple perpetrators, females as perpetrators, use of extreme threats, severity of the abuse, and in some instances ritualistic activities. Research findings support clinical impressions that children are negatively impacted by sexual abuse in day care. Consequences of abuse in day care include anxiety, excessive fearfulness, behavioural disturbances, sexual acting out and sleep disorders. Parents whose children are abused in day care centres also experience psychological distress with symptom profiles consistent with post‐traumatic stress disorder. Abuse of children in day care settings warrants a specialized treatment approach. A major goal of treatment is to decrease symptomatology among all family members.

Factors related to depression among higher income mothers with young children in day care centers

This study examined the association between maternal depression, maternal separation anxiety, social support, and maternal involvement in the day care center. A factor analysis identified a cluster of maternal involvement variables, including the amount of time spent in the center, frequency of communication with caregivers, maternal participation in caregiving, and mid‐day visits to the center. The sample consisted of 54 mothers with infants in on‐site, near‐site, and off‐site centers. Mothers who were more involved in the center reported less depression.

Antimicrobial resistance among bacterial isolates from children

Antimicrobial resistance patterns were studied in isolates from children hospitalized with respiratory tract infections in Mexico City and Cuernavaca, Morelos, Mexico, and from healthy children attending a day-care center in Cuernavaca. All the children were aged <5 years. We determined the in vitro susceptibilities of 294 isolates to antimicrobial agents of potential use in the treatment of diseases caused by Haemophilus influenzae (56 strains from the hospitalized patients and 82 from the healthy children), Streptococcus pneumoniae (39 from patients and 44 from healthy children), and Moraxella catarrhalis (16 from patients and 57 from healthy children). Thirty-four (25%) of the H influenzae strains (17 were type b) produced beta-lactamase and were thus resistant to ampicillin. Forty-eight (58%) of the S pneumoniae isolates were resistant to one or more antimicrobials. Serotypes or serogroups 6A/6B, 23F, 14, 19, and 15 were most prevalent. Fifty-three (73%) of the M catarrhalis strains were resistant to ampicillin, 48 (66%) were resistant to cefaclor, and a few were resistant to trimethoprim/sulfamethoxazole or cefotaxime; they were, however, susceptible to the other antimicrobials tested. The results indicate that changes can occur in the susceptibility of these pathogens and that selective susceptibility testing and epidemiologic studies in hospitalized patients and children in day-care centers are necessary.

Lead in the ambient air and blood specimens of children in Helsinki

Ambient air lead concentrations have been measured in Helsinki since 1978. The mean concentrations at various stations reached maximum values in 1980, being then 209–1150 ng/m3. From 1980 to 1991 the concentrations decreased to one-eighth (335-41 ng/m3) at the three stations where measurements were made continuously. Concomitantly the estimated annual lead emissions in Helsinki decreased from 78 to 9 tons, mainly owing to the reduced emissions of lead in exhaust gases from road traffic. The mean concentration of lead in the blood of children in day-care centres was 46 μg/l in 1983 and 30 μg/l 5 years later. Similar concentrations were found in blood samples from a day-care centre beside a street with heavy traffic and in those from an area with less traffic.

Child care arrangements and repeated ear infections in young children.

The purpose of this study was to assess the association between child care arrangements and repeated ear infections in young children. Data on 5818 children younger than 6 years of age were taken from the 1988 National Health Interview Survey of Child Health. Seventeen percent of the children had had repeated ear infections in the year preceding the interview. Multiple logistic regression analysis showed that factors significantly associated with repeated ear infections were age (1 to 2 years), race (White), sex (male), and medical history (repeated tonsillitis, enlarged adenoids, or asthma). When these factors were controlled for, children in a current child care arrangement still had a 50% higher chance of repeated ear infections than did children not in care. Children in day care centers were at higher risk than children cared for in homes. Care in settings with more than six children elevated the risk, but hours per week of care did not. Decreasing the risk of repeated ear infections in young children in out-of-home child care settings may require smaller group sizes. Given the increasing use of child care, research should continue to identify specific aspects of child care that contribute to this problem.

Community wide outbreak of hepatitis A linked to children in day care centres and with increased transmission in young adult men in Florida 1988-9.

To investigate a community wide outbreak of hepatitis A (HA). Description of the outbreak, with a case-control study to assess transmission. A Florida county, USA, 1988-9. A total of 311 cases of HA. A 13 month outbreak of HA is described. Most of the 311 cases (95%) were residents of a large metropolitan area (attack rate per 10,000 population (AR) = 3.7) and two smaller cities (AR = 61.5 and AR = 6.4). The ARs were greater for males than females and for residents aged 25-34 years (9.7) and < 5 years (8.3). Altogether 37% of cases were linked to day care centres, independent of the city of residence. A household case-control study showed an increased risk of HA in households in which a child attended a day care centre (p = 0.02), and centres that could take more than 50 children had an increased risk of HA introduction than smaller ones (p = 0.05). Day care centres were an important source of HA in the community, and the need for timely surveillance and immunoglobin prophylaxis is emphasised. Homosexual transmission may have played an important role in this outbreak.